What Is Microstransit And How Is It Affecting The Future Of NEMT?

Microtransit has been a buzzword in American transportation for several years, but what exactly does it mean? Microtransit is a “demand-responsive” form of transit with multi-person vehicles like minibusses. Essentially, this means that microtransit is a way to transport people that falls somewhere in the middle between on-demand rideshare services like Uber and public transportation operating on a fixed schedule.

While forms of microtransit have been popular in other parts of the world for decades, the concept has gained a lot of traction in America’s public and private sectors more recently. This is mostly because of the ubiquity of cell phones: 95% of people in the US now own a cell phone, and smartphones make up about three-quarters of the phones in use. This has opened up the possibility of new technologies that can make flexible forms of transportation easier to operate.

Why is Microtransit so Important?

Many Americans who don’t own cars struggle with the so-called “first/last mile.” This is the gap between their home, job, or other chosen destination and the nearest public transportation stop. Taxis and rideshare programs can sometimes be used to bridge this distance, but the costs can quickly add up. Walking or cycling can be an option too, but these can be challenging in bad weather or at night, in areas without good sidewalks or bicycle lanes, or for people with special mobility or medical needs. In suburban or rural areas, the distance may simply be too large to make these options realistic.

For people struggling with the “first/last mile” to public transit, life can be negatively impacted in many different ways. Indeed, everything from employability to getting basic needs like groceries and medical care depends on having safe, convenient, and reliable transportation. Microtransit is one way to address this gap by combining the convenience of flexible stops and pick-up times with the potential savings of sharing the vehicle with other people in the same area.

Urban and Rural Microtransit: What are the Differences?

In America, transit systems are typically divided into two categories by policymakers. Population density and existing public transportation infrastructure vary greatly not only between rural and urban areas but in different parts of the country as well. The interesting thing about microtransit is that because of how it’s structured, it can be used across the board. Let’s consider two very different situations: the city of Detroit, Michigan, and Gwinnett County, Georgia.

Detroit was once a thriving metropolitan area, but it entered a period of decline after manufacturing jobs left. This left a large-size city that possesses an extensive public transportation system with a population that is now spread out, struggling with above-average levels of poverty and below-average rates of car ownership. In an attempt to remedy the situation, Detroit is building a program to match its citizens to affordable city-run microtransit using private-sector technology so that people can more easily access existing public transportation and bridge the “first/last mile.” The pilot plan was so innovative that it won first place in the 2017 MicroTransit Accelerator Challenge.      

Gwinnett County, GA is a rural area with a different kind of problem: the population density is too low for a comprehensive public transit system to be feasible. Like other parts of the rural US, people in the area without cars are struggling to get basic needs met because of the potentially large distances between homes, jobs, and other services. The County just completed a different kind of pilot; in this case, they used public transit funds to provide an on-demand minibus system that was completely free of charge within a specific radius of the small town of Snellville. The county is currently studying the data in hopes of rolling out a permanent program in the future.

Microtransit and Non-Emergency Medical Transportation (NEMT)

Why is microtransit an especially important aspect in the field of non-emergency medical transport? People with special mobility needs or medical issues are more likely to be affected by gaps in public transit for several reasons. People with chronic health conditions statistically make less money than their peers and are less likely to own a car--especially those living on fixed incomes like Social Security. More directly, people with special medical or mobility needs may not have the option to walk or bike to and from bus or train stops. Those in wheelchairs or with limited physical mobility may also have trouble negotiating public transportation itself. The problem is so serious that millions of Americans miss or delay medical care every year because of the lack of accessible transportation.

What is NEMT?

Non-emergency transportation (NEMT) can be a public or privately-run vehicle that is retrofitted for people with chronic health or mobility needs who need transportation to and from medical facilities.

Besides being wheelchair-accessible, NEMT vehicle operators can help with medical equipment like oxygen tanks. NEMT is actually a required benefit for Medicaid patients; it has been shown to be an extremely cost-effective way to help increase health outcomes by ensuring that those with chronic health conditions are able to get to medical providers regularly.

In places without NEMT or other forms of microtransit, ambulances sometimes serve as the unplanned “bridge” to services for people with chronic health conditions, a practice that is shockingly expensive; the average ambulance ride is more than $500.

The lack of NEMT services is costing both individuals and taxpayers tremendous amounts of money both directly through ambulance bills and indirectly through poorer health outcomes associated with people missing appointments with providers.        

   Even in cities with great public transportation networks, distances to transit can prove to be prohibitive for those with limited physical mobility. Someone with full mobility may not consider an 8-minute walk up a slight hill with several curbs to be a big deal, but to a person who uses a wheelchair, the same distance could be insurmountable. Unfortunately, even if transit stops are close to the home or destination of people with limited mobility, older transit systems may also have infrastructure that is simply impossible for this population to access. For example, in New York City, only 36 out of 147 subway stations are wheelchair accessible. In one of the cities with the highest utilization of public transit in America, NEMT is still a very real need.

Rural people with medical or mobility needs experience the same overall problems that microtransit is already trying to solve, except the issue is even more complex. Although on-call NEMT services are available in many cities, the same is not true for America’s rural counterparts. Because public transportation services are often funded according to census data, these programs simply may not exist at all. Problems with lack of access are also further magnified because this population, in particular, is less physically mobile and may not be able to afford transportation alternatives like Uber. Additionally, rural people with medical or mobility needs also may have to travel even greater distances to access a medical provider or specialist, adding even more cost to the equation.

Microtransit: the Future of Public Transportation?

   Although there is a demonstrated need in transportation infrastructure for microtransit for both the general public and those with medical or mobility issues, actually executing it successfully has proven difficult and in many cases not profitable. Although we have looked at two relatively successful microtransit pilot programs, most of the media coverage of microtransit has concerned enterprises that have not worked. In particular, there have been several high-profile microtransit companies that have failed in the past few years, namely Chariot and Bridj.

   Case studies and analytical discussions of what went wrong with these companies point to the fact that balancing ridership and convenience with a sustainable operating budget is a complex task. Bridj attempted to do this in Kansas City with a relatively simple concept: for a very affordable cost ($1.50), a ride could be summoned that would be within ten minutes’ walk of both the origin and destination. The vehicles were all compliant with the Americans with Disabilities Act, meaning they were wheelchair-accessible. Although the service seemed convenient and affordable, less than two thousand people used the service in a city of several million. Does this failure mean that microtransit is doomed?

Some analysts and city policy planners say no. Several issues may have come up with Bridj, including a lack of public awareness and problems with how the vehicles were dispatched. Ultimately, microtransit is a service that is clearly needed in both urban and rural areas across the country for the general population and people with medical or mobility needs alike. So if the potential base of ridership already exists, how can public and private providers fulfill their needs successfully? Lessons learned from the failures of startups like Bridj as well as the positive outcomes of pilot programs in several cities point to the same thing. The only way to make microtransit systems meet the public need without bankrupting providers is to use smarter, data-driven dispatch systems to both fully engage the public while incorporating features like intelligent route planning to maximize ridership per mile.