The Transportation Broker Model Is Broken — Patients Deserve Better Access to Care

Stephen Newman is President of 360 Quality Care + Transport Services in St. Louis, MO

At some point, the healthcare industry has to confront a difficult truth:

The current transportation brokerage model is placing unsustainable pressure on high-quality providers — and patients will ultimately bear the cost.

Across the country, national brokers have built large platforms designed to coordinate rides at scale. But the prevailing procurement approach continues to prioritize price compression over performance, clinical competency, and accountability.

For quality providers like 360 Quality Care + Transport Services — one of only 14 NEMTAC-accredited providers in the United States — the reality is increasingly clear:

"We are being pushed to accept reimbursement levels that fall below the true cost of delivering safe, reliable, clinically appropriate transportation.

That is not a sustainable model and we can prove it, says Stephen Newman, President of 360."

When reimbursement fails to reflect operational reality, high-performing providers are forced to make difficult decisions — including reducing service areas, limiting availability, or exiting broker networks altogether.

Carly Newman, Director of Operations for 360

When that happens, the system does not become more efficient. It becomes more fragile. The burden shifts to smaller operators already working on thin margins, increasing the likelihood of missed trips, delayed discharges, poor patient experiences, and disruptions in care continuity.

Transportation is not a commodity. It is a critical access point to healthcare.

When reliability declines, appointments are missed. Care plans are interrupted. Hospital throughput slows. And for vulnerable populations, the consequences can be serious — sometimes life-altering.

This is not about protecting margins. It is about protecting access to healthcare for those who need it the most. Healthcare leaders, policymakers, and payers must begin aligning incentives with outcomes — recognizing that performance, safety, and accountability require appropriate investment.

If we want a transportation system that supports value-based care, reduces downstream costs, and improves patient experience, we must move beyond lowest-bid procurement toward models that reward quality and reliability.

At 360, we remain committed to elevating the standard of care transportation. But the industry must acknowledge that sustainable access requires sustainable economics.

The future of access to care depends on it.

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