必要而非补充：医疗保险优势计划成员对非紧急医疗转运（NEMT）的使用。
Essential not Supplemental: Medicare Advantage Members' Use of Non-Emergency Medical Transportation (NEMT).
机构信息
Department of Family and Community Medicine, University of California, Davis, Davis, CA, USA.
Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA.
出版信息
J Gen Intern Med. 2023 Dec;38(16):3566-3573. doi: 10.1007/s11606-023-08321-1. Epub 2023 Jul 18.
BACKGROUND
Over five million people in the USA miss or delay medical care because of a lack of transportation. Transportation barriers are especially relevant to Medicare Advantage (MA) health plan enrollees, who are more likely to live with multiple chronic conditions and experience mobility challenges. Non-Emergency Medical Transportation (NEMT) helps to address transportation gaps by providing rides to and from routine medical care (for example, medical appointments, laboratory tests, and pharmacy visits) and has been added as a supplemental benefit to some MA health plans.
OBJECTIVE
We aimed to characterize MA enrollees' experiences with supplemental NEMT benefits.
DESIGN
Qualitative interviews focused on participants' experiences with existing NEMT benefits, transportation, and mobility.
PARTICIPANTS
Twenty-one MA enrollees who used their MA NEMT benefit in 2019 and who remained eligible for ongoing transportation benefits through 2021.
APPROACH
Using purposive sampling from a list of eligible participants, we recruited individuals who used their MA NEMT benefit in 2019 and who remained eligible for benefit-covered transportation services through 2021.
KEY RESULTS
Participants considered NEMT an essential service, particularly because these services helped them decrease social isolation, reduce financial insecurity, and manage their own medical needs. Navigating logistical challenges associated with arranging NEMT services required participants to commit considerable time and energy and limited the effectiveness and reliability of NEMT.
CONCLUSION
Participants described NEMT as a valued service essential to their ability to access health care. They suggested ways to increase service flexibility and reliability that could inform future NEMT policy and practice. As health systems and payers learn how to best address social risks, particularly as the US population ages, our findings underscore the importance of NEMT services and highlight opportunities to advance comprehensive transportation solutions for MA participants.
背景
美国有超过 500 万人因为交通问题而错过或延迟医疗护理。交通障碍尤其与医疗保险优势计划（MA）的参保者有关，他们更有可能同时患有多种慢性病，并面临行动不便的挑战。非紧急医疗转运（NEMT）通过提供往返常规医疗护理（例如医疗预约、实验室检查和药房就诊）的乘车服务来帮助解决交通差距问题，并已作为补充福利添加到一些 MA 健康计划中。
目的
我们旨在描述 MA 参保者对补充 NEMT 福利的体验。
设计
定性访谈侧重于参与者对现有 NEMT 福利、交通和流动性的体验。
参与者
2019 年使用 MA NEMT 福利且在 2021 年仍有资格获得持续交通福利的 21 名 MA 参保者。
方法
通过合格参与者名单进行有针对性的抽样，我们招募了在 2019 年使用 MA NEMT 福利且在 2021 年仍有资格获得福利覆盖的交通服务的个人。
主要结果
参与者认为 NEMT 是一项必不可少的服务，特别是因为这些服务帮助他们减少了社交孤立、降低了财务不安全感并管理了自己的医疗需求。安排 NEMT 服务时遇到的后勤挑战需要参与者投入大量时间和精力，限制了 NEMT 的有效性和可靠性。
结论
参与者将 NEMT 描述为一项至关重要的服务，是他们获得医疗保健的能力所必需的。他们提出了一些方法来提高服务的灵活性和可靠性，这些方法可以为未来的 NEMT 政策和实践提供信息。随着医疗系统和支付方了解如何最好地解决社会风险，特别是随着美国人口老龄化，我们的研究结果强调了 NEMT 服务的重要性，并突出了为 MA 参与者推进全面交通解决方案的机会。
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