A NEMT History: The Early Days of Non-Emergency Medical Transportation (NEMT) Services

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The vital non-emergency medical transportation (NEMT) services haven’t always been in service or a service offered period. Can you imagine that? You better Bambi believe it!

It’s true, every industry has a starting point — a beginning, a story. And because we create care-tech for this caring NEMT industry, we thought it’d be interesting to study up and share some brief history on NEMT services to see how it’s evolved over the years.

At a high level, the concept of non-emergency medical transportation has been around for as long as medical care itself. 

Leaning on loved ones

Historically, it’s been loved ones and fellow community members (talk about nice neighbors!) who would assist those in need of transportation to and from their medical appointments. 

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Trusting public transport

And for those those folks who didn’t have kind caretakers to call on, they would have to rely on public transportation — that is, if this was even an option where they lived. And we all know or, at least, understand how hopping along with crutches or being wheelchair bound could make even arriving at the bus stop a challenge, let alone getting on a bus that might not have the infrastructure or space for wheelchairs, walkers and other medical machinery.

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No-shows

In a worse case, prior to NEMT services, some patients wouldn’t even attend their appointments. Sadly, this still happens. Even when NEMT services are well-known, it’s not a prevalent service in some parts of the country, making that 9-1-1 emergency call a last resort for a non-emergency. And most would never make that call for the exuberant costs of dialing those three digits.

All this is why so many entrepreneurs are tapping into this growing billion dollar industry, but that’s an article we’ve already written.

Now, to get into the nitty gritty of historic dates, NEMT services began to emerge as a recognizable industry during the latter half of the 20th century, spurred by the Vietnam War. 

It’s important to note, though, the exact timeline of when NEMT services became widespread can vary quite a lot depending on the part of the country and region-specific healthcare systems.

Made possible by Medicaid

‍Here in the US, NEMT services began to really gain that traction in the late 1960s and 70s, as the government began to realize and recognize the need to provide transportation assistance to Medicaid beneficiaries for non-emergency medical appointments. This is directly correlated to the thousands of Vietnam soldiers returning home wounded and permanently disabled who would need long-term care. The inclusion in the Medicaid program significantly boosted the formalization and growth of NEMT services as an industry, and, in fact, today almost 3.2 million Medicaid beneficiaries use NEMT on a regular basis.

A state responsibility

‍NEMT officially became a state-administered service in 1974 following the Smith v. Vowell District Court Case. This meant states became directly responsible for providing patients with medical transportation to and from their medical appointment. Because it became a state responsibility, individual state governments needed to tackle the infrastructure and policies to make this service available to its tax payers and patients in need.

Policies, rules & regulations:

Upon recognizing the critical importance of ensuring the safety and reliability of NEMT whilst watching demand for such services grow, governments and healthcare organizations got more and more involved (and continue to do so). They realized the need to standardize the industry. To do this, they started implementing standard operating procedures for upgrading vehicles, creating training programs for drivers and developing eligibility criteria for starting an NEMT business. 

Worth it for the red tape (and don’t worry, it’s not much!), as it sure is an industry that’s really driving the economy forward and up these days!

All in all, it’s important to remind ourselves that before NEMT was a popular four-letter acronym of a service and serviced industry, patients had to be patient. They had to lean on a lot on loved ones and wait out and for policies, infrastructures and insurances to be set in place. These things take time, but in time this industry has taken off and is still on the run and running nimbly, like Bambi!

The good news for the future is that: 

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Where there's a wheel there’s a way! 

When there’s a demand for NEMT wheels, there’s always a way for more businesses in the market! And as populations grow (especially the elderly) and age older, the demand for NEMT services grows, too. 

And the NEMT will continue to add success stories to its history, like bringing emerging tech (like Bambi!) into it, too. Be sure to stay tuned to our Insight articles as we have a story about the future of the NEMT coming soon to add more fun to the overall industry’s coming of age story.

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