How to Transition to a Value-Based Model in NEMT

For many years now, Non-Medical Emergency Transport (NEMT) providers have operated under a volume-driven model. This model is essentially built around the idea that the more rides you complete, the more revenue you bring in.

As simple and logical as it may seem, such an approach can be inefficient, expensive, and also fail to provide quality, personalized care. Moreover, the healthcare ecosystem as a whole is now moving towards more patient-centric frameworks.

This means non-emergency medical transportation providers have to rethink their approach.

Enter the value-based NEMT model: A model that shifts the focus from the traditional “how many rides” to “how meaningful were those rides."

In this blog, we delve into the importance of this value-based model and take you through the steps involved in successfully transitioning.

Contents:

• What is a Value-Based Model in NEMT?
• Why Transition to a Value-Based NEMT Model?
• Step-by-Step Guide to Transitioning to a Value-Based Model
• Final Thoughts
• Frequently Asked Questions

What is a Value-Based Model in NEMT?

A value-based NEMT model is one that does away with the traditional fee-for-service model and instead focuses on how well the trips can support passenger care, their experiences, and system-wide efficiency.

This outcome-based medical transportation services are built around:

• Ensuring passengers arrive at medical appointments on time
• Minimizing missed visits and reducing wait times
• Supporting consistent treatment follow-through
• Enhancing comfort and safety with well-equipped, accessible vehicles
• A collaborative approach between medical teams and healthcare entities to improve care

Why Transition to a Value-Based NEMT Model?

Focusing on value doesn’t mean you have to ignore revenue. In fact, according to a McKinsey report, healthcare organizations that are leading with value-based care are already experiencing about 2X revenue growth.

Here are other top reasons to make the transition:

1. Improved Patient Outcomes

Reliable and on-time transport can help passengers avoid missed appointments and keep on track with their care.

This is because when they can count on priority medical transport, they’re more likely to attend follow-ups, stick to treatment plans, and avoid preventable hospital visits. In fact, a study found that implementing modern NEMT programs reduced no-show rates by 73%. It is worth noting that improved patient outcomes also result in an increase of patient satisfaction.

2. Greater Provider Efficiency

To provide more value, such as on-time performance or well-equipped vehicles, you have to look at optimizing your resources. This will involve making more effective use of your time, staff, as well as your fleet. For example, you could look into smart routing to reduce unnecessary mileage. Or, employ digital scheduling tools to manage appointments in a more streamlined and hassle-free manner.

Over time, such changes lead to your operations becoming smoother and more efficient.

3. Financial Sustainability

Remember, value-based care does not mean a cut in profits.

When you deliver higher-quality and more reliable services, you also build trust with clients. This trust, in turn, helps you secure stronger contracts as well as minimize costly no-shows.

Over time, this approach helps increase profits in NEMT and drives a higher return on investment.

4. Stronger Healthcare Partnerships

According to one study, 72% of healthcare executives said that partnerships with vendors who also prioritized value played a vital role in improving the way they provided care. In fact, it also made a positive difference in their operational performance. Thus, by adopting a value-based concept in NEMT and delivering premium medical transport services, you also position your business as a trusted care partner.

This trust further leads to stronger relationships, increased referrals, and long-term collaboration.

Step-by-Step Guide to Transitioning to a Value-Based Model

Here are the steps you need to follow when shifting to a value-based NEMT model.

1. Evaluate Your Current Model

Firstly, assess how your current services are performing. Use indicators that can be measured, such as:

• On-time arrival rate
• No-show percentage
• Patient feedback
• Fuel usage
• Costs related to maintenance

These factors will help you identify any performance gaps that you will need to address as you transition.

2. Assess Patient Experience and Workflow Gaps

Passengers, drivers, dispatchers, and partner facilities can also offer you valuable information. Engage with them and compile feedback on delays, missed pickups, miscommunication, or uncomfortable rides. This feedback helps highlight areas that require attention.

As you transition, you can make value-led changes to these gaps and improve both passenger experiences as well as your operations.

3. Set Realistic KPIs That Prioritize Outcomes

Outcomes that can be measured help you track your progress as well as build credibility with your healthcare partners.

You should consider benchmarks such as:

• On-time arrival rate of at least 95%
• An average delay per trip of under 10 minutes
• Repeat ride requests
• Fewer no-shows and readmission rates

4. Upgrade Technology and Reporting Tools

With real-time insights, automation, and streamlined communication, you can deliver consistent and high-quality care. Therefore, invest in tools that support this approach, such as:

• Fleet tracking and routing software
• Mobile apps
• Digital forms
• Integrated billing systems

5. Build Collaborative Relationships

Collaboration is another key aspect in this model. Work closely with hospitals, managed care organizations (MCOs), and brokers to align your goals, share data, and define clear expectations.

There’s also a growing interest in premium NEMT offerings for patients who have complex or private care needs. If you're exploring this, take a look at how luxury NEMT services fit into your value-based care model.

6. Train Your Team

Drivers, dispatchers, and call center staff all play a crucial role in shaping the passenger experience. A well-trained team is better equipped to deliver the level of service required for a value-based NEMT model.

7. Get Accredited

Accreditation tells your stakeholders that your NEMT service meets or exceeds industry standards. It also shows partners that you're committed to maintaining the higher standards of service that are a hallmark of value-based NEMT models.

You should look at organizations like NEMTAC. It offers formal recognition for providers that can demonstrate safety, reliability, and a commitment to quality care.

Final Thoughts

Value and outcome-based models are increasingly becoming the norm in NEMT as well as the overall healthcare industry. So, when considering the way forward, you should know it's more than about building an impactful business. It's also about setting up your transportation business to be future-ready.

And, if you are ready to transition, RouteGenie’s all-in-one NEMT software is built to support your journey. From outcome tracking to real-time dispatching and billing, it’s truly designed with value-based care in mind.

Request a demo today.

Frequently Asked Questions

What is the value-based model in NEMT?
It’s an approach to NEMT that shifts focus from volume to value and prioritizes patient outcomes. 

Do NEMT companies need special software to support this model?
Yes, tools that help route optimization, driver tracking, billing, and reporting are crucial in value-based models. For example, RouteGenie is designed specifically for outcome-focused NEMT providers.

Can small NEMT providers make the switch to value-based care?
Yes. Smaller operations can actually transition more easily. Begin with things like better routing, improved driver training, and digital record-keeping, and scale gradually.