Enhancing Non-Emergency Medical Transportation (NEMT) in Missouri Medicaid: A Quality-Driven Approach
- Team 360
- 20 minutes ago
- 4 min read
Reliable, high-quality non-emergency medical transportation (NEMT) is essential for Missouri’s Medicaid population, ensuring timely access to health care for patients with chronic conditions, mobility limitations, and urgent medical needs. Stephen Newman, founder of 360 Quality Care + Transport Services, and a leading provider of high-quality NEMT services, emphasizes that timeliness, operational precision, and patient-centered care must be prioritized to improve health outcomes.
"Missouri’s current NEMT system faces serious challenges, including missed rides, delayed hospital discharges, rural accessibility issues, and inconsistent service reliability," says Newman. This past September, Washington University, through the Center for Advancing Health Services, Policy & Economics Research, (CAHSPER), brought together diverse stakeholders in the NEMT industry to identify gaps, propose policy solutions, and discuss ways to strengthen accountability and implement quality-driven improvements in the state’s NEMT framework.
This paper distills the CAHSPER event’s findings through the lens of Newman’s commitment to high standards, offering actionable recommendations to enhance NEMT by redefining service expectations, implementing better scheduling practices, and ensuring Missouri’s Medicaid transportation system supports the most vulnerable patients effectively. A summary of the entire event, along with inputs from the keynote speaker and other panel members can be found by downloading the document below. Read on for a synopsis of Newman’s remarks.
Missouri’s current NEMT system faces serious challenges
Missouri’s MO HealthNet (Medicaid) program provides NEMT to ensure beneficiaries can access medically necessary care. While NEMT covers a range of transportation options—including rideshares, ambulances, and wheelchair-accessible vehicles—persistent failures in scheduling, lack of coordination, and service inconsistencies continue to disrupt patient care.
At the CAHSPER event, Newman spoke at length about quality control, operational efficiency, and solutions to improve scheduling accuracy and transport reliability. His remarks emphasized that transportation is not just a logistical service—it is an extension of patient care.
Key Challenges in Missouri’s NEMT System
1. Service Reliability and No-Show Rates
In Missouri’s current NEMT system, missed pickups and last-minute cancellations result in serious disruptions to patient care. Many providers rely on volume-based ambulatory transport, prioritizing efficiency over individual patient needs. This model often results in overloaded schedules, leading to delays and no-shows.
Newman highlighted that 360 Quality Care + Transport Services achieves 99% on-time performance by pre-scheduling all rides and eliminating “will-call” return rides. His company’s structured approach—setting fixed pickup times based on estimated appointment durations—ensures timeliness and reliability, reducing patient anxiety and provider disruptions.
2. Rural Accessibility and Transit Limitations
Missouri’s rural population faces extreme transportation gaps, with many counties lacking rideshare services or reliable transport options. According to Jana Cook, Senior VP at Phelps Health, rural Missouri lacks Uber, Lyft, and taxi services, forcing hospitals to allocate ambulances for non-emergency rides—often without reimbursement.
Newman emphasized that deadheading miles—long empty trips to pick up patients in rural areas—present a financial challenge for providers, making it difficult to sustain high-quality transport in underserved regions.
3. Hospital Discharge and Emergency Room Flow
Transportation inefficiencies often delay hospital discharges, increasing hospital costs and preventing new patients from being admitted. According to Jamie Bruce, CEO of UnitedHealthcare Community Plan of Missouri, hospitals often absorb transportation costs when Medicaid beneficiaries cannot secure a ride home.
Newman’s solution involves cap limits on ride requests per driver, ensuring availability for hospital discharge patients while minimizing wasted mileage and inefficient scheduling.
4. Standardizing Quality Metrics for Accountability
Current complaint tracking systems are ineffective, with no uniform mechanism for logging patient concerns about delayed or unsafe rides. Bruce highlighted that only complaints formally filed through a dedicated hotline are recorded, leaving many serious issues undocumented.
Newman recommended introducing GPS tracking, vehicle monitoring systems, and a transparent complaint resolution process to hold providers accountable and prevent service failures.
Policy Innovations and Solutions
Based on the event discussions, Newman and panelists identified several key strategies to improve Missouri’s NEMT system:
1. Prioritizing Quality-Driven Scheduling
Eliminate volume-based scheduling: Cap ride assignments per driver to ensure punctuality.
Optimize pickup accuracy: Introduce real-time driver tracking and adjust pickup schedules based on appointment durations.
Expand high-acuity transport capacity: Ensure wheelchair and stretcher services meet patient needs effectively.
2. Enhancing Coordination Across Stakeholders
Bridge hospital-NEMT gaps: Strengthen partnerships between hospitals and transportation providers to reduce discharge delays.
Expand communication channels: Establish 24/7 real-time scheduling and ride verification systems for emergency requests.
Standardize reporting: Introduce a unified complaint tracking system to ensure consistent accountability across all transport providers.
3. Strengthening Reimbursement Models
Reform Medicaid payment structures: Increase reimbursements for wheelchair-accessible rides and high-acuity patient transport.
Introduce value-based payment incentives: Reward providers with high on-time rates and low complaint volumes.
Conclusion: Transforming NEMT with a Quality-First Approach
Stephen Newman’s perspective reinforces the urgent need for quality-driven improvements in Missouri’s NEMT system. High-need patients—including those with disabilities, chronic illnesses, and urgent medical concerns—depend on reliable transportation to access critical care.
Newman and other experts advocate for accountability measures, precision scheduling, and higher service standards to ensure Medicaid patients receive safe, timely, and effective transport.
By implementing targeted reforms, transparency in scheduling, and stronger coordination across providers, Missouri can transform its Medicaid transportation system into a patient-centered model that prioritizes reliability, dignity, and efficiency.