Georgia: A High-Potential Market for Non-Emergency Transport

Georgia is rapidly becoming one of the most attractive states for launching or expanding a Non-Emergency Medical Transportation (NEMT) business. With 15.6% of residents aged 65+ and projections showing that by 2030 one in five Georgians will be over 60, demand for transportation to dialysis centers, rehab facilities, and follow-up appointments is guaranteed to rise. Rural areas, where public transit options are limited, will be especially reliant on dependable NEMT providers. 

Unlike many states, Georgia allows NEMT providers to perform ambulatory, wheelchair, and stretcher transports under the NEMT model. This is a critical distinction because stretcher trips are often restricted to licensed ambulance operators elsewhere. By including stretcher transports, Georgia greatly expands the revenue potential for NEMT businesses.

Ambulatory and wheelchair trips form the foundation of most operators’ work but typically yield slimmer margins due to lower reimbursement and heavy competition. Stretcher transports, by contrast, command higher rates because they require specialized equipment, additional staff training, and enhanced safety procedures. Providers who invest in stretcher-capable vehicles and trained attendants can diversify their service lines, balance high-volume rides with high-margin trips, and position themselves as indispensable to hospitals and skilled nursing facilities.

Georgia hospitals and emergency rooms struggle with bed blocking when patients are medically cleared but cannot be discharged due to lack of transportation. Skilled nursing facilities, rehab hospitals, and long-term acute care providers face the same challenge. Many residents are non-ambulatory yet do not require ambulance care, making stretcher-capable NEMT providers a vital resource for discharges and transfers.

The state’s broker-based Medicaid system, divided into five regions (North, Atlanta, Central, East, and Southwest), provides coverage for both urban and rural areas. Still, gaps remain—particularly for real-time discharges. Increasingly, hospitals and long-term care facilities are contracting directly with NEMT providers to guarantee timely transport and reduce discharge delays. For entrepreneurs, these direct-pay agreements often yield higher reimbursement rates and more predictable cash flow than relying solely on broker trips.

Beyond Medicaid, Georgia’s private-pay market is expanding. Families, senior living communities, and managed care organizations are actively seeking reliable transportation partners. In metro areas like Atlanta, traffic congestion makes timeliness critical, while rural counties present opportunities where no alternatives exist. Providers who market directly to hospitals, dialysis centers, and senior care administrators can capture steady recurring revenue and higher ROI. 

•  Nursing & Skilled Nursing Facilities (SNFs): ~350–360 statewide, serving 40,000+ residents.
   
• Assisted Living Facilities (ALFs): 680–874 facilities, depending on source.
   
• Personal Care Homes & Other Senior Care: ~2,910 licensed facilities serving ~55,000 residents.
   
• Hospitals: ~182 facilities statewide, including 102 acute care, 30 critical access, and 25 specialty hospitals.
   

This extensive network underscores the consistent, year-round demand for NEMT services, from high-volume dialysis trips to facility discharges and inter-facility transfers.

Georgia combines an aging population, Medicaid and broker-based demand, and one of the most favorable regulatory environments for stretcher transport in the nation. Providers who invest in stretcher-capable fleets, staff training, and compliance systems can secure premium contracts with hospitals and long-term care facilities while balancing volume with high-margin trips.

Entrepreneurs who follow Joel’s strategies, building private-pay relationships, targeting facility contracts, and expanding beyond Medicaid broker work, are best positioned to scale independently and achieve higher ROI. In Georgia, a well-structured NEMT company can meet an urgent healthcare need while building a profitable, resilient business.