Embracing the 6 Ps in NEMT: A Holistic Approach to Business and Sustainability

In the ever-evolving forest of non-emergency medical transportation (NEMT), businesses are constantly seeking innovative ways to improve efficiency, enhance patient care and promote sustainability. At Bambi, we have redefined the traditional Triple Bottom Line by introducing an expanded framework that addresses the unique needs of the NEMT industry and our planet today.

Our approach centers around six key pillars: People, Profit, Planet, Product, Peace (of mind and on Earth) and Patients. We’ll explain the importance of these traditional and new pillars, showing how they contribute to making a positive (oh look, there’s another P) impact on the world we live in.

People: the heartbeat of NEMT

At Bambi, people are the core of our business. This includes not only our dedicated team members who build, sell, market and support our Bambi software but also our customers — NEMT business owners and their teams, including drivers and operational staff. Most importantly, it includes the patients (who have their own dedicated P below; that’s how important they are to what we do!) who rely on NEMT services.

By fostering a culture of respect, collaboration and continuous improved iterations, we ensure that everyone involved in the full circle of services — from our software built for softies to patient support — feels valued and supported. In the end, our aiNEMT software is carefully crafted to make the jobs of NEMT business owners more productive, easier and overall more fulfilling, allowing them to spend more time in the forest with their Bambi friends (i.e. their dear drivers and patient riders alike).

Profit: ensuring financial viability

Profitability is essential for any business’s success, and the NEMT industry is no exception. Our software helps NEMT service providers optimize operations, reduce costs and increase revenue. By streamlining scheduling, route planning and fleet management, Bambi enables providers to achieve greater financial stability, allowing them to reinvest in their businesses for long-term growth and sustainability.

Planet: commitment to environmental stewardship

Sustainability is at the forefront of our mission at Bambi. We understand the importance of minimizing our environmental footprint, which is why our software includes features that promote eco-friendly practices. The Run Bambi Run feature optimizes routes to reduce fuel consumption and emissions, contributing to a healthier planet. By adopting our caretech, which is also a green technology, we help NEMT providers play a crucial role in combating climate change while positively contributing to their own Environmental, Social and Governance (ESG) goals — which are more important than ever.

Product: innovative solutions for NEMT

Our product is the pinnacle (look, yet another P!) of our success. Bambi offers cutting-edge software that addresses the specific needs of NEMT providers. With user-friendly interfaces, robust functionality and continuous updates, our software ensures that providers can manage their operations with ease (and a Bambi smile to boot!). We are committed to delivering software features that drive our customers’ operational excellence and their customers’ satisfaction.

Peace (of mind and on Earth): trust and reliability

One of the greatest benefits we offer to our NEMT business customers is peace of mind. Investing in Bambi's software means choosing a reliable, secure and environmentally conscious product. Our clients can rest their busy minds assured that they are using a product that not only enhances their business operations but also aligns with their own good-hearted values. By providing dependable service, we help NEMT providers focus on what matters most — delivering quality care to patients. This peace of mind extends to peace on Earth, with less stress and more sustainable businesses running the world.

Patients: improving lives through better care

Ultimately, the success of NEMT services is measured by their impact on patients (yes, they were also included in the P for people section, but they are such a vital pillar of our work that they deserve their own P). Our software is meticulously designed to ensure that patient riders receive timely and safe transportation to their medical appointments. By optimizing routes and improving scheduling, we reduce wait times and enhance the overall patient experience.

At Bambi, we are dedicated to helping patients live their best lives by providing them with reliable access to essential medical care. Additionally, we empower more entrepreneurs to join the NEMT industry (perhaps even swapping their scrubs for software), thereby increasing the availability of services and ensuring that patients have more options to access the care they need.


All in all, we believe that a successful NEMT business is one that balances financial performance with social and environmental responsibility. By embracing the 6 Ps – People, Profit, Planet, Product, Peace (of mind and on Earth) and Patients – we are setting a new, safe and sustainable standard for the industry. Our commitment to innovation, sustainability and patient care ensures that we’re not just meeting today’s needs, but also paving the way for a brighter (or lighter) and healthier future.

