A friend of mine recently had an aging relative that needed dialysis treatment, and had horror stories of all the different NEMT services available in this industry. I believe I have a solution to that problem that incorporates providing out of work people an opportunity, and heavily relying on the unemployed Veterans of the country. I believe there is a huge void in this industry based upon the research I have done. It seems that companies that get funded through Medical seem to desire a revenue stream, instead of truly caring about the individuals they service. If anyone can chime in and give some direction/advice/feedback, I sure would appreciate it.

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CK, you're quite welcome.

Perhaps you can think of this venture as a military op, with patients being wounded soliders who need transport from one base to another, but not on a critical basis So how you would schedule the transport planes, monitor the pickup and delivery, work in maintenance time, find constructive uses for downtime so the assets aren't sitting idle?

And how do you schedule the personnel, after training for transporting noncritical patients? What kind of person would handle this in the military?
Identify those skill sets, perhaps contact whatever organizations/associations help former and ex-military find jobs.

There was recently a large job fair just for ex and former military members. I don't remember who held it but I'll post back or PM you if I can find the information. That might be a recruiting source.

I think military scheduling has got to be one of the most complex tasks in existence, so your training should hold you in good stead, and I'm guessing that with your military and transit background, you can come up with some viable plans as well as test markets, perhaps based on demographics.

I don't know if there are any professional associations of companies that do this commercially, but if so, I'd join one. And as you say, research is a major component.

I'd be interesting in knowing what you eventually decide to do - it's always inspiring to read of someone who's ready to tackle a new venture.

And best wishes and good luck!

To Gardenartist

Wow! Thanks so much for the insight. You included so much valuable information. A lot to think about, that is for sure. I need to find a talented operations manager to run this business. I do not even know where to begin to look. Research is the biggest investment with this business ;-/

Here are my thoughts:

Existing NEMT Options:

Sizeable public transit companies may have point to point service a/k/a dial-a-ride, small bus, etc. These are small, adaptive device equipped buses with capacity to mechanically lift and secure wheelchairs while the patient remains in the wheelchair.

Rides need to be pre-arranged, but in my area are reasonable at $1.00 per ride. The limitation, again in my area, is that the destination range is limited to w/i 10 miles of the pickup point.

Taxicabs, with obviously no adaptive device accommodation, are tolerable for use by someone who doesn’t need that assistance.

Private carriers, charge around $40 (again, in my area) one way. The drawback is if the destination is a medical facility, including for surgery, the driver and vehicle wait at that facility and that time is charged at a lesser rate but is incorporated into the total. Thus it could easily cost over $100 oneo way for this kind of transport. The only advantages are (1) no range limitation and (2) they’re available. The prohibitive cost, however, renders these options much less than desirable.


I would add a marketing focus toward individual consumers in addition to commercial facilities. It’s the spouse, adult children and/or other family or friends that generally make these kinds of point to point transit arrangements.

To reach private users, I would include renting a booth at the Area Agency on Aging semi-annual expos and local community expos. EG., the AAA alternates between the East and West side of the SE Michigan area for its annual caregiver expos. To get an example of other vendors (which include would-be competitors, see:

Senior centers of local communities have much smaller but equally effective expos, albeit lacking the space for NEMT transit vehicles as demonstration factors.

In my experience, some areas such as older communities with renovated historic districts may focus more on a different mix of vendors as opposed to those with a more amalgamated population. One expo included a variety of natural product, spa and therapeutic oils vendors. At one point the browsing was held in abeyance while the lights were dimmed and one vendor used the entire visiting group as a demonstration for meditation.

Other expos are more focused on discount dental options, facilities, and things that are more meaningful to a more centralized median income population.

You mentioned elderly centers. I assume you mean senior centers? They’re also good sources to leave cards, as some of them will respond to requests for information on companies that cater to seniors. Others won’t get in the position of providing any information, as it is to close to a “recommendation.”

I personally think the target sources should be individuals, and these expos are ways to reach them. Advertising in AARP Bulletin and magazine as well as the AAA 1-B’s publication “Access (I think that’s the name)” are potential other sources. Personally, I think ARRP sucks, but some people do read its ads.

Retirement communities are another option. There might be more predictable trips from these sources.

