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How to Start a Medical Transportation Business – NEMT Opportunities Author – Steve Sutherland Copyright © 2012

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Free pdf guide explaining how to start up your own non-emergency medical transportation (NEMT) business and some of the opportunities.


Page 1: How to Start a Medical Transportation Business

How to Start a Medical Transportation Business –

NEMT Opportunities

Author – Steve SutherlandCopyright © 2012

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Legal Notice/Disclaimer/Disclosure

Copyright © 2012 Steve Sutherland. All Rights reserved

No part of this publication may be sold, copied, reproduced, stored in a retrieval system or transmitted in any form or by any means including electronic, mechanical, photocopying, recording, scanning, or otherwise without prior written permission from the author.

All trademarks mentioned in this report are the property of their respective owners.

The information contained in this guide represents the opinions of the author. The author has made all reasonable efforts to ensure that the information is correct and up to date. However, it cannot be guaranteed that this is the case and we make no representations or warranties with respect to the completeness or accuracy of the following information. By reading this guide users acknowledge that they cannot hold the author or publisher liable for any losses suffered as a consequence of their actions. This information is intended for educational purposes only and should be used at your own risk.

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1) Introduction – Read This First


My name is Steve Sutherland. I did some research into the non-emergency medical transportation business last year. I still haven't opened a business in the NEMT industry as I ended up going into other areas of business. However, I still think that medical transportation represents an excellent opportunity and I may get in at some point in the near future.

While I was researching this business I took a lot of notes and chatted with a few business owners. The following guide contains the information that I uncovered.

Some of the content in this guide is fairly generic business advice and other parts contain information that is specific to the non-emergency medical transportation business.

If you are looking for more information check out (this site has some awesome information that is quite different from what you will read below).

It can be hard to find good quality information on how to get started as business owners in this industry are usually fairly secretive. Business owners will never let on how good they have it or share information as they fear that newcomers will steal ideas from them.

If you have a desire to start an NEMT business then I strongly encourage you to pursue your dream. Read on and find out how you can join this elite group of entrepreneurs who have achieved the lifestyles and incomes of their dreams by helping people in need to get around on a daily basis.

All the Best

Steve Sutherland

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What is the NEMT Business About?

When people think about business opportunities they usually think of something that everyone else is doing or something with limited market potential. With non-emergency medical transportation you have an opportunity that is still relatively unexploited as well as a huge market with enormous potential for further growth. With the growth in the health care industry, driven mainly by aging baby boomers, medical transportation is the ideal 'recession proof' business model right now and in the coming decades.

A non-emergency medical transportation (NEMT) business, sometimes known as an ambulette service is not to be confused with a regular '911' style ambulance service. The non-emergency sector of the business involves the transportation of the elderly and disabled in non-emergency situations. Typical trips will include runs between residences, hospitals, medical centers and other destinations that will depend on your clients needs and lifestyles. As such, drivers don't require any medical training.

Reasons to Start a Non-Emergency Medical Transportation Company

If you are looking around at business opportunities then you will have discovered that your options are almost endless when it comes to industries and business models. However, not every opportunity is equal. Some are laden with advantages and offer good future potential while others are overly competitive or are in industries that are on the decline. As you continue to do your research we are sure that you will find that non-emergency medical transportation (NEMT) or ambulette service is one of the juicier apples on the tree.

We've put together a list of reasons why we think that a medical transportation company could be your best bet for a business opportunity with solid potential right now and well into the future.

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An Aging Population

There is a booming market for medical transportation right now. In recent years, members of the huge post-war baby boomer generation have started to retire. As people is this age group enter their sixties, seventies and beyond, many of them will require assisted transportation. According to government data, the percentage of the population who are over 65 is set to rise from 12.9% in 2009 to 19% by 2030.

Unlike generations before them, the baby boomers are used to a high standard of living and medical care. So not only is the market growing in terms of size but the average number of journeys per head should also slowly increase as well.

The Growth in the Health Industry

Healthcare is definitely a growth business and should represent more than 20% of GDP by the year 2020. There are many reasons for the growth in health care other than the rise in the number of elderly citizens. Government spending via the Health Care Bill could lead to a rapid rise in the number of hospital visits and thus the number of people requiring transportation to and from hospitals.

A Changing Health Care System

Due to improvements in the quality and efficiency of medical care there has been a trend that is moving away from lengthy stays in hospital and more towards outpatient care. Outpatients don't require overnight stays in hospital but still have to come in regularly for a variety of check ups and treatments. More frequent hospital visits also require more transportation as patients go back and forward between their home and their hospital or medical center.

Income Security

Unlike many other industries, medical transportation is reasonably resilient during economic downturns. Medical care and mobility are essential for most people and they are unlikely to cut back on their spending in these areas, even when the economy is

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slow. Why follow the boom and bust cycles of the economy when you can have a business that brings in consistent profits in any economic climate?

