Cost-Effectiveness of Access to Nonemergency Medical Transportation: Comparison of Transportation and Health Care Costs and Benefits

Abstract

Although a lack of access to nonemergency medical transportation (NEMT) is a barrier to health care, national transportation and health care surveys and data sets have not comprehensively addressed this link. The current study builds on earlier work that identified and described the population that lacks access to health care because of transportation barriers by examining the combined transportation and health care impacts of providing access to NEMT for those who currently lack such access. The goal of this study was to compare the costs and benefits, including the potentially large net health benefits, of providing NEMT to those who lack access to it. This analysis uses data from the Medical Expenditure Panel Survey, which is administered by the Agency for Healthcare Research and Quality; the National Transit Database; and data provided by selected NEMT providers, as well as the transportation and health care literature. By a focus on 12 prevalent and costly medical conditions experienced by those who lack access to NEMT, it was determined that the provision of NEMT to those who currently lack it results in a net cost savings across the transportation and health care domains for four of these conditions (prenatal care, asthma, heart disease, and diabetes) and is cost-effective for the remaining eight conditions (influenza vaccinations, breast cancer screening, colorectal cancer screening, dental care, chronic obstructive pulmonary disease, hypertension, depression, and end-stage renal disease). These cost-effectiveness analyses take into account increased life expectancy and improved quality of life and indicate that the provision of additional transportation is worth the investment for these eight conditions. On the basis of these findings, it was concluded that the provision of NEMT to those transportation-disadvantaged individuals who lack access to it would result in net societal benefits for all 12 conditions examined.