How to Start an NEMT Business in New York: A Several Part “Bambi Knows Best” State-By-State Series Part 1: Research the New York NEMT Market Welcome to New York State, where starting your NEMT business is as promising as a friendship between Bambi and Pizza Rat ! Before diving into the details of launching your venture, conducting thorough market research is essential. This critical step will guide you through New York's diverse communities and expansive rolling Adirondack terrain — and beyond, helping you pinpoint underserved areas to avoid competing in over-saturated markets.
1 | Identify existing NEMT providers in your area New York State has a substantial Medicaid population, providing essential non-medical services through its Medicaid program, known locally as Medicaid . Managed care health plans within the state also include comprehensive NEMT services. The New York State Department of Health is a valuable resource for locating information about NEMT providers statewide. Here are some of the leading NEMT providers offering services today:
Modivcare Medical Answering Services (MAS ) : MAS provides NEMT services in New York, focusing on managing transportation logistics for healthcare appointments and services.Acadian Ambulance Service :Access-A-Ride MTM, Inc . : Although based nationally, MTM also provides NEMT services in New York through partnerships with managed care organizations and healthcare providers.Uber Health :Your Favorite Search Engine : For a personalized search, use keywords such as "NEMT providers in New York" or specify a locality like "NEMT companies in New York City" to find more specific results.2 | Assess the demand for NEMT services To capitalize on the abundant opportunities for your NEMT business in the diverse landscape of New York, we recommend you begin by assessing local demand and deciding whether to serve multiple counties or focus within a specific radius. Conduct thorough research on nearby hospitals, healthcare facilities, wellness centers and other healthcare providers. Explore unconventional avenues to uncover distinctive opportunities that distinguish your business in the competitive market.
Adult Day Care (ADC) Centers. ADCs in New York State play a crucial role in supporting its sizable senior population. For the latest statistics and information, consult the New York State Office for the Aging (NYSOFA) or the New York State Department of Health (NYSDOH) . These agencies regulate and oversee adult day care centers, offering databases or lists of licensed facilities statewide.Dialysis Clinics. Dialysis clinics in New York State benefit from a robust healthcare infrastructure catering to its diverse population. Leading providers like Fresenius Medical Care , DaVita Kidney Care and U.S. Renal Care have established significant presences in the state, though specific data points may vary. For detailed information, refer to local healthcare provider directories or contact the New York State Department of Health for comprehensive listings.Physical Therapy Centers. PT Centers in New York State vary in number and distribution due to diverse reporting methods and the state's comprehensive healthcare network. For precise information, we suggest referring to records from the New York State Department of Health, professional organizations like the New York Physical Therapy Association (NYPTA) or industry reports that focus on healthcare facilities within New York State. Hospitals. There are approximately 210 general acute care hospitals and specialized facilities in New York. For more current information, consult the New York State Department of Health or the New York State Hospital Profile , which provides comprehensive data on healthcare facilities across the state.Rehabilitation centers. We don’t have an up-to-date number on these, but many hospitals partner with rehab centers so it’s always best to get in touch with those 210 from up above!Nursing homes and assisted living facilities. Nursing homes and assisted living facilities in New York State serve a significant elderly population. There are approximately 613 nursing homes and over 1,200 assisted living facilities throughout the state. These facilities offer essential long-term care services, including skilled nursing care and assistance with daily living activities, to elderly residents needing ongoing medical and personal care. For the latest information, we suggest you refer to the New York State Department of Health and the Centers for Medicare & Medicaid Services (CMS) .Outpatient care centers. Similar to rehab facilities, New York has plenty of outpatient care centers statewide. For more details on these estimates, consider consulting your local county’s hospitals as they’ll likely be partnering up with one or several!3 | Decide on a target market After diving into the NEMT market across New York State and gauging demand, pinpointing your target demographic is key — whether it’s seniors, individuals with disabilities or a broader patient base. Focusing on a specific group allows you to tailor your services and marketing strategies more effectively.
4 | Choose a specific NEMT service (or offer them all!) Ride the New York NEMT biz train like you would the NYC subway: strategically. By concentrating on the most in-demand services to meet your community's needs effectively. This strategic focus lays a strong foundation for long-term success. Stay ahead of the competition by offering unique services or targeting underserved niches. Launch with a top-notch fleet designed for New York, catering to destinations such as nursing homes, hospitals or other vital facilities.
5 | Understand the different Medicaid delivery models New York runs the nation’s largest Medicaid transportation program, accounting for a quarter of all NEMT spending. This is huge! NEMT is classified as an administrative service for maximum flexibility, with federal reimbursement at 50%. Previously, New York had a county-based fee-for-service model, where counties covered 50% of Medicaid costs. Two-thirds of NEMT spending goes through this program, with the rest managed by Medicaid managed care organizations. Instead of brokers, New York now uses administrative contractors and medical transportation management firms to run call centers and coordinate services efficiently.State-by-State Profiles for Examining the Effects of Non-Emergency Medical Transportation Brokerages on Transportation Coordination :
NEMT Model is a blend of In-House Management and Managed Care Organization The Operating Authority is a blend between the NEMT Assurance under the State Medicaid Plan and Federal Section 1115 Demonstration Waiver NEMT expense is classified as an “Administrative Expense” 15% live below poverty (US Census 2015 5-Year Estimates) 83% live in Urbanized Areas (US Census 2010) $646.9 Million is the estimated annual NEMT 2013 expense (Source 2014 National NEMT Survey) 10,791,315 is the 2013 estimated number of annual NEMT trips
6 | Getting Paid In New York State, NEMT providers receive payment through various methods under the Medicaid program:
Fee-for-Service (FFS): Providers submit claims directly to Medicaid for each NEMT service rendered. Reimbursement rates are determined by Medicaid and depend on the type of transportation service provided and other factors.
Managed Care Organizations (MCOs): New York operates under a managed care model where MCOs are contracted by Medicaid to oversee healthcare services, including transportation. NEMT providers contract with these MCOs and receive payment according to negotiated terms and rates set by the MCOs.
Administrative Contractors: Instead of brokers, administrative contractors and medical transportation management companies may coordinate NEMT services in New York. Providers work with these entities and receive reimbursement based on agreed-upon terms and rates.
Providers in New York must adhere to Medicaid billing guidelines and procedures when submitting claims for reimbursement. For detailed information and specific requirements, providers should consult the New York State Department of Health (NYSDOH) or their contracted MCO.Part 2 , where we'll guide you through crafting a business plan tailored to New York's unique regulations and market dynamics. Stick with us, or jump ahead through the series' table of contents here .
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