Another great thing about this business is that if you do get contracts with hospitals, medical centers and schools, you are dealing with reliable clients that are unlikely to skip town or refuse to pay your invoice. And if you are getting government money through the Medicaid system then this income is guaranteed.

Home Business Potential

It is possible to start your non-emergency medical transportation business from your own home. You will be going out to meet your clients rather than having them come in to see you so you don't need fancy looking premises. As long as you have space to park your vehicle and a small area to set aside for a home office then you can avoid the expenses and monthly overheads associated with renting a commercial space.

Low Start up Costs

While you can invest hundreds of thousands of dollars in kitting out a modern fleet of medi-vans or ambulettes, you can also opt to start out at a slower pace. It is possible to start out in this business with a second hand van, a mobile phone and a simple home office set up. Start out small and reinvest your profits so that you can slowly improve your fleet and refine your systems without taking on too much risk.

Operational Simplicity

Compared to other business models, a medical transportation company or ambulette business is relatively simple. You just need a system to receive inquiries and schedule and dispatch drivers. You don't need to manage a store front or order and ship inventory. As a service based business you can eliminate a lot of those headaches.

Lack of Competition in Some Areas

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Medical transportation is not a glamorous field to be in and is therefore one of the last business opportunities that most people consider. You will find that excellent NEMT business opportunities exist in certain towns, cities and communities around the US once you do your research.

In some areas people are forced to use a much more expensive regular ambulance service as there are no non-emergency medical transportation companies servicing their area. Non-emergency transportation is usually around 80% cheaper than a regular ambulance. Your service is therefore not a 'hard sell' in cases where your vans are the only alternative to expensive fully equipped and fully staffed ambulances.

Low Barriers to Entry

This business is not to be confused with regular ambulance service. You do not need any medical training in order to transport and assist the elderly and the disabled. Anyone can run a non-emergency medical transportation company or drive such a vehicle without needing a university degree or advanced technical training.

Changing Lives

This is one industry that you can genuinely feel good about being involved in. Many of your clients will lead difficult lives and face challenges that most people can only imagine. By providing them with the transportation that they need to improve the quality of their health and their lives in general you are doing them a great service. You are also doing your community a great service. Once you take the time to get to know some of your clients personally you will really start to see why a medical transportation company can be so rewarding.

The Benefits of Business Ownership

Being a business owner in general comes with lots of advantages. You become the master of your own destiny and can determine how much success you find by the amount of work that you put in. Free yourself from all the constraints of a regular nine to five job such as a boss, a limited salary and a daily commute. Create something that

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you can be proud of instead of working hard to build somebody else's dream. You will also find that there are certain tax advantages that go along with business ownership.

How to Get Started

By now you must be aware of the many compelling reasons why a non-emergency medical transportation business offers entrepreneurs such a great business model. With the growth in the health care industry and the explosion of baby boomer retirees, this market is big and set to get even bigger still.

In this article we look at how to start a non-emergency medical transportation (NEMT) business. Learn about some of the steps that are involved and some of the aspects of this business that you will have to consider.

Franchise or Independent Operator?

There are now several players offering non-emergency medical transportation franchises. Entrepreneurs benefit with the franchise model as they can operate under an established brand and get advice and training to get started and run a business. However, with the franchise fees that must be paid initially and on an ongoing basis, the upside potential for profit is reduced. If you do your homework, you will find that this business is not that difficult and it is possible to start up and thrive independently.

Choosing the Right Area

Give some thought to the demographics of the area where you are setting up your business. Look for statistics that prove that there are a good number of elderly, disabled or Medicaid citizens living nearby. Compile a list of hospitals, dialysis centers, retirement homes, assisted living centers and other relevant operations. You could even make initial contact with some of these organizations and find out about the transportation solutions that they currently have in place.

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Research the Competition

Identify all of the major competitors that you will have in your area and evaluate them in terms of their strengths and weaknesses. You may decide to incorporate parts of their business model into your own business and reject other parts. Learn as much as you can about them by reading their websites and calling their offices to ask questions. You can even spend some time following around some of their vans in order to understand how they work and to find out exactly who their customers are.

Licenses and Permits

Regulations and requirements for medical transportation businesses vary from state to state so you should make inquiries at the local level to find out what your obligations are.

As you are in the business of transporting paying customers from one place to another you will need some kind of permit, just as a taxi driver does. Your application for this kind of license will be handled by transportation authorities at the state or local level. Due to the nature of this work, some states will also require businesses in this industry to be registered with local health authorities.

There may also be other paperwork that needs to be done such as registering your business name, getting a business license (possibly more if you serve multiple counties) and zoning considerations if you run a home business.

