Journal article
Transportation Barriers for Iowa Medicaid-enrolled Adults with and without Non-Emergency Medical Transportation Services
Health affairs scholar, Vol.3(8), qxaf142
08/04/2025
DOI: 10.1093/haschl/qxaf142
PMCID: PMC12359131
PMID: 40831917
Abstract
Introduction
State Medicaid programs must provide transportation to medical appointments through the non-emergency medical transportation (NEMT) benefit. Iowa is one of a few states not required to provide NEMT for adults in their Medicaid expansion program if not medically exempt or under age 21.
Methods
Data from a 2022 survey assessed transportation barriers for three adult Iowa Medicaid groups (N=2,181): 1) expansion without NEMT, 2) expansion with NEMT through medical exemption/age, and 3) traditional Medicaid members. Primary outcomes were transportation-related missed health visits, unmet health care needs, unmet transportation needs, and transportation cost concerns. Logistic regression examined transportation barriers by Medicaid group and sociodemographic and health factors.
Results
Recipients without NEMT reported fewer transportation barriers than recipients with NEMT. For example, 6% of expansion members without NEMT reported transportation-related missed health visits (past 6 months) vs. 15% for expansion members with NEMT, and 11% for traditional Medicaid members. Few Medicaid group differences remained in adjusted models. NEMT benefit impact was limited by low reported awareness and use of the benefit and higher vulnerabilities in NEMT-eligible populations.
Conclusion
Adults in all Medicaid groups could benefit from transportation services, but innovation is needed to determine more effective ways to meet transportation needs.
Details
- Title: Subtitle
- Transportation Barriers for Iowa Medicaid-enrolled Adults with and without Non-Emergency Medical Transportation Services
- Creators
- Kandyce Larson - University of IowaBrooke McInroy - University of IowaPeter Damiano - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health affairs scholar, Vol.3(8), qxaf142
- DOI
- 10.1093/haschl/qxaf142
- PMID
- 40831917
- PMCID
- PMC12359131
- NLM abbreviation
- Health Aff Sch
- ISSN
- 2976-5390
- eISSN
- 2976-5390
- Publisher
- Oxford University Press
- Grant note
- Iowa Department of Health and Human Services: MED-21-008
This research was conducted under contract with the Iowa Department of Health and Human Services (MED-21-008).
- Language
- English
- Electronic publication date
- 07/29/2025
- Date published
- 08/04/2025
- Academic Unit
- Preventive and Community Dentistry; Health Management and Policy; Institute for Public Health Practice, Research and Policy; University College Courses
- Record Identifier
- 9984927087902771
Metrics
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