NEMT vs. Ridesharing: Can Ridesharing Companies Offer NEMT Services?

For those who don't drive, Non-Emergency Medical Transportation (NEMT) isn’t just a convenience; it’s what makes healthcare possible. NEMT is a service that allows scores of people across the U.S. to reach their healthcare appointments safely and on time.

In recent years, however, rideshare platforms such as Uber Health and Lyft Healthcare have also entered the medical transportation space. This overlap of services has raised one crucial question:

Can rideshare companies offer the same reliability, consistency, and compliance as a traditional NEMT provider?

In this blog, we explore NEMT vs. rideshare as well as dissect how they fit into the overall medical transportation arena.

Contents:

• How Rideshare Fits Into Healthcare
• Rideshare-as-NEMT vs. Traditional NEMT
• Benefits and Limitations of Rideshare-as-NEMT
• Regulatory & Liability Considerations
• Final Thoughts
• FAQs

How Rideshare Fits Into Healthcare

Rideshare services first emerged in the early 2010s. Initially, they were designed as basic app-based transport services that provided quick transport using personal vehicles. Over time, these platforms evolved to include several other features such as scheduled rides, business accounts, and fleet options.

A few years ago, both Uber and Lyft identified a gap in the transportation industry: An increasing number of missed medical appointments. This led to Lyft Healthcare partnering with Medicaid, Managed Care Organizations, and non-profits as early as 2016. Uber Health also launched a platform for hospitals, clinics, and care managers to book rides on behalf of patients back in 2018.

These services target a specific niche: ambulatory NEMT. Ambulatory patients are those who need a ride but don’t require any additional assistance, equipment, or medical supervision.

Rideshare-as-NEMT vs. Traditional NEMT

At first glance, both rideshare and NEMT seem to be doing the same thing. However, there are specific differences:

What is Each Best For?

Ridesharing NEMT services are designed for those who can walk independently and don’t require any mobility aids or personal assistance.

Traditional NEMT providers serve both—ambulatory passengers as well as individuals who use wheelchairs, require stretchers, or need support during pick-up and drop-off.

Assistance Level

Rideshare drivers are not trained on how to assist passengers. They will not help you into buildings or even up the stairs. Their responsibility essentially ends at the curb. This poses a big challenge for passengers who are elderly, frail, or have any type of cognitive impairment.

Conversely, traditional NEMT service drivers are trained for this. They usually provide door-to-door as well as door-through-door assistance. This means that the passenger will be assisted right to their door, and even inside.

Vehicle Accessibility

Most rideshare vehicles are sedans that simply cannot accommodate wheelchairs. This is especially true for services outside major cities.

NEMT fleets, however, are built with accessibility in mind. You can find wheelchair-accessible vehicles (WAVs), stretcher vans, as well as lift-equipped vehicles to accommodate a variety of physical needs. NEMT vans are also fully equipped with oxygen mounts, first aid kits, and other essential tools that ensure the safety and comfort of passengers during transport.

Driver Training

Rideshare drivers typically receive only general customer service training. They are not trained in handling any medical situations, vulnerable passengers, or emergencies.

In contrast, NEMT drivers will often undergo training in CPR, patient handling, HIPAA compliance, and disability awareness.

Scheduling and Dispatch

Rideshare services typically offer API-based scheduling platforms that are used to book, track, and manage rides online.

NEMT providers schedule rides through dispatch software. These complex systems include compliance features and are often integrated with billing workflows.

Benefits and Limitations of Rideshare-as-NEMT

The top advantages of rideshare-as-NEMT include:

1. Flexibility and Scalability

Rideshare platforms allow you to make real-time or pre-scheduled bookings through digital dashboards. This makes it easier to manage last-minute needs or overflow capacity.

2. Cost Savings

Rideshares can be more affordable in situations where the distance is shorter and the passenger is also ambulatory

3. Better Access in Urban Areas

There are more drivers available in urban areas. This makes rideshares particularly useful in cities by reducing no-shows and wait times.

Limitations of Rideshare-as-NEMT

Despite the convenience, ridesharing NEMT services come with critical constraints that cannot be ignored.

1. No Support for Wheelchair or Stretcher Needs

While some platforms claim to offer rideshare wheelchair accessible options, their availability is extremely limited.

2. Lack of Driver Training

Rideshare drivers aren’t trained to handle elderly, disabled, or medically vulnerable passengers. There is also no standard protocol for handling patient emergencies.

3. Curb-to-Curb Only

Rideshare services come under curb-to-curb medical transportation. For patients with limited mobility, cognitive impairments, or vision issues, this can become a safety concern.

4. Poor Rural Coverage

In many rural areas, rideshare simply isn’t available. Here, wait times can be unpredictable, or providers may not accept rural pickups at all. This makes it unreliable for Medicaid or recurring transport needs.

Regulatory & Liability Considerations

Most State Medicaid Agencies (SMAs) and NEMT brokers have strict requirements that rideshare cannot consistently meet. These include:

• Verified driver background checks
• Medical transport insurance coverage
• Vehicle inspections and compliance documentation
• Driver training in HIPAA and patient safety
• Performance oversight and complaint resolution

Because of these gaps, most brokers continue to largely contract with licensed NEMT providers and fleets that meet regulatory standards and prefer to avoid granting contracts to ridesharing companies.

Liability Risks

NEMT providers also assume liability for their vehicles, drivers, and passengers. However, with rideshare, the question of liability becomes more complex. It raises important questions such as:

• Who is responsible if a rideshare driver refuses service after seeing a wheelchair?
• What happens if a patient falls getting in or out of a non-accessible vehicle?
• How is Protected Health Information (PHI) handled during scheduling?

All of these questions make rideshare a riskier proposition for brokers and healthcare providers. Therefore, very often major organizations post contracts with specific instructions that deny eligibility to ridesharing companies. MCOs are willing to absorb the costs of working through pure NEMT providers due to audit risk, potential payment denial and to ensure compliance and passenger satisfaction.

Final Thoughts

There is no doubt that ridesharing has introduced flexibility into healthcare transportation. However, the answer to a question can ridesharing companies offer NEMT services is still a no. Ridesharing isn’t a replacement for traditional NEMT. At most, it can be a supplemental option that is best used in the specific situations we have outlined above.

As a provider, understanding these distinctions between NEMT vs. ridesharing helps you adapt without compromising on your service quality.

And, if you're looking to manage your NEMT operations more efficiently, you can check out iSi Technology. Our software is built specifically for NEMT providers. From scheduling and dispatch to driver tracking, billing, and compliance, we help you run a smarter, more connected transportation business.

Explore our resources to see how our NEMT software can support your growth.

FAQs

Are rideshare services reliable for recurring NEMT appointments?

Rideshare platforms typically lack the route planning, accountability, and driver consistency that NEMT providers deliver. For patients who need routine transport, traditional NEMT ensures a higher level of reliability and coordination.

Are Uber or Lyft rides safe for elderly or disabled patients?

Rideshare platforms are generally safe for ambulatory patients. However, they are not designed for those who need physical assistance or medical equipment.

What does “curb-to-curb” transportation mean?

Curb-to-curb transportation is when a driver picks up and drops off the passenger at the curb without offering assistance into buildings or medical facilities.