Vehicles and Equipment

It is common for medical transportation services to purchase regular vans, either new or used, and then have them fitted out to suit special needs clients. Business owners typically start out with one vehicle and gradually add to their fleet as their business grows.

The best vans for an ambulette have a high raised roof and doorways. Access is usually on the side of the vehicle but can also be at the rear.

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Some operators still use manual lifts to help them get wheelchair passengers into and out of their vans. However, you should be able to provide a faster, more professional service if you have a modern hydraulic lift installed.

Once inside the van, wheelchairs can be fastened to various securing devices so that they don't move around during transit. Vehicles also require customized seat belts for wheelchair bound passengers. You can also improve the quality of your service if you have some comforts like TV and air conditioning.

A decent sized van that is properly kitted out should be able to transport four wheelchair bound passengers at a time as well as have extra seats available for caregivers. Depending on your clients, you may also need a space in your van that will allow you to fit in a passenger that is confined to a stretcher.

Insurance Policies

To protect yourself from unforeseen events you will need to purchase a variety of insurance policies. A general liability insurance policy will ensure that you are covered in situations where your customers are injured or suffer losses while they are in your care. You will also need regular automotive insurance to protect yourself in cases where your vehicles are damaged, stolen or involved in traffic accidents.

Payment Options

Decide on how you want to collect payment for your services. You may have to invoice medical institutions on a monthly basis or you may need to process credit card payments for individual clients. If you service large clients like Medicaid then it may be as simple as receiving a check in the mail each month. Talk to some prospective clients and look at what their needs are. Find out what payment options your competitors are offering.

Service Hours

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Give some thought to your operating hours. The best ambulette services in the market usually offer weekday service from early morning to late at night with decent hours on Saturdays too. As a sole operator you will be limited in the hours that you can take on. As you expand into a multi-driver operation you will be able to offer more flexible scheduling to clients.

Staffing Requirements

If you start out doing all the driving while also managing your business you will quickly get burnt out. In order to grow you need to step back and hire some drivers so that you can move into a purely management and marketing orientated role.

Staff should have a drivers license that allows them to take passengers and they may also be subject to certain standards or requirements at the local level. No matter what you should make sure that your staff are trained on how to do the practical side of the job. They need to know how to assist passengers and their caregivers as they get in and out of vehicles. They should also be instructed to smile and make pleasant conversation if the opportunity arises so that they help your brand to gain a positive reputation.


There are many different ways to market a non-emergency medical transportation business. For some ideas on markets that you can target read our article on Medical Transportation Business Opportunities.

Initially you will have to go out and meet prospective clients and possibly even bid to try and win contracts. However, if your team are doing a good job then you will find that eventually business will come directly to you through word of mouth and referrals.

You can of course improve your chances of getting calls from private paying clients if you do a little advertising. A website that comes up in the search results when people search for ambulette services in your area can really help. A small Yellow Pages listing will also almost certainly be worth the cost. You can pretty much try any method that other local service businesses are using to promote themselves. Vehicle advertising is

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great for exposure and flyers, postcards or door hangers may work as well.

NEMT Business Opportunities

When it comes to starting a non-emergency medical transportation business or ambulette service you need to understand the market. Once you get a better understanding of the market you can then decide if you want to target a particular sector or if you want to provide a more general service.

The market is basically comprised of those who require assisted transportation from one place to another, on a one off, occasional or regular basis. It includes those who are not mobile enough to walk, drive or get in and out of public transport independently. The market does not include those who require emergency medical care and the speed and trained paramedics on board a regular ambulance.

Let's take a closer look at some of the markets that you may consider targeting as you set up and develop your non-emergency medical transportation business (NEMT business). You can then evaluate the potential that each of these opportunities has in your area and decide on which ones you want to go after.

Private Paying Clients

Some businesses in this industry target private paying clients. This kind of client usually pays full price and you can benefit from regular business if you serve them well and take some time to build a relationship. Profit margins with this kind of customer are great. However, you will have to do some marketing to reach them at first until you build up a good reputation and start getting 'word of mouth' referrals.

Medicaid Opportunities

Another great market opportunity to target is Medicaid, a federal program that provides healthcare to those on low incomes, the elderly and disabled. Medicaid also

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provides for these individuals to receive free transportation to and from their medical appointments if necessary.

In some states Medicaid uses regional brokers who determine who is eligible and how they should be transported to and from their appointments. In other states you will have to seek approval from Medicaid directly. Rates will vary so you will have to do a little research in order to find out if it is worth transporting Medicaid clients in your area. However, such an opportunity usually means a good monthly volume of decent paying work as well as checks that come on time like clockwork.

Medical Institutions

Many transportation businesses get contracts directly with hospitals, medical centers, dialysis centers and various other medical institutions. Such relationships can provide you with one off clients who are being discharged from the emergency room or regular clients who have appointments for treatments as often as three times a week.

