Provider. Broker. Software. Morgan has seen the NEMT industry from every angle. This series is your inside scoop into Non-Emergency Medical Transportation: honest answers and actionable advice to help you navigate the chaos and scale your business.
Medicaid trips keep most NEMT companies alive. Facility contracts are what keep them around long-term.
Margins on Medicaid work are thin. They always have been. If you want more predictable revenue and a business that isn’t constantly hanging on by a thread, you must work directly with facilities: nursing homes, assisted living, hospitals, rehab centers, and clinics.
Having multiple contracts makes your business stronger. Once you land one facility, the next ones get easier. Not easy or immediate, but easier.
I started in NEMT back in 2012, and after working with providers, facilities, and brokers, here is the reality: Facilities pick people they trust. They don't pick providers because of pitch decks.
Most people don’t realize this, but many nursing homes and assisted living facilities aren’t a single location. They’re part of a larger company. Administrators talk. Social workers talk. Directors of Nursing talk.
If you do a good job at one facility, your name gets passed around. If you do a bad job, it spreads even faster.
People work with people they like. Some of the best traction I ever got with facilities came from doing something very simple: showing up, being friendly, and feeding people.
I’ve brought donuts. I’ve brought boudin. I’ve shown up with breakfast for the staff I was trying to build relationships with. Not as a sales pitch, just to be human.
A friend of mine who worked almost exclusively with facility clients taught me this rule years ago:
“If you want more business from facilities, feed them.”
He’d cook jambalaya, fry fish, grill steaks. Nothing too fancy, just good food shared with everyone who works there. He figured out early that everyone managing a facility is busy, stressed, and underappreciated. Almost everyone appreciates a free meal. Food gets you conversations.
Different facilities care about different things.
You have to ask questions to find their specific pain point. Maybe their current problem is getting discharges out in less than 3 hours. Maybe they don’t have a nighttime driver. Find the gap and fill it.
You eventually need to talk to the decision-maker—usually the Administrator or Director of Nursing. But the people who actually call you are:
Make friends with them. Find out what problems they are having with their current transportation. Give them your card. They are the ones who will get you in front of the person who signs the contract.
I always get asked about pricing. It’s easy: Know your numbers or you’ll lose before you start.
Before you quote a facility, you need to calculate your true cost per trip:
If it costs you money, it counts. Only after you add it all up should you ask yourself, "What do I need to charge to make money?"
Keep pricing simple. Facilities don’t want complicated math.
Contracts don’t need to be fancy, but they do need to be detailed. One page, no surprises.
Note: Always have a lawyer review it. It is worth the cost to cover you.
Facility contracts don’t happen fast. They can take months, or even years. The key is to be the name they think of when their current provider fails.
Once you win them, you keep them by showing up. Do what you say you will. Make the staff’s life easier.
Be visible. Be memorable. Be reliable. Be human.
If you do that, facilities will keep calling you.
Meet Morgan: The Guy Who’s Sat in Every Chair
- The Provider: Started in the trenches. Started by managing and growing a fleet to become the largest private fleet the state.
- The Broker: He took a 13-van fleet and scaled it into the state's #1 operator for Medicaid brokers. Managed operations for a nationwide NEMT broker, gaining a behind-the-scenes understanding of how trip placement and performance work.
- The Software: Now at MediRoutes, he helps owners improve dispatch and operations using the exact strategies that scaled his own career.