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How to Grow a $1.5M/Year Non Emergency Medical Transportation (NEMT) Business | NEMT Experts Podcast #34

See the full interview on YouTube.

Please don't forget to subscribe and like NEMT Experts Podcast on YouTube.
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Also, available to watch on Spotify

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And listen (audio only) on your other favorite podcast platforms Apple and Pandora.
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Podcast Show Notes:

Bambi CEO Nirav Chheda talks with Patricia Curnan, Owner of Prime Medical Transport in Cape Cod, Massachusetts about how she has grown her NEMT business to $1.5M in revenue and to 13 vehicles over 11 years.

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‍Summary:

• Prime Medical Transport is a non-emergency medical transportation (NEMT) business founded in 2013 by Pat Keran.
• The company has grown steadily over the years, from 2 vehicles in 2013 to 13 vehicles in 2024. Pat expects to add 2-4 more vehicles in the next year.
• The company's revenue has also grown steadily, from $1.3 million in 2023 to a projected $1.5 million in 2024. This growth is due to a focus on private pay services, which are more profitable than brokered services.
• Pat measures the success of her business by looking at its labor costs as a percentage of revenue. She believes that if she can keep labor costs under 30% of revenue, the other aspects of the business will fall into place.
• The company is looking to hire a general manager in the near future so that Pat can step back and focus on big-picture initiatives, such as expanding the use of stretcher chairs.

Key takeaways:

• Prime Medical Transport is a growing company with a focus on providing high-quality, non-emergency medical transportation services.
• The company is committed to providing its employees with a positive work environment and competitive wages and benefits.
• Prime Medical Transport is a leader in the NEMT industry and is well-positioned for continued success.

Interesting quotes:

• “I started with two vehicles… I had had been taken care of my own mother who had a stroke and had looked around for transportation and there was really nothing available except for the old high top wheelchair vans really clunky that the ambulance company ran and it was… didn’t seem you know safe or clean or anything so I had seen these other vehicles being made out of Dodge Caravans and said well let’s try that.” - Pat Keran
• “The metric that you’re measuring is the total amount that you’re paying for labor versus the amount that your company’s bringing in as Revenue… It’s interesting… I measure what our um labor percent is and I come from a service industry business where labor is your biggest expense which it is here it’s a we’re running a service so I don’t pay attention too much to the um price per mile or the the miles driven that kind of thing but if our um payroll is in line then it’s everything else kind of Falls in line so that’s really you know kind of the key metric um when that’s out of balance then you can see maybe we’re driving too much out of our way to get some place and um or they just don’t they’re sitting around you know too too much dead time.” - Pat Keran

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How to Start an NEMT Business in Kansas: A Several Part “Bambi Knows Best” State-By-State Series

Part 7: Take Care of That Tech

Finally, harnessing technology is essential for optimizing operations and improving patient care in your Kansas NEMT business.

Settle up on some NEMT Software: Lean into technology to streamline operations and enhance patient care. Explore NEMT software solutions that automate scheduling, dispatching and route optimization (like ours!). Use GPS tracking for real-time vehicle location and efficient communication with patients. Whether you're a seasoned pro or a new NEMTpreneur, Bambi supports you in starting, streamlining and sustaining your business with our user-friendly software. We’re here to help!

And most of all, congratulations! You've completed the comprehensive Kansas series, meticulously researched and crafted by our dedicated editorial team at Bambi. As you prepare to enter the Kansas NEMT market, do so with agility and grace — Bambi style.

Don’t forget, Bambi knows best! Our team and technology are here to support you. Contact us today for any questions about getting started or to schedule a demo of our all-in-one aiNEMT software designed for entrepreneurs like you! Experiencing streamlined, user-friendly software can be the catalyst to confidently advancing in business, just like Bambi.

