What is the future of the non-emergency medical transportation industry?

The non-emergency medical transportation (NEMT) industry is entering a period of significant growth and transformation. Driven by demographic trends, policy support, and rapid technological innovation, the NEMT industry is expected to nearly double in size within the next decade. In the United States alone, the market is projected to grow from approximately $6.6 billion in 2023 to $13.4 billion by 2031, with a compound annual growth rate of about 9%. This expansion reflects both rising demand and the increasing recognition of NEMT as an essential component of healthcare delivery.

At the core of this growth is an aging population and a rising number of people livingwith chronic illnesses. These groups rely heavily on regular medical appointments, and without reliable transportation, they are at risk of missing critical care. Additionally, there is a growing demand from hospitals and nursing homes for dependable NEMT providers to assist with discharge transportation. Safe and timely discharges are essential for maintaining patient flow, freeing up beds, and preventing unnecessary extended stays, which can be costly for facilities and stressful for patients. By partnering with NEMT providers, healthcare institutions can ensure patients are transported home or to follow-up care facilities promptly and safely, directly supporting overall operational efficiency and improving patient satisfaction.

By providing accessible and dependable rides, NEMT reduces missed appointments and hospital readmissions - outcomes that align with broader healthcare goals and help improve patient health while reducing system costs. Government programs like Medicaid continue to support NEMT services, and insurers are exploring value-based care models that integrate transportation as a key health determinant. In the coming years, there will be an increased focus on outcomes-based partnerships with health systems and insurers, with reimbursements tied to reliability and patient health results. Ultimately, the future of NEMT is centered on improving patient access, enhancing operational efficiency, and contributing to better healthcare outcomes.

How much money can I make in starting a non-emergency medical transportation business?

The amount of money you can make varies widely depending on your market, business size, and operational strategy. On average, an NEMT business can generate anywhere from $200,000 to over $2 million in annual revenue. Profit margins can range from 10% to 30% with lower margins being earned by working through Medicaid brokers and higher margins being garnered through direct pay contracts with area hospitals, medical centers, nursing facilities, retirement communities, school districts, and more.

For a small operation with one to three vehicles, annual revenue can range from $150,000 to $450,000, depending on the number of trips and the mix of services (ambulatory, wheelchair, or stretcher). Mid-sized businesses operating five to ten vehicles might see $500,000 to $1.5 million in revenue each year. Larger operations with fifteen or more vehicles can exceed $2 million in annual revenue, especially if they secure contracts with hospitals, dialysis centers, and nursing homes.

Several factors drive these revenue numbers. The type of contracts you secure-whether Medicaid, private pay, or direct agreements with facilities—significantly influences your rates and trip volume. Hospitals and nursing homes, for example, increasingly rely on reliable NEMT providers to support patient discharge transportation. Timely discharges are critical for freeing up beds, improving patient flow, and reducing healthcare costs. By establishing these relationships, you can secure steady and higher-paying business that elevates your overall profitability.

Your actual profitability will depend on how efficiently you manage your operations, including driver wages, insurance costs, vehicle maintenance, dispatch systems, and compliance requirements. In studying Joel Davis' material and working directly with him, the goal is always to structure your NEMT business to operate at a minimum 25% profit margin, with a strong focus on reaching and sustaining margins closer to 30% or more. This approach emphasizes disciplined cost control, effective routing and scheduling, and strategic partnerships that ensure consistent, high-quality revenue.

Ultimately, while the financial potential of an NEMT business is substantial, your success will depend on careful planning, ongoing process improvement, and building trusted relationships with healthcare providers. With the right guidance and execution, you can create a business that not only delivers strong profits but also plays a vital role in supporting community health.

What is the difference between Joel's information and strategies versus all of the other online content that is readily available?

What sets Joel Davis' strategies and materials apart from other online content is the depth of real-world experience and operational insight. While much of the information you find online is high-level, generic, and often limited to basic "how to get started" checklists, Joel's approach is rooted in decades of firsthand success building, scaling, and ultimately selling a profitable NEMT business. Rather than simply telling you how to get licensed or purchase a van, he provides in-depth, actionable strategies that address the daily realities and challenges of running a transportation company - from pricing and route optimization to managing brokers and controlling operational costs.

One of the biggest differences is Joel's unwavering focus on profitability. Many online resources concentrate on helping people launch their business but fail to explain how to make it sustainable and truly profitable long term. Joel teaches operators to build their business to operate at a minimum 25% margin, always aiming for 30% or higher. He offers advanced guidance on negotiating better rates, creating efficient dispatching systems, reducing unnecessary expenses, and maximizing vehicle and driver productivity. His teachings ensure you aren't just busy - you're operating a business that generates strong, dependable profits.

