How to Start an NEMT Business in New Jersey: A "Bambi Knows Best" State-By-State Series Part 1: Research the New Jersey NEMT Market Hey there, how ya doin'? Welcome to Jersey! As New Jerseyans like to say, launching your NEMT business here is as promising as the friendships on Jersey Shore! Remember that reality show?
But in all seriousness, before diving into the details of setting up your venture, conducting thorough market research is essential. This crucial step will guide you through New Jersey's diverse communities, bustling urban centers and shiney shorelines, helping you identify underserved areas and avoid over-saturated markets
1 | Identify Existing NEMT Providers in Your Area
New Jersey hosts a massive Medicaid population, with essential non-medical services provided through its Medicaid program, locally known as NJ FamilyCare . Managed care health plans within the state also include comprehensive NEMT services. The New Jersey Department of Human Services and local health authorities provide valuable resources for locating information about NEMT providers statewide. Here are some leading NEMT providers offering services in New Jersey:
Modivcare American Medical Response (AMR) On Time Transport Uber Health: Local Directories and Online Searches: For a personalized search, use keywords such as "NEMT providers in New Jersey" or specify a locality like "NEMT companies in Newark" to find specific results.2 | Assess the Demand for NEMT Services
To capitalize on the abundant opportunities in New Jersey's diverse landscape, begin by evaluating local demand. Research nearby hospitals, healthcare facilities, rehabilitation centers and senior care facilities. Explore unconventional avenues to uncover unique opportunities that set your business apart in a competitive market.
Adult Day Care (ADC) Centers: ADCs in New Jersey play a pivotal role in supporting its senior population. For the latest statistics and information, consult the New Jersey Department of Human Services or local health departments overseeing adult day care facilities.Dialysis Clinics: New Jersey has a robust network of dialysis clinics serving its diverse population. Leading providers include Fresenius Medical Care , DaVita Kidney Care and U.S. Renal Care . Contact local healthcare provider directories or state health authorities for detailed information.Physical Therapy Centers: PT Centers in New Jersey vary widely in number and distribution. For precise details, refer to the New Jersey Department of Health or professional associations like the New Jersey Physical Therapy Association (APTANJ) .Hospitals: From our findings, there are 113 hospitals and specialized facilities across New Jersey. For current information, consult the New Jersey Hospital Association or the New Jersey Department of Health. Rehabilitation Centers: Many hospitals partner with rehabilitation centers throughout New Jersey so find those 113 hospitals and call them up! For updated statistics, contact local healthcare providers or consult directories provided by the state.Nursing Homes and Assisted Living Facilities: New Jersey has a significant number of nursing homes and assisted living facilities, providing essential long-term care services to elderly residents. For the latest data, refer to the New Jersey Department of Health or Centers for Medicare & Medicaid Services (CMS) .Outpatient Care Centers: New Jersey's outpatient care centers contribute to its comprehensive healthcare infrastructure. For more information, consult local healthcare providers or professional associations.3 | Decide on a Target Market
After analyzing the NEMT market and assessing demand, define your target demographic. Whether focusing on the elderly, individuals with disabilities or a broader patient base, tailoring your services and marketing strategies accordingly enhances effectiveness.
4 | Choose Specific NEMT Services (or Offer Them All!)
Navigate — like Bambi would the forest — the New Jersey NEMT market strategically by concentrating on high-demand services. Build a strong foundation for success by offering specialized services targeting nursing homes, hospitals and essential healthcare facilities Garden State(wide).
5 | Understand Different Medicaid Delivery Models
In recent years, New Jersey's NEMT program, previously managed locally by the Division of Medical Assistance and Health Services, underwent significant changes. New Jersey operates a managed care model under NJ FamilyCare, overseeing healthcare services and transportation. Providers collaborate with managed care organizations (MCOs) to deliver NEMT services, ensuring compliance with Medicaid billing guidelines.
Initially supported by casino revenues for specialized transportation, there was robust statewide coordination among public and community transit providers for Medicaid clients. However, in 2010, the state shifted from a county-level fee-for-service Medicaid model to a centralized approach using a statewide contract broker, currently managed by Modivcare. This transition prompted many public and community transportation providers to withdraw from the program.
Recent developments include negotiations between these providers and Modivcare aimed at establishing agreements. The goal is to reimburse providers based on marginal rather than fully allocated costs, ensuring fair compensation and fostering increased participation in Medicaid's NEMT services by community and public transit agencies.
Here are some fast New Jersey facts according to the report State-by-State Profiles for Examining the Effects of Non-Emergency Medical Transportation Bro11% kerages on Transportation Coordination :
NEMT Model is a Statewide Broker The Operating Authority is 1902(a)(70) State Plan Amendment NEMT expense is classified as a “Medical Expense” 11% live below poverty (US Census 2015 5-Year Estimates) 92% live in Urbanized Areas (US Census 2010) $140 Million is the estimated annual NEMT 2013 expense (Source 2014 National NEMT Survey) 4.5 Million is the 2013 estimated number of annual NEMT trips 20% of NEMT is public transportation 6 | Getting Paid
Navigating payment methods for NEMT providers in New Jersey under NJ FamilyCare involves several approaches:
Fee-for-Service (FFS) : Providers directly submit claims to Medicaid for reimbursement.Managed Care Organizations (MCOs) : Providers contract with MCOs for NEMT services, receiving payment based on negotiated terms.Administrative Contractors : Instead of brokers, administrative contractors and medical transportation management companies oversee NEMT services and payment processes.Providers are required to follow Medicaid billing guidelines and procedures when submitting claims. For specific requirements, consult the New Jersey Department of Human Services or contracted MCOs.
Get ready to navigate New Jersey's NEMT scene with the precision of a turnpike exit! Stay tuned for Part 2, where we'll guide you through crafting a business plan tailored to New Jersey's unique regulations and market dynamics. Stick with us or jump ahead through the series' table of contents to plan your path to success!
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