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How to Start an NEMT Business in : A Several Part “Bambi Knows Best” State-By-State Series

Part 6:  Hire and Train Up Your NEMT KS Dream Team

Building a capable and compassionate team, from safe drivers to skilled dispatchers, is crucial for delivering high-quality NEMT services and ensuring a positive experience for your riders. Hiring NEMT professionals can be achieved through various platforms and strategies, such as posting job openings on employment sites like Indeed and LinkedIn, and participating as a vendor in job fairs. There are many places to find caring talent these days.There’s just one more article left in the series! Go ahead now and move on to the final part, Part 7, which focuses on managing your technology. Click here to continue, or you can skip ahead to other sections in the series by visiting the table of contents here.

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How to Start an NEMT Business in Kansas: A Several Part “Bambi Knows Best” State-By-State Series

Part 5: Flesh Out Your NEMT Fleet in Kansas

Establishing a reliable and accessible fleet is crucial for the success of your NEMT business. This section of the series covers key considerations when selecting and maintaining vehicles and equipment to ensure safe and comfortable patient transportation.

Select your vehicles: Invest in comfortable and accessible vehicles that meet the needs of your patient population. Consider features like wheelchair ramps or lifts to comply with Americans with Disabilities Act (ADA) regulations.

Pick your supporting equipment: There are various equipment options to enhance your fleet, such as ramps, lifts and first-aid kits. Conduct local research to find reputable brands that align with your sustainability goals. Supporting Kansas businesses can also improve efficiency and environmental friendliness.

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Maintain regular vehicle checks: Establish a comprehensive maintenance plan to keep your fleet safe for everyone, including the environment.

You’re almost there! To proceed to Part 6 on hiring and training your dream team, click here. Alternatively, you can skip to other sections in the series by visiting the table of contents here.

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How to Start an NEMT Business in Kansas: A Several Part “Bambi Knows Best” State-By-State Series

Part 4: Secure Funding in Kansas
Starting a startup involves costs. It's necessary to be realistic about the initial investment required. Factor in expenses such as vehicle purchases, licensing fees, insurance costs, marketing expenses and operational overhead. Afterwards, seek adequate funding to successfully launch and sustain your NEMT business during its initial stages.

The following links are a good place to start to look for financial support. Explore funding options such as small business loans, seeking angel investors or even crowd-funding platforms.

NetWork Kansas is a valuable resource available statewide and allows entrepreneurs and small business owners to connect with over 500 NetWork Kansas partners throughout the state. This is a great place to learn from each other regarding starting businesses and funding opportunities.

 

Here’s an initial list of some of your options in Kansas:

1 | Small Business Loans

The SBA offers various loan programs for small businesses, including the 7(a) loan program, which provides financial assistance for businesses with special requirements.

Kansas Association of Certified Development Companies (KACDC) is also a good place to look for small business loans.

2 | Financial incentives 

The Kansas Department of Commerce offers several programs and resources for new businesses, including financial assistance and incentives.

3 | Grants 

While direct grants specifically for starting a business are rare, there are grants available for specific purposes such as technological innovation and rural development. If you’re providing NEMT services to Kansas rural residents, you might even have a chance at a grant! Grants.gov  is a comprehensive resource for finding federal grants.

You're over halfway through this comprehensive series! To proceed to Part 5 on expanding your NEMT fleet, click here. Alternatively, you can navigate to other sections in the series by visiting the table of contents here.

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How to Start an NEMT Business in Kansas: A Several Part “Bambi Knows Best” State-By-State Series

Part 3: Study Kansas’s Regulations and Get Insured

To successfully launch your NEMT business in Kansas, you must navigate both state and federal regulations. This involves understanding the specific registration and compliance requirements in Kansas, as well as adhering to federal guidelines.

1 | Find out Kansas's NEMT Requirements

Kansas has specific licensing requirements for NEMT providers. Visit the Kansas Public Health Association and Kansas Department of Transportation for detailed information on obtaining the necessary NEMT licenses and permits.

