Your Guide to Choosing the Right Level of NEMT Transportation: Companion Rides vs. Wheelchair Vans

Navigating the world of non-emergency medical transportation (NEMT) can be confusing for healthcare professionals, program administrators