Healthcare has spent the last decade digitizing clinical and financial workflows. Transportation is one of the last major functions still operating without true infrastructure—and it is costing health plans more than they realize.
Non-emergency medical transportation (NEMT) exists to solve a critical access problem. Yet in practice, it remains disconnected from the rest of the healthcare system by operating as a fragmented service reliant on call centers, intermediaries, and manual workflows never designed for real-time coordination or oversight. The result is not just inefficiency. It is a structural limitation that prevents plans from delivering consistent access, controlling costs, or ensuring accountability.
Medicaid NEMT supports tens of millions of rides annually (e.g., over 60 million ride-days per year based on federal data).” making transportation one of the most utilized and operationally complex benefits in the program.
Most transportation programs rely on a patchwork of brokers, call centers, and transportation providers. A single trip moves across multiple handoffs between phone calls, spreadsheets, and disconnected systems—before the trip is even scheduled. By the time a trip is completed, the data is often delayed, incomplete, or unverifiable.
This is not a matter of optimization. The model itself is fundamentally reactive.
Health plans lack real-time visibility into whether a trip is on time, delayed, or missed entirely. Issues surface weeks later in reports, long after they have impacted care. And when claims are submitted, plans are often asked to pay for services they cannot independently verify.
Traditional broker-led models reinforce these challenges. They introduce layers of cost, limit transparency, and centralize critical operational data outside of the health plan’s control. Plans are left without a clear sight into one of their most important access levers.
The downstream impact is significant. Patients miss dialysis. Follow-up appointments are delayed. Preventable conditions escalate. For Medicaid populations and rural communities, transportation is often the deciding factor in whether care is accessed at all. Approximately 3.6 million Americans delay or miss care each year due to transportation barriers, and 25% of Medicaid beneficiaries report transportation as a barrier to care. Missed appointments alone cost the U.S. healthcare system an estimated a period. $150 billion annually” with “Missed appointments alone cost the U.S. healthcare system an estimated $150 billion annually.”.
The lack of real-time verification creates systemic exposure to fraud, waste, and abuse. Phantom rides, inflated mileage, and improper billing are predictable outcomes in a system where validation happens after payment rather than during service delivery. Plans are left auditing the past instead of controlling the present.
Healthcare has solved this problem before—just in other parts of the system. Revenue cycle moved from manual claims processing to automated, audit-ready workflows. Clinical data moved from paper charts to interoperable electronic health records. In each case, progress came from treating the function as infrastructure, not a service. Transportation is now at that same inflection point.
A modern approach treats transportation as a closed-loop system of record, where every step of the trip lifecycle is connected, verified, and visible in real time. Trip intake, eligibility validation, provider assignment, trip execution, and claims generation all operate within a single workflow. GPS tracking and geofencing ensure trips occur as authorized. Claims are generated from verified trip data—not submitted independently after the fact.
Instead of asking what happened last month, plans can understand what is happening in real time. Instead of reacting to complaints, they can intervene before issues impact care. Instead of accepting cost as a fixed output, they can actively manage it at the trip level.
The impact is measurable. When transportation is delivered reliably, missed appointments can be reduced by 25–30%. More importantly, transportation consistently demonstrates positive ROI—delivering more than $4 in healthcare savings for every $1 invested.
This shift moves transportation from an outsourced, opaque service to a controllable, measurable component of care delivery with network performance managed in real time. Costs can be attributed and optimized with precision. Program integrity becomes embedded in the workflow, reducing reliance on audits. And members experience a more reliable path to care.
Transportation is often treated as a downstream function, a logistical step after care is planned. In reality, transportation is upstream infrastructure. That determines whether care is accessed, outcomes are achieved, and healthcare investments deliver their intended value.
As the industry moves toward value-based care with measurable outcomes and transparency into how fraud, waste, and abuse is prevented; expectations for transportation will increase. Plans will be asked to prove not just that rides were scheduled, but that care was actually accessed—and that dollars were spent appropriately. That level of accountability is not achievable in a fragmented system.
Until transportation is treated as infrastructure, healthcare will continue to optimize around a constraint it does not control.
About Kinetik: Kinetik is a healthcare technology company that has built the nation’s first digitally integrated healthcare transportation platform connecting members, health plans, health systems, and transportation providers. Our interoperable platform allows for seamless delivery of non-emergency medical transportation services, providing full visibility into the life cycle of each trip for health plans and their members while allowing transportation providers to get paid on time. Key benefits include program transparency, improved access to care, an enhanced member experience, ability to auto-generate timely and accurate claims, and reduction of fraud, waste, and abuse (FWA).
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