2 | Stay on top of federal NEMT regulations

NEMT services are also subject to federal regulations established by the Centers for Medicare & Medicaid Services (CMS).. Ensure you are familiar with these federal requirements before starting your business operations.
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3 | Get insured

Securing the appropriate insurance coverage is crucial for establishing a reliable and legally compliant NEMT business. This insurance protects your company, employees and patients against accidents, injuries and other unforeseen events. While  ITR  is one provider that can cover specific aspects, you will need various types of insurance to fully protect your business.
4 | Obtain necessary licenses and permits

Check with local city and county offices, as well as the Kansas Insurance Department for specifics around NEMT businesses.

5 | Know your employer responsibilities

If you hire employees, you’ll need to comply with employment laws, including workers' compensation insurance, unemployment insurance and the reporting of new hires. The Kansas Department of Labor is a great source of information on this topic!

By following these steps and utilizing available resources, you can ensure that your new business in Kansas is established correctly and complies with state regulations.

You're making great progress in learning about the NEMT business in Kansas — keep it up! To proceed to Part 4 on securing funding in Kansas, click here. Alternatively, you can explore other sections in the series by visiting the table of contents here.

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How to Start an NEMT Business in Kansas: A Several Part “Bambi Knows Best” State-By-State Series

Part 2: Develop a Business Plan and Get Registered in Kansas

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Now that you’ve gained insights from your Kansas NEMT market research in Part 1, it’s time to develop a detailed business plan. This plan is essential for registration and obtaining funding. If you require further assistance, consider contacting local business consultancies like Kansas Business Services.

We also recommend furthering your research through the Kansas Department of Commerce and The Kansas Secretary of State. Starting a new business in Kansas involves several important steps such as: selecting a business structure, registering the business, obtaining the necessary licenses and permits and understanding tax obligations.

Also, we recommend looking at NetWork Kansas as a valuable resource available statewide that allows entrepreneurs and small business owners to connect with over 500 NetWork Kansas partners throughout the state. This is a great place to learn from each other regarding business plan development and where to look for funding opportunities when the time’s right.

Here is a simple guide to help you through this process:

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1 | Choose a Business Entity

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Decide on the legal structure of your business. Common options include Sole Proprietorship, Partnership, Limited Liability Company (LLC), and Corporation (C-Corp or S-Corp). Each structure has different legal and tax implications so be sure to understand the differences.

2 | Register Your Business Name and Entity

After selecting the entity that best suits your needs, you'll need to come up with a name for it. Both the entity and the name must then be registered with the Kansas Department of Revenue if you are conducting business in Kansas or with Kansas customers.

3 | Obtain an Employer Identification Number (EIN)

Apply for an EIN from the IRS if you will have employees or operate as a corporation or partnership.

4 | Register for State Taxes

You’ll need to register with the Kansas Department of Revenue for state taxes such as sales tax and employer withholding tax.

Great! To proceed to Part 3, which covers Kansas’ regulations and obtaining insurance, click here. Alternatively, you can skip to other sections in the series by visiting the table of contents here

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How to Start an NEMT Business in Kansas: A Several Part “Bambi Knows Best” State-By-State Series

Part 1: Research the Kansas NEMT Market

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Before launching a new NEMT business in Kansas, it's essential to conduct thorough market research. This ensures that you're not entering an oversaturated market and helps identify any gaps in existing NEMT services. For instance, you may find that while there are NEMT providers in your area of Kansas, they only offer services to Adult Day Care centers. This presents an opportunity to expand your services to rehabilitation centers, hospitals and more healthcare facilities. In this section, we'll outline how to get started and where to focus your market research efforts in Kansas.

