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Racial and Ethnic Disparities in Access to the Medicaid Transportation Benefit and Implications for Patient Outcomes

Award Number: R01MD018178
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/25/2023
PERIOD OF PERFORMANCE END DATE: 10/31/2027

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Racial and Ethnic Disparities in Access to the Medicaid Transportation Benefit and Implications for Patient Outcomes - ABSTRACT Racial/ethnic minority populations in the United States face pervasive disparities in health care access, utilization, and outcomes. Access to transportation is an important factor that has the potential to affect access to care. Past work has found that improved transportation has significant impacts on both health care utilization and outcomes. Little is known, however, about the extent to which the Medicaid non-emergency medical transportation (NEMT) benefit is associated with racial/ethnic disparities in health care access and outcomes. The long-term goal of the proposed research is to determine how transportation services and related policy are related to health care disparities in the United States and can be used to improve access to care. The overall objective of this project is to provide evidence for state and federal policymakers on who uses the NEMT benefit, how use and disparities in use correlate with state-level NEMT program design, how eligibility and use correlate with patient outcomes, and how to ensure meaningful transportation to access care. The central hypothesis is that use of the NEMT benefit, and the association between use and health care access and outcomes, vary substantially by race/ethnicity and across beneficiary populations, as a function of discrete features of states’ NEMT policies and administrative requirements. These hypotheses will be tested by pursuing three specific aims: (1) examine racial/ethnic disparities in beneficiary-level NEMT utilization across states and assess the correlation between observed disparities and state-level NEMT policies; (2) estimate the association between use of and eligibility for the NEMT benefit and health care access and outcomes, as well as heterogeneity in this association by race/ethnicity; and (3) investigate the process of NEMT benefit administration and use of NEMT to identify potential ways to improve the program. Methodologically, the project will employ rigorous quasi-experimental approaches, including difference-in-differences analyses, as well as semi-structured interviews with Medicaid beneficiaries, health care providers, and transportation providers. The proposed research is innovative, in the applicants’ opinion, because it fills critical gaps on the potential for the NEMT benefit to reduce health care disparities in the United States using quantitative findings from a large, multi-state data source paired with in-depth, qualitative research. It also relies on a multi-stakeholder advisory board composed of Medicaid beneficiaries, policymakers, clinicians, and transportation providers to inform the research design and maximize translation to policy. The project is significant because it will provide actionable guidance for state and federal policymakers on how to optimize the design of the NEMT benefit to improve access to medical care in the United States.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $551,698 )
2026	2026	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	001	3	2/21/2026	NON-COMPETING CONTINUATION	$55,170
2026	2026	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	000	3	1/12/2026	NON-COMPETING CONTINUATION	$496,528
														Subtotal = $551,698

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	001	2	7/21/2025	NON-COMPETING CONTINUATION	$0
2025	2024	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	000	2	3/7/2025	NON-COMPETING CONTINUATION	$0
2025	2024	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	002	2	8/12/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $587,548 )
2024	2024	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	002	2	6/13/2024	NON-COMPETING CONTINUATION	$56,151
2024	2024	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	001	2	2/9/2024	NON-COMPETING CONTINUATION	$505,369
2024	2023	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	000	1	11/29/2023	NEW	$26,028
														Subtotal = $587,548

Issue Date FY: 2023 ( Subtotal = $531,508 )
2023	2023	CORNELL UNIVERSITY	341 PINE TREE RD	ITHACA	NY	14850	TOMPKINS	USA	Minority Health and Health Disparities Research	000	1	8/25/2023	NEW	$531,508
														Subtotal = $531,508

Grand Total All Awards = $1,670,754

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Racial and Ethnic Disparities in Access to the Medicaid Transportation Benefit and Implications for Patient Outcomes

Award Number: R01MD018178

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/25/2023

PERIOD OF PERFORMANCE END DATE: 10/31/2027

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