Brokered Vs Direct NEMT: What Healthcare Systems Should Know
- Suncore Transport
- Jul 17
- 4 min read
Updated: Aug 9
Non-Emergency Medical Transportation (NEMT) plays a critical role in ensuring patients reach essential appointments — especially those with mobility challenges or no access to reliable transportation. But healthcare organizations face an important choice:
Do you partner with a transportation broker like Modivcare, Alivi, or MTM — or contract directly with a local NEMT provider?
More hospitals, clinics, and health networks are rethinking brokered NEMT due to concerns about reliability, accountability, and patient experience. This article explores why.
🔄 What Is a NEMT Broker — and What Are the Trade-Offs?
A NEMT broker is a third-party administrator hired to coordinate transportation on behalf of Medicaid programs, managed care plans, or healthcare facilities. Brokers like Modivcare, Medical Transportation Management (MTM), Alivi Health, SafeRide Health, and Veyo do not operate their own vehicles. Instead, they subcontract trips to external transportation companies.
This model is designed to lower costs by pooling a large network of providers who compete for trip assignments. While this may benefit insurers seeking scale, it often leads to:
Inconsistent driver quality
Trip assignments driven by price, not reliability
Limited accountability when issues arise
Delays caused by third-party handoffs
In short: cheaper doesn’t always mean better — especially when patient care is on the line.
🚘 What Is a Direct NEMT Provider?
A direct NEMT provider like Suncore Transport operates its own fleet, employs its own drivers, and manages each trip in-house. There’s no middleman. No subcontracting. Just one accountable team.
Direct providers handle:
Driver hiring, training, and safety compliance
Real-time dispatch and routing
ADA-compliant vehicles (wheelchair, stretcher, ambulatory)
On-time performance and trip fulfillment
A consistent patient experience from start to finish
This model prioritizes service quality, communication, and reliability — especially for facilities that need trusted managed transportation partners for recurring trips, complex transport needs, or timely discharges.
🔍 Where Brokers Often Fall Short
1. 🚫 Missed Trips and Late Arrivals
Broker networks rely on third-party vendors who may decline unprofitable trips — which can result in missed rides.
Direct providers manage their own fleets, improving reliability and completion rates.
2. 📞 Lack of Real-Time Communication
With brokers, facilities often work through call centers with no direct access to drivers or dispatchers.
Direct providers offer local dispatch and live updates — no layers, no delays.
3. 🧑⚕️ Inconsistent Patient Experience
Brokered rides can involve different companies or drivers every time, making consistent care difficult. Direct providers deliver familiar drivers and reliable service that builds trust.
4. 🦽 Limited Specialized Transport
Brokers must locate third-party vendors for wheelchair or stretcher rides — sometimes with little notice.
Direct providers maintain in-house ADA fleets ready for complex needs.
🧠 Broker vs. Direct NEMT: Key Comparison
When comparing brokered NEMT models (like Modivcare, Alivi, or MTM) to direct providers, the differences boil down to control, consistency, and quality.
Brokers often assign trips based on price, not performance — leading to variable service. Communication is routed through national call centers, making it hard to respond quickly.
Accountability is spread across subcontractors and admin layers, and ride completion can fluctuate depending on which vendor accepts the trip. Special transports are often outsourced, which can limit availability. And with a rotating pool of drivers, patients rarely see the same face twice. Pricing is frequently layered and hard to interpret.
In contrast, direct providers manage every aspect in-house. Trips are dispatched locally, communication is immediate, and a single point of contact oversees each ride. Vehicles for specialized care are owned and maintained internally, while patients benefit from consistent drivers and transparent pricing — often flat-rate or clearly mileage-based.
🗣️ What Facilities Are Saying
“We experienced too many delays and no-shows with a brokered setup. After switching to a direct provider, our patients are getting picked up on time, every time.”— Clinic Director, Central Florida
“There was no one to talk to when a driver didn’t show. Now, we speak directly with dispatch and get real-time updates. It’s a night-and-day difference.”— Hospital Case Manager, Florida
⚠️ When Is a Broker Right for You?
Brokers may suit large-scale Medicaid programs that require coverage across multiple states and focus on cost control. But for clinics, hospitals, and managed care organizations that prioritize accountability, reliability, and communication — the broker model often creates unnecessary risks.
✅ When to Choose a Direct NEMT Provider
Direct NEMT providers are often the better choice for:
Clinics and hospitals with repeat or high-need transport
Facilities that require wheelchair or stretcher access
Health systems frustrated by missed rides or lack of visibility
Organizations looking for a trusted, responsive transportation partner
📣 Final Thoughts: Is It Time to Cut Out the Middleman?
While brokers like Modivcare, Alivi, and MTM are built for scale and efficiency, their model can create delays, miscommunication, and fragmented care. Direct NEMT providers offer hands-on service, real-time communication, and a patient-first approach that many facilities are now seeking.
🚐 Ready to Make the Switch?
We work with hospitals, clinics, and managed care organizations to provide safe, professional, ADA-compliant transportation — with no broker in the middle.
👉 Contact us today to explore direct NEMT solutions built around your patients — not pricing algorithms.
