In the United States, about 2 in every 1,000 people are living with end-stage kidney disease, and 68% of those patients are on dialysis. Most of them go to a dialysis center several days a week for hours to filter their blood outside their body, essentially doing the work that their kidneys can no longer do. This treatment is, quite literally, helping to keep them alive.
Studies have shown that rates of kidney disease are higher for low-income residents and minorities, and that kidney disease can make economic barriers even worse.
One of the most common social determinants of health is transportation insecurity, which is tied closely to economic challenges. A recent study found that nearly 1 in 5 adults in the U.S. struggle with inadequate access to transportation. This is especially pressing for people who must get regular care for chronic conditions, such as dialysis for end-stage kidney disease or chemotherapy treatment for cancer.
So how can the healthcare system better ensure these people can get the care they need? Non-emergency medical transportation (NEMT) is a major resource, but it’s not enough to simply offer transportation benefits for outpatient care: Patients must be able to count on their NEMT provider to get them to their appointments regularly, safely, and on time. Transportation is care.
Non-Emergency Medical Transportation for Chronic Conditions
Non-emergency medical transportation is a federally mandated benefit for people enrolled in Medicaid, including those who qualify for both Medicaid and Medicare and are enrolled in Dual-Eligible Special Needs Plans (D-SNPs). Some Medicare Advantage plans also cover transportation as a supplemental benefit.
Transportation is increasingly recognized for its role in the care continuum, especially for people who are managing chronic conditions and/or require regular critical care. SafeRide Health, one of the nation’s leading NEMT brokers, coordinates nearly 1 million rides every month for members of its health plan partners, and as many as 70% of those rides are to life-sustaining care.
As a provider of NEMT services, SafeRide recognizes the heightened importance of getting patients to dialysis, chemotherapy, substance-abuse treatment, and other critical care. The health and financial costs of failing these patients are substantial.
How On-Time Rates Can Prevent Readmissions, Improve Health Outcomes, and Lower Costs
As healthcare systems increasingly focus on value-based care and health equity, NEMT performance has become a measurable driver of outcomes. Gauging NEMT success means tracking every aspect of the ride process, from booking to ride progress to claims and encounters. In 2025, SafeRide had a 99.3% fulfillment rate, meaning the percentage of completed rides, and a 97.3% on-time rate—performance metrics that exceed typical industry benchmarks.
On-time transportation directly influences appointment adherence, chronic disease management, and total cost of care. When rides are late, it jeopardizes appointments. We’ve all been late for a doctor’s appointment at some point, only to find that we had to reschedule because that provider’s schedule was just too full to squeeze us in. For some appointments, that’s simply an inconvenience. For others, it’s harmful to their health. That’s especially true for people undergoing critical-care treatment such as dialysis or chemotherapy.
Even the use of rideshare to support NEMT has been shown to improve appointment adherence rates. One 2018 study of patients in Philadelphia found that offering rideshare rides to primary care appointments increased the likelihood of attendance by 2.57 times. Since then, NEMT brokers like SafeRide have adopted rideshare options, when authorized by the state, for patients who do not have mobility challenges. SafeRide has gone further in offering health plans the option of on-demand transportation for both rideshare and NEMT providers.
Ensuring that patients make it to their appointments on time, so they don’t need to reschedule, also saves healthcare costs: Kept appointments require fewer provider resources and avoid the risk that someone won’t reschedule, harming efforts to manage their chronic conditions and avoiding costly emergency department visits and avoidable hospital admissions. SafeRide further incorporates cost controls and compliance layers to proactively prevent fraud, waste, and abuse.
Advanced Scheduling for People with Complex Needs
Unfortunately, managing chronic conditions can be complicated, but transportation should be the easiest part of someone’s critical-care journey. SafeRide lets patients schedule their own one-time or recurring rides using the MySafeRide member app or web portal, or caregivers can do it for them. The SafeRide Care Portal enables authorized users at approved provider facilities to schedule rides directly for their patients, bringing transportation further into a patient’s integrated healthcare journey.
The SafeRide platform stores all relevant information about members, including complex mobility needs and multiple chronic conditions, enabling seamless, easy scheduling. For instance, what kind of provider are they seeing? Are they able to walk or do they need a wheelchair? Is their requested ride or series of rides covered under their health plan or subplan benefits? Do they have unique language or cultural needs that a customer service representative or driver needs to know? Is there a specific door drivers should use? These factors and others can mean the difference between a smooth, on-time ride and a late or cancelled ride leading to missed appointments.
SafeRide’s process of integrating human compassion and digital efficiency contributed to a complaint rate of just 0.2% of rides and an average member ride rating of 4.78 out of 5 in 2025. It’s also led to better transportation, better adherence to care, and healthier patients. With all the difficulties of undergoing dialysis and chemotherapy—the discomfort, pain, inconvenience, and cost—transportation should be the least of patients’ worries.