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1 | Identify existing NEMT providers in your area

Across the state of Kansas, there are numerous NEMT providers servicing both rural areas and urban centers. Directories aggregate these providers, and many healthcare facilities partner with NEMT services. It's wise to explore all options and be bold, like Bambi, by reaching out to them for guidance! Although these providers may be your competitors, they could also become valuable business partners. Approach them thoughtfully to gain insights into your market. Below are some helpful directories, services and providers to begin your search for NEMT business in Kansas:

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• The Kansas Department of Health & Environment is on a mission to protect the health and environment of all of Kansas and so is a great resource for reaching out to find out about NEMT providers across the state.
• Belfast Transportation LLC: Based in Kansas City, Belfast Transportation LLC is a leading provider of NEMT services. They offer ambulatory, wheelchair and out-of-area trips.
• ACC MedLink: Specializing in long-distance medical transport, Kansas Medical Transport provides services from Kansas to other states, covering distances of 200 miles or more.
• Uber Health: Offers HIPAA-enabled NEMT services. Healthcare providers can request and monitor patient rides through their platform.
• The Office of Kansas Medicaid (OCCK) contracts with KanCare providers to offer NEMT services throughout Kansas exclusively for Medicaid-recipient passengers. A minimum advance notice of 48 hours is required for booking.
• Your favorite search engine. Of course, one can always do an internet search via the keywords, “NEMT providers in Kansas” or get more granular with your search by putting in specific municipalities (i.e. “NEMT companies in Wichita”). 

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2 | Assess the demand for NEMT services

Determine if there is adequate demand for your NEMT business to enter the market in your local area of Kansas. Also, consider whether you'll be crossing multiple jurisdictional lines or operating within a minimal radius. To make this assessment, research local hospitals, health and wellness facilities, including establishments such as:

• Adult Day Care (ADC) Centers. It is not exactly known how many ADCs Kansas has throughout the state, however a great place to contact would be Kansas Department For Aging and Disability Service (KDADS). Adult Day Services Network is an aggregator of the ADCs in Kansas and Active Day is one of the most prevalent chains operating in Kansas.
• Dialysis Clinics. As of the latest information available, there are approximately 70 dialysis clinics in Kansas. These clinics provide essential dialysis services to patients with kidney disease, including both hemodialysis and peritoneal dialysis treatments. For the most accurate and current count, it would be best to check with the Centers for Medicare & Medicaid Services (CMS), the Kansas Department of Health and Environment (KDHE), or other health regulatory agencies that oversee dialysis facilities in Kansas. They maintain up-to-date records of healthcare facilities, including dialysis clinics.
• Physical Therapy Centers. There are numerous physical therapy centers across Kansas, providing a range of rehabilitation services to patients. Finding the exact number of physical therapy centers in Kansas can be a bit challenging as the information isn't always centrally compiled. However, there are several ways to estimate this. For instance, Kansas Department of Health and Environment (KDHE) would be good to reach out to as they oversee healthcare facilities in Kansas and may have information or a directory of licensed physical therapy centers. 
• Hospitals: As of the latest information, Kansas has a total of 141 hospitals. These hospitals include various types such as general acute care hospitals, critical access hospitals, specialty hospitals and psychiatric hospitals. For the most accurate and current count, you may want to verify with the Kansas Department of Health and Environment (KDHE) or other authoritative sources. Some of the major hospital systems are University of Kansas Health System,  HCA Midwest Health and AdventHealth Shawnee Mission
• Rehabilitation centers.  For exact numbers, we recommend reaching out to the Kansas Department of Health and Environment (KDHE), the Kansas Physical Therapy Association (KPTA) or the American Physical Therapy Association (Kansas Chapter).  They can provide more detailed and up-to-date statistics and resources regarding the number and types of rehabilitation centers across the state of Kansas.
• Nursing homes and assisted living facilities.As of the latest available data, there are approximately 340 nursing homes in Kansas. This number can fluctuate slightly due to closures, openings or changes in licensing status. For the most accurate and current count, it's advisable to check with the Kansas Department for Aging and Disability Services (KDADS) or other authoritative sources. These organizations maintain comprehensive databases and can provide detailed statistics regarding nursing homes in Kansas.
• Outpatient care centers. There are a significant amount of outpatient care centers throughout the state — talk to your local hospitals for more information on these numbers.

