Operations

Non-Emergency Medical Transportation: A New Revenue Stream

Jim Luff
Posted on February 6, 2019

L to R: Executive Secured Transportation co-owners: Christina Yancy, CFO, VP/human resources; Robert Yancy, VP/operations; J.C. Yancy, CEO/President; Jan Yancy, VP/finance.
L to R: Executive Secured Transportation co-owners: Christina Yancy, CFO, VP/human resources; Robert Yancy, VP/operations; J.C. Yancy, CEO/President; Jan Yancy, VP/finance.
As the ground transportation industry evolves, we can remain focused on luxury, but we must look for new revenue streams as well as ways to differentiate our companies in our local markets.

A great idea trending in the industry is offering non-emergency medical transportation (NEMT) to clients considered “transportation disadvantaged.” Millions of Americans fall into this category, providing a big opportunity to offer services to this overlooked population. You can jump into this lucrative business with your fleet or enhance your service by adding wheelchair lifts.

Who Uses This Service?

Americans who are “transportation disadvantaged” are mostly elderly, poor, mobility-impaired, and/or injured on the job and being treated under a worker’s comp policy. These employees must be taken to and from medical appointments, and may need other routine trips such as to the grocery store, work, classes, and shopping.

Medical appointments could range from daily physical therapy to mental counseling, meetings with attorneys, and medical specialists based out of town. In a report on the cost benefits analysis prepared for the Transportation Research Board of the National Academies, 3.6 million Americans miss or delay non-emergency medical care each year because they cannot provide or pay for their own transportation. The buzz phrase for this type of transportation is “medically necessary.” Some insurance companies will happily cover the cost of transportation when it’s seen as medically necessary.

What Are The Requirements?

More strict requirements govern the use of a wheelchair lift than other forms of NEMT, such as those involving sedans and SUVs. Your existing authority allows you to drive any passenger who is ambulatory (can walk on their own). DOT regulations for transporting wheelchair bound patients are included in the Americans with Disabilities Act (ADA), and apply to transporting clients in wheelchairs or any mobility aid with three or more wheels including non-motorized scooters. The DOT requires all platform lift systems and manufacturers to make sure their lifts meet minimum dimensions and maximum size limits on protrusions and gaps. There are also rules for handrails and threshold warning signals, and retaining barriers for lifts to keep a passenger from falling off the lift.

What About Training?

Obviously, you must train your chauffeurs to handle disabled or injured patients. A program must include not only the physical aspect of loading a patient, but also sensitivity for disabled passengers. The DOT ADA regulations prohibit an operator from refusing a person with a specific type of disability, as long as your lift can physically accommodate them. You cannot require a person to transfer from a wheelchair to a vehicle seat. This is important because many wheelchair patients can transfer from a wheelchair to a car using a device known as a transfer board. You cannot refuse a patient who uses a board and cite a liability concern. In other words, you are either in the business or not. Obviously, there is a higher risk in transporting injured people.

Chauffeurs will also need training on using a two-part securement system. One part to secure the wheelchair, and the second part is a seatbelt and shoulder harness to secure the wheelchair- bound passenger. Just as important to securement is training chauffeurs on how to properly help and treat individuals with respect and sensitivity. Additionally, chauffeurs will be exposed to private information such as insurance and patient care records. Your company will have to be HIPAA (Health Insurance Portability and Accountability Act) compliant before you can schedule such patients. Many online companies can help you achieve certifications such as HIPAAtraining.com and Adaptible.com.

L to R: Using the skills of professional chauffeurs provides an opportunity to raise the bar on NEMT rides by providing kindness, compassion, and even friendship to passengers.
L to R: Using the skills of professional chauffeurs provides an opportunity to raise the bar on NEMT rides by providing kindness, compassion, and even friendship to passengers.
The Right Vehicle

How in depth you want to be in this business is up to you. You can purchase a new or used wheelchair accessible van, or modify a vehicle in your fleet with a wheelchair conversion. The conversions range from $10,000 to $20,000. You can modify a van with a rear entry wheelchair ramp from $10,000 to $14,000. A side entry wheelchair lift will cost about $20,000. This option can require the side door to be removed and replaced with a double-hinged or electronic opening door. This also includes a lift that will lower to the wheelchair surface. Variables in conversion pricing span manual vs. power ramps, step flares, removable seating, rubber, hardwood or carpeted flooring, and lighted ramps. Many wheelchair companies such as Mobility Works sell used wheelchair vans. A California-based limo operator, for example, bought a one-year old Dodge van for $4,500 when the owner passed away and the family wanted to get rid of it. As of press time, Mobility Works had wheelchair vehicles advertised at $14,000.

Another option not well known is to apply for grants and other disability assistance programs. These resources are offered by the federal government and many non-profit organizations devoted to serving disabled people. You can find a list of organizations and grants by state at websites such as mobilityworks.com, mobilityresource.com, and braunability.com.

All About the Money

Billing for ADA transportation differs from the standard version. Take note transportation network companies (TNCs) already pursue this market. Uber offers WAV (Wheelchair Accessible Vehicles). Its fees are based on cost per distance, costs for trained personal, and sometimes a special pick up fee. In most cases, the passengers our industry will seek are not the person paying the bill. Rather than you dictating the prices, insurance companies or NEMT transportation brokers such as ProCare, Albors & Alnet, and One Call will tell you what they are willing to pay. These fees are also based upon mileage and waiting time.

Wheelchair lift vans command a price every time the lift is used. Using the skills of professional chauffeurs provides an opportunity to raise the bar on NEMT rides by providing kindness, compassion, and even friendship to those passengers in need of NEMT service. We can create an experience and added value that other companies like Lyft or Uber simply cannot. The rates paid can range anywhere from $1.65 a mile to $2.95 per mile, and wheelchair lift rates can range from $25 per lift to $55 per lift depending on the broker and your geographic region. Wait time varies from $25 to $45 per hour, depending upon the vehicle type.

Why You Should Consider

J.C. and Christina Yancy, owners of Blasian Executive Secured Transportation in Phoenix, saw the need to provide luxury wheelchair transportation because no one else in their area did. Blasian commissioned Battisti Customs, a well-known coachbuilder, to build a luxury wheelchair transport vehicle capable of carrying wheelchair riders as well as ambulatory passengers.

J.C. Yancy said the company spent $30,000 on the vehicle and vowed to offer its services at a rate comparable with any other van in their fleet. They immediately found a client base and have dramatically increased their revenue stream. More importantly, the couple shares important milestones with their passengers as they work towards recovery or improvement of their lives. They call these encounters “angel moments,” and they share in many of them with their NEMT passengers. Their passengers send emails and post on social media about the company and the compassion of Blasian staff. You can’t beat a marketing campaign like that for growing this specific niche of business.  

To see a video from Blasian Executive Secured Transportation, click here.

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Related Topics: ADA vehicles, client markets, customer service, medical transportation, revenue growth

Jim Luff Contributing Editor
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