Transportation is not a nice-to-have in healthcare. For millions of Medicaid members, it is the difference between receiving care and going without it. Yet for decades, Non-Emergency Medical Transportation (NEMT) has been a behind-the-scenes back-office process: fragmented, broker-dependent, and starved of technology and financial accountability.
That needs to change. And in states like New Mexico, it already is.
At a recent webinar hosted in partnership with the Medicaid Health Plans of America (MHPA), Kinetik founder and CEO Sufian Chowdhury joined Rebecca Geist, National Director of Government Programs at Kaiser Permanente, and Drew Peterson, CEO of UnitedHealthcare New Mexico Community and State, for a candid conversation about what it takes to modernize NEMT and why the stakes are so high.
The problem is structural, not surface-level
NEMT's dysfunction is the predictable outcome of a system with deeply misaligned incentives. In traditional models, health plans delegate the transportation program management to third-party brokers. This creates limited visibility into operations, delayed data access, and challenges aligning incentives across plans, brokers and transportation providers. The result is inconsistent service quality, limited provider stability, and poor member experiences. The downstream consequences are staggering. According to CMS data shared during the session: adults with disabilities are three times more likely to miss care due to transportation issues, 25% of missed clinic appointments are tied to chronic transportation problems, and in 2023, 21% of U.S. adults went without needed medical care because they couldn't get a ride.
These are not edge cases. For states like New Mexico, where 40% of the population is on Medicaid, 31 of 33 counties are rural or frontier, and expectant mothers may travel up to 90 miles to reach prenatal care — they are everyday realities.
What modernization actually looks like
Modernizing starts with a simple premise: you can't fix what you can't see. NEMT has historically lacked the data infrastructure needed to make good decisions. Without clean, reliable data flowing across the ecosystem, meaningful analysis is impossible.
The first step is a platform that connects every stakeholder in the transportation ecosystem: health plans, transport companies, drivers, and members into a single, closed-loop infrastructure. Rather than replacing existing dispatch systems, Kinetik’s platform integrates with them, meeting transport providers where they are. Kinetik builds the connections that allow real-time trip management, automated reassignment, and end-to-end visibility.
For health plans, this creates the ability to bring NEMT management in-house without rebuilding from scratch. Plans can use their existing contact centers, extend member touchpoints beyond transportation, and finally see what's actually happening with their NEMT dollars in real time, not in a monthly encounter report, but as it unfolds.
For plans that prefer not to operate transportation directly, the same infrastructure also supports a fully delegated model—where Kinetik manages day-to-day operations end-to-end while the health plan retains full visibility, governance, and control. This ensures execution can be outsourced without reverting to the black-box limitations of traditional broker models.
New Mexico: A view of what's possible
When UnitedHealthcare (UHC) entered the New Mexico Medicaid market in 2022, the UHC team listened to Medicaid members across the state before they bid. What they heard was unmistakable.
Transportation was a recurring theme in member feedback. Members reported missed rides, unreliable service, and in some cases, having to walk long distances (such as a mile down dirt roads) just to access a pickup location. Since working with Kinetik, UHC NM has achieved the following:
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Performance metrics in the 97th to 99th percentile on state reporting for on-time delivery and missed rides with zero penalties from the state Medicaid authority
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Extended transportation access to dual-eligible members
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Expanded the benefit to include up to three additional riders (so a parent can bring their children, or a spouse can accompany a partner to an important appointment)
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Actively using transportation data to help members access care closer to home
The last point is worth unpacking. Peterson shared an example of a member traveling 100 miles to see a specialist when one was available 20 or 30 miles away. Because the plan could see that pattern in the data, they were able to reach out, offer a better option. In many cases, the member simply hadn't known a closer provider existed. The result is a transportation benefit that functions not as a logistics operation, but as an extension of care coordination.
The benefits extend to transportation providers as well. Small transportation businesses, who are the backbone of the NEMT network in rural states, need predictability. They need to know the ride volume to ensure adequate staffing and trust that payment will arrive reliably and on schedule. When that foundation is in place, those businesses become loyal partners. They invest in quality, show up consistently and the entire network becomes more effective.
Fraud, waste, and abuse: Prevention beats detection
Leading health plans are moving away from retrospective auditing toward continuous, real-time program monitoring — catching anomalies before they become patterns and addressing issues before they result in financial or compliance exposure.
This shift is only possible with the right infrastructure. In Kinetik’s closed-loop ecosystem, booking data, trip verification, and billing are fully integrated. The information used to authorize a trip is the same information that generates the claim, leaving no gap for manipulation. If a member is being routed to a pharmacy 50 miles away when one exists two miles from their home, the system flags it. If a transportation provider’s route deviates meaningfully from a member’s actual location, it’s visible immediately. Since launch, Kinetik's platform has processed over $1 billion in claims with this model in place.
Why plans should ask hard questions now
For health plan executives and state Medicaid directors evaluating their current NEMT programs, Chowdhury and Peterson offered direct advice.
Peterson's top recommendation: What data are you actually getting from your transportation partner, and how fast can you get it?
He cautioned that some vendors present a polished digital front while operating on spreadsheets behind the scenes. The gap between claiming to be digital and truly operating in real time is significant and worth pressing on.
Chowdhury's message was more pointed. NEMT has been treated as a low-priority program for too long. Until plan executives make transportation a strategic priority, the market won't change. Drivers won't be paid fairly, transport companies won't invest in quality, and members will keep getting stranded. Chowdhury acknowledged that change brings discomfort, but encouraged decision-makers to lean on the data and the track record of a proven partner rather than staying anchored to a model that isn't working.
Transportation as infrastructure for health equity
Perhaps the most important reframe from this conversation is this: NEMT is not a transportation problem. It is a health equity problem.
In New Mexico, Kinetik has worked with UnitedHealthcare to bring Native American transportation providers from Pueblo reservations into the network, matching drivers already traveling to Albuquerque with members who need that same route to a doctor. In communities where members once sat outside a library to update their pacemaker software because they had no internet access at home, grants tied to transportation data have helped bring WiFi directly to those households.
These examples point to what becomes possible when the infrastructure is right: data flows cleanly, incentives align, and the people delivering care and transportation are treated as partners rather than commodity vendors.
When done well, NEMT is an on-ramp to health. It reduces missed appointments, connects members to the right provider, extends care coordination, and gives health plans a meaningful touchpoint with their most vulnerable members. The technology exists. The model has been proven. The question for plans and states is whether transportation will remain a line item to minimize or finally become the strategic lever it has always had the potential to be.