3 | Decide on a target market

After researching NEMT market opportunities and assessing demand from healthcare facilities, identify the demographic that strategically makes the most sense to target. Will you focus on seniors, individuals with disabilities or a broader patient population? Specializing in a specific group will allow you to tailor your services and marketing strategies more effectively.

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As of the latest estimates in 2023, the population of Kansas is approximately 2.9 million people. The population is varied across the state and includes urban centers like Witchataw, as well as suburban and rural areas.(Source: United States Census Bureau - Kansas Population Estimates)

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4 | Choose a specific NEMT service (or offer them all!)

NEMT providers offer a variety of services in their vehicle fleets, including ambulatory, stretcher and wheelchair support. It's recommended to start with one service based on the needs of your target market and market gaps, and then expand from there. This approach ensures sustainability! Take note of what competitors are doing and either differentiate yourself or identify a niche neighborhood that could benefit from your support. Start with a well-equipped fleet to meet the specific needs of that service, whether it's supporting ADCs or physical therapy centers.

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5 | Understand the different Medicaid delivery models

KanCare is Kansas' Medicaid program administered by the state. Before January 2013, transportation for Medicaid beneficiaries was provided statewide through a broker by the Kansas Department of Health and Environment. Since January 2013, the state transitioned to a mandatory Managed Care Organizational (MCO) approach under a Section 1115 Demonstration Waiver, requiring all Medicaid recipients to enroll in one of three designated health plans, which are the following: are Aetna Better Health of Kansas (Aetna), Sunflower State Health Plan (Sunflower), and United Healthcare Community Plan of Kansas (United).

In Kansas, the Medicaid program primarily utilizes a managed care delivery model for NEMT. And those three aforementioned MCOs provide NEMT services throughout the state.

How it works is that these managed care organizations are contracted by the Kansas Department of Health and Environment (KDHE) to provide comprehensive healthcare services, including transportation, to Medicaid beneficiaries. They manage and coordinate NEMT services for eligible individuals, ensuring they have access to necessary medical appointments and services.

Under Kansas' revamped NEMT program, each MCO is contracted with a broker to oversee medical transportation services. Two health plans have partnered with LogistiCare which is now Modivcare, while the third has engaged Access2Care, a subsidiary of American Medical Response. These brokers operate under full-risk, competitively bid contracts.

Here are some fast KS facts according to report State-by-State Profiles for Examining the Effects of Non-Emergency MEdical Transportation Brokerages on Transportation Coordination:

• NEMT Model is run by Managed Care Organizations
• The Operating Authority is Federal Section 1115 Demonstration Waiver
• NEMT expense is classified as a “Medical Expense” (Source: Kaiser Family Foundation)
• 13% live below poverty (US Census 2015 5-Year Estimates)
• 50% live in Urbanized Areas (US Census 2010)
• $9.9 Million is the estimated annual NEMT 2013 expense (Source 2014 National NEMT Survey)
• 458,030 is the 2013 estimated number of annual NEMT trips

6 | Getting Paid

NEMT fee schedules in Kansas are structured according to the guidelines and rates established by the Kansas Medicaid program. Here’s how it works:

NEMT services for Medicaid recipients in Kansas are reimbursed based on the fee schedule set by the Kansas Medicaid program. This schedule outlines rates for different types of transportation services, including mileage rates for various vehicle types and rates for waiting time.

Kansas Medicaid operates under a managed care model, where some Medicaid recipients are enrolled in Managed Care Organizations (MCOs). These MCOs have specific contracts and fee schedules with NEMT providers. Providers must adhere to the rates and guidelines set by the MCOs when delivering services to their members. Think of it as a quasi-employment scenario.

To receive payment, NEMT providers submit claims for the services they have rendered to Medicaid recipients. Claims must detail the type of service provided, mileage accrued, and waiting times. These claims are then processed by the Kansas Medicaid program or the relevant MCO. Upon verification that the services rendered align with the fee schedule and additional guidelines, payment is issued.

Well done for navigating through this information-packed first part! Now, let's progress to Part 2 on developing a business plan. Click here to continue, or skip ahead to other sections in the series by visiting the table of contents.

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