Retirement Communities and Nursing Homes

Another great market to tap into is retirement homes and assisted living communities. These people who are aged or disable often require transport for medical appointments. They will also often need transport for other purposes such as shopping, recreation or visiting family members.

Opportunities with Schools

Schools often require daily transportation services for disabled students. Such a contract could provide one of your vans with several hours of work every morning and afternoon transporting these children to and from school. They may also require specialized transportation for occasional school field trips.

Workers Compensation

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Many NEMT businesses also provide transportation to those on workers compensation. People who have been injured at work often need transportation to and from medical clinics for checkups and treatments.

Contact workers compensation authorities in your state to find out how you can go about applying to provide medical transportation to recipients of workers compensation. A list of official offices by state can be found here.

Local Health Authorities

Once you business is set up, licensed and in compliance with local regulations you can then submit your details to health authorities in your state. Health authorities often receive requests from individuals or organizations looking for non-emergency medical transportation. If your business is on the list of contacts that is given out in cases where such inquiries are received then you can pick up some easy business without much effort.

How to Name Your Business

When it comes to starting a non-emergency medical transportation business it is important that you choose a suitable name. Many entrepreneurs overlook the importance that a name can play in the development of a brand. The right name can help you to make a great first impression on people in your market and it can help you to build long term relationships and reputation.

Don't make the mistake of leaving this important decision to the last minute like other business owners do. Put some thought into coming up with a great name that will serve your ambulette business well as you develop and grow over the years.

Here are a list of points that you may consider as you go about the process of naming your non-emergency medical transportation business (NEMT business).

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Relevance and Professionalism

A great name should be relevant to what your business does. Rather than having something obscure that leaves people guessing, you may as well use the words 'medical' and 'transportation' in the title. This will immediately communicate to people exactly what it is that you do.

You could even use other words that further define your services. It can be a good idea to avoid getting too specific though as you may change your business model further down the line and cater to a different section of the market.

The qualities that people will look for in a medical transportation business are of course professionalism and reliability. Your name should instill confidence in people and let them know that you are indeed a reliable operation that is committed to running a safe and reliable ambulette service. For this reason, many small business owners use their own surname or first name as a part of their business name.

Be Unique, Original and Memorable

While the word 'transportation' will hardly be unique in the industry you can combine it with other words to create something new and original that will stand out. Take a look at what other local non-emergency medical transportation companies have done with their names and make sure that your name clearly distinguishes your business from theirs.

A great name should be memorable. As well as giving people a good first impression it should be easy enough, and catchy enough so that it stands out in their minds over the long term. Create a list of names and then run them by some of your friends and colleagues to find out which ones have a positive impact on them. Ask them about the names again several days later and see which ones they are able to remember.

Legal Considerations

There are also important legal considerations to think about when it comes to choosing

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a name. You absolutely must ensure that the name that you select is not already in use by another business in the same industry. Run a names search through the database at your county clerks office and do a thorough check online to make sure that your selection will not cause you to encounter legal issues further down the road.

Practical and Functional

Good choices for names will typically be short and practical. A short name is easier to remember and more practical when it comes to using it on business cards or using it to answer the phone. Don't mess around with words that are difficult to spell or pronounce.

You may also consider a name that works well as an acronym. For example, 'Sacramento Transportation Services' could be called STS for short.

Remember that you will want to get a website set up at some point. Before you finalize your choice and register a name for your business you should also snap up any relevant domain names.

Brainstorming for Ideas

To help you come up with some name ideas put a big list of relevant words together. These words could be related to your location, your industry, your market or the services that you offer. You could also come up with words related to reliability and friendliness that describe your service. Emotional sounding words can also have a strong impact.

As well as your own thoughts you can also ask other people for their opinions. Look over some of the names that other medical transportation businesses around the world are using for ideas. Names in use by businesses in the transportation and medical industries may also provide some inspiration.

Some entrepreneurs even hire branding or marketing consultants to help them come up with the right name and brand image before they go into business. It could be a

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good idea to seek professional help if you really feel that you are not up to this important task.

A Name to Be Proud Of

Perhaps most importantly, the owner of the business has to love its name. You ideally need a name that you can feel proud to be associated with. The right choice should inspire you, help you to focus on developing the business and make you want to work hard to grow your brand name.

Once you have started your business it is not easy to backtrack and make changes to your name. if you do so then you will come up against many expenses relating to alterations to paperwork and printed promotional materials. Changing your business name is one of the best ways to confuse and isolate your customers unless the process is carefully managed.

For the above reasons it is essential that you ensure that you have a great name for your non-emergency medical transportation business right from the start. Give this important decision the time and attention that is deserves.

I hope that you enjoyed this short report. For more information check out