How to Start an NEMT Business in North Carolina: A "Bambi Knows Best" State-By-State Series Before setting your serious sights on North Carolina’s NEMT market, it’s important to dive into thorough market research to understand the state’s healthcare landscape and transportation needs. North Carolina’s diverse regions — from bustling cities like Charlotte and Raleigh to more rural areas and mountain communities — offer a wide range of opportunities for NEMT services. Here’s how to effectively navigate North Carolina’s NEMT market:
1 | Identify Existing NEMT Providers in North Carolina Understanding the current NEMT landscape in North Carolina will help you identify opportunities and assess any keen competition. The North Carolina Department of Health and Human Services (NCDHHS) manages Medicaid-funded NEMT services, ensuring compliance with state and federal standards. Key providers include:
Modivcare : A major NEMT broker coordinating transportation for Medicaid recipients across North Carolina.MTM : Offers non-emergency transportation services across the state, focusing on medical appointments, hospital discharges and more.Local Transportation Networks : Numerous local providers serve smaller cities and rural areas, catering to specific community needs.Uber Health : Operates in select North Carolina areas, providing HIPAA-compliant ride scheduling for patients.Consult local directories, state resources and online listings to identify additional NEMT providers in areas like Greensboro, Asheville or wherever you plan to set hoof in for your business.
2 | Assess the Demand for NEMT Services To evaluate demand, focus on key healthcare facilities and the needs of North Carolina communities:
Adult Day Care Centers: North Carolina hosts around 100 licensed adult day care centers, a figure that can be confirmed through the North Carolina Division of Health Service Regulation for the latest data.Dialysis Clinics: The state has approximately 200 dialysis centers operated by major providers such as DaVita and Fresenius Medical Care. Check with NCDHHS or use the Medicare.gov Dialysis Facility Compare tool for the most updated information.Physical Therapy Centers: Widely available across North Carolina, these centers support a range of rehabilitation needs. For the most accurate data, consult the North Carolina Physical Therapy Association or local healthcare providers.Hospitals: North Carolina is home to over 130 hospitals, including prominent systems like UNC Health and Novant Health .Nursing Homes and Assisted Living Facilities: With a growing elderly population, North Carolina has over 400 licensed nursing homes. NCDHHS provides detailed information on these facilities and their transportation needs.Outpatient Care Centers: A critical part of the healthcare system, these centers frequently require reliable transportation for patients. Reach out to hospitals for NEMT opportunities in this space.3 | Decide on a Target Market Define your primary audience based on demand, such as seniors, individuals with chronic conditions or those needing regular medical and mental health appointments. Tailoring your NEMT services to these groups will help you effectively market your business and meet North Carolina’s specific needs.
4 | Choose Specific NEMT Services Decide which NEMT services are most relevant to North Carolina’s needs. Whether it’s rides to medical appointments, specialized transport for dialysis patients or senior transportation, defining your niche will help you stand out from competitors and address critical local requirements.
5 | Understand Medicaid Delivery Models in North Carolina North Carolina’s Medicaid program, managed by NCDHHS, operates through a managed care system, which includes prepaid health plans (PHPs) that oversee healthcare services, including NEMT. The state uses a brokerage model where brokers handle coordination and payments.
Key aspects of North Carolina’s NEMT landscape include :
NEMT Model: In-House management of regional brokers supported by PHPs to facilitate NEMT services.Operating Authority: NEMT Assurance under the State Medicaid PlanNEMT Expense Classification: Classified as a medical expense within Medicaid.Poverty Rate: About 16% of residents live below the poverty line.Urban Population: Approximately 55% of the population lives in urban areas.Estimated Annual NEMT Expense: Roughly $54.1 million.Estimated Number of Annual NEMT Trips: About 1,916,857 million.Public Transportation Use: Limited outside major cities, increasing the need for NEMT in rural areas.6 | Getting Paid Payment for NEMT services in North Carolina typically flows through PHPs. Here’s how you’ll generally be compensated:
Prepaid Health Plans (PHPs): Contract with PHPs to coordinate and receive payment for services.Fee-for-Service (FFS): Direct reimbursement from Medicaid for covered services.Always follow Medicaid billing guidelines to ensure compliance and prompt payment. For further details, consult NCDHHS or your contracted PHPs.
With a clear understanding of North Carolina’s NEMT market, you’re ready to move forward. Stay tuned for Part 2 , where we’ll guide you through developing a business plan tailored to North Carolina’s regulations and market nuances, or jump ahead in the TOC to continue your journey toward NEMT business success in the Tar Heel State!
Comments
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique. Duis cursus, mi quis viverra ornare, eros dolor interdum nulla, ut commodo diam libero vitae erat. Aenean faucibus nibh et justo cursus id rutrum lorem imperdiet. Nunc ut sem vitae risus tristique posuere.