Non-Emergency Medical Transportation and the Iowa Health and Wellness Plan

Serving more than 100,000 Iowans at or above the Federal Poverty Level (FPL), the Iowa Health and Wellness Plan (IHAWP) was implemented in 2014 to expand health coverage for low income individuals through two separate programs: the Iowa Wellness Plan (IHAWP-WP) and the Iowa Marketplace Choice Plan (IHAWP-MPC). Designed to include a benefit structure more like commercial insurance, the IHAWP does not have all of the extensive benefits traditionally associated with Medicaid; in particular, the program does not include the non-emergency medical transportation (NEMT) benefit.

Consistent transportation access to health care can help enhance medical outcomes and lead to cost-savings. While the Code of Federal Regulations requires states make NEMT available to their Medicaid beneficiaries, the provisionof NEMT services and reimbursement methodologies are determined by individual state Medicaid programs. Since the initial year of the IHAWP, a waiver has been approved for the state of Iowa’s responsibility to provide NEMT services for IHAWP members. With continuances of the waiver, the state of Iowa sought to review IHAWP member experiences regarding transportation and access to health care.

In the fall of 2015, the University of Iowa Public Policy Center (PPC) fielded a survey to IHAWP members (no NEMT benefit) and Medicaid members (having an NEMT benefit) to determine if IHAWP members experience more unmet NEMT need than those who have the benefit and whether plan type and/or unmet NEMT need have an effect on obtaining particular health care services.

In this study, researchers analyzed survey data and members’ associated administrative claims experiences and used statistical modeling to predict the likelihood of healthcare utilization. Key findings are presented in this brief, with the full report available on the PPC website.

Bentler, S. E., McInroy, B., Damiano, P., Heeren, T., & Momany, E. Non-Emergency Medical Transportation and the Iowa Health and Wellness Plan. Iowa City, IA:University of Iowa Public Policy Center.