Goodies: Seniors love treats. It wouldn’t hurt to hire a local person or crafty Veteran to make shopping bags with your company’s logo, an American flag, and a Veteran owned design or logo. Get decent ones, though; the usual ones are made cheaply, and don’t hold canned goods well.

For 10 or so rides, give one to a customer and add some treats such as fresh fruit or something healthy for a senior. Believe me, they might not remember you but they’ll remember the company that gave them a freebie.

And providing something healthy is a lot different and not tacky such as giving out lollipops or Tootsie Rolls.

Service Area, and Underserved vs. Saturated Markets

If you search this website and read past posts on locating transportation, you’ll find questions and answers that are fairly similar, reflecting what you might encounter in direct marketing to potential clients. Most seem to be outside of or close to major population centers.

But an important issue I think would be market saturation vs. underserved markets. With the former, you’d be entering an already existing market.

With the latter, you might have more of a chance to create your own market, as well as provide a needed service. I think the problem with this though is that sometimes these underserved markets are rural, and the number of health facilities is limited. So the opportunities might be as limited as well.

Senior centers, assisted/independent living and possibly other facilities may have (contractual?) arrangements with transit companies/agencies. I’ve seen small buses outside one of the local senior centers, and have also seen vans with logos for one of the large assisted living companies in the area. Whether those vans provided point to point individualized service is unknown.


You mentioned an employment agency would vet the staff. What about training for the drivers? Not everyone knows how to handle wheelchairs. I once saw a NEMT vehicle driver taking a patient in a wheelchair down, FORWARD FACING, on a ramp. I did stick around long enough to see if the person fell out (hoping that wouldn't happen) in the event any assistance was needed. But obviously that company would never get my business.


You might consider discount pricing for multiple trips, especially for someone who sees specific doctors regularly, or someone who needs dialysis. Even a few dollars off a ride might be an incentive, as these people are very often on SS only and struggling just to get by.


I would definitely list your services with Veterans groups. Earlier this year I was looking for someone to provide lawn care services, and I wanted a Veteran. I found no one; couldn’t even find lawn service or lawn care in the lists of the organizations I checked. Eventually I lucked with a referral from a senior center and found a man whose wife was a Veteran, and hired them.

I would also add something on your vehicles to reflect that your company is Veteran owned, and (hopefully) Veteran staffed.

Hope this helps. If you have more specific questions or I missed anything, please feel free to post again or PM me directly.

Well, I had a lot of thoughts and suggestions and just lost them all in cyberspace. I'll be back after I go searching for them in a NEMT starship.

It would be all self funded, and we have an employment agency that has agreed to vet the drivers, and confirm all necessary background requirements, fingerprint, EMT, BLS, etc.

I am a 91B (Veteran), Army combat medic, that is how I came up with the idea ;-)

I am a little prejudice as well, lol. I will need no outside funding. If there is a need for the model, I will self fund it.

I posted this discussion to see if the peers of the industry felt the same way about the existing infrastructure, and if so, launching the business will be effortless due to the other industries I currently participate in, e.g. travel, logistics, automobiles, etc.

All of the start up costs will be funded by me.

Marketing would be to all the clinics, hospitals, elderly centers, etc that have an immediate need for a superior service at a similar price point. I plan on spending more money on outside sales reps than I do traditional marketing. I think building those relationships with people that care about delivering a superior product, will create long lasting account retention.


Let's start with the funding aspect. Where would the funds come from to train the unemployed people, and who would provide the training?

Veterans, especially medics, would be ideal candidates. There already are a number of Veteran employment opportunities undertaken by corporations, and if I'm reading correctly the VA updates I get, it also has plans for the unemployed Veterans.

In my opinion, this should be a higher priority than the general unemployed. Am I prejudiced? Yes, I suppose so.

If you're really serious about undertaking action, I'd research the entire scope of the field, including and especially Medicare and various supplemental plan funding. Contact veterans organizations to ask for their input and suggestions.

In order to implement changes, you need to have a very extensive grasp of what exists, what the competition is, what the start-up capital as well as operating costs would be, etc.

But there already are a number of NEMT options; some of them are good, but very expensive. Given the need for a vehicle fleet, insurance, assistive equipment for the vehicle, how would you propose to fund these kinds of start-up costs?

How would you propose marketing the service? How will you fund that marketing outreach?

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