Another unique aspect of Joel's material is the emphasis on designing your business to be scalable and potentially sellable. Instead of building a company that is fully dependent on the owner, he shows you how to structure your team, create operational systems, and set up processes that allow you to step back over time. This future-focused mindset enables you to grow beyond a "self-employed" job and move toward a true business that holds tangible value and could eventually be sold or passed down as part of your legacy.

A major strategic differentiator in Joel's approach is the focus on developing direct relationships with hospitals, nursing homes, and other healthcare facilities. Most online guides push operators toward Medicaid brokers, which often means lower rates and thinner margins. Joel, however, emphasizes the importance of securing facility contracts-especially for hospital discharge transportation and standing orders, which are higher paying, more consistent, and less reliant on middlemen. This strategy not only increases revenue and stability but also strengthens your business's position in the market.

While most online content stops at the basics, Joel Davis teaches you how to build, operate, and scale a highly profitable, mission-driven NEMT business. His comprehensive, hands-on strategies, emphasis on margin and growth, and commitment to ethical leadership makes his approach uniquely valuable for anyone serious about long-term success in this industry.

How long does it take to get operational with a new non-emergency medical transportation business?

The timeline for getting your NEMT business fully operational is one of the most important considerations. On average, it typically takes about 3 to 6 months from the initial concept to completing your first paid trip. This timeframe depends on factors such as state regulations, the type of contracts you pursue (Medicaid, private pay, or direct pay facility partnerships), your access to funding, and the time needed to prepare your vehicles and staff. Some states have additional requirements, such as a certificate of need or public convenience and necessity certificate, which can extend this stage if not handled efficiently.

Vehicle acquisition is also of paramount concern because you need to ensure you have the "right vehicles" to properly serve the needs of your clients, families, facilities and staff. This is where working with Joel and his team is critically important because you need to get the right vehicles, equipment, and insurance without overpaying or outright making the wrong purchase!

Recruiting and training drivers and dispatch personnel can take time, especially in a tight labor market. For drivers, training can include wheelchair and stretcher patient handling and transfers, loading and unloading, securing procedures, and customer service standards.

Lastly, marketing your service, cultivating relationships with area hospitals, nursing homes, dialysis centers, various government agencies and strategic partnerships is crucial for creating a steady stream of business. All these relationships and your overall sales process take time to develop and implement effectively.

In working directly with Joel Davis, the focus is building efficiently and longevity. This is strategic planning is so important. Combining speed with thoroughness to avoid common pitfalls is essential to saving you time, money and effort. Joel's approach ensures that your business launches on a solid foundation, ready to operate profitably rather than simply rushing to start as quickly as possible.

With focused effort and proper support, you can realistically expect to have your NEMT business operational in three to six months. However, it's essential to approach each phase carefully to build a business that is not only operational but also positioned for long-term success and profitability.

Can Joel help me in purchasing an existing NEMT business, so I can get started even faster?

Yes, absolutely. In fact, Joel Davis is uniquely qualified to assist you in purchasing an existing NEMT business, and this is one of the areas where his expertise can bring you exceptional value.

Buying an existing NEMT company can be a powerful strategy to accelerate your entry into the market or rapidly expand your current operations. Instead of starting from scratch, you acquire a business that already has vehicles, drivers, contracts, operational systems, and (most importantly) cash flow. However, this path comes with complexities and risks that require careful evaluation.

This is exactly where Joel's real-world experience sets him apart. Unlike general business brokers or advisors who might understand numbers but not the day-to-day challenges of medical transportation, Joel has built, scaled, and sold his own NEMT company and directly assisted an untold number of NEMT providers to do that same across the country. Joel understands not just the financial side of the transaction, but the operational realities that determine whether a business is truly profitable and sustainable after purchase.

Joel can help you analyze and perform due diligence on key elements such as trip volume, payer mix (Medicaid, private pay, facility contracts), vehicle condition, driver retention, compliance history, broker relationships, and profit margins. His goal is not just to help you buy a business but to ensure you buy the right business — one that aligns with your financial goals and long-term growth plans.

Additionally, Joel's strategies emphasize structuring the business to operate at a minimum 25% profit margin, with the aim of moving closer to 30% or higher. He can help you identify immediate opportunities for operational improvements, cost reductions, and revenue growth once the business is acquired.

Moreover, Joel provides guidance on negotiation strategies, deal structuring, and transition planning so that you can step into ownership confidently and maintain continuity with staff and clients.

Joel can assist you in purchasing an existing NEMT business, help you make the right purchase decision to protect your investment, and assist in setting up the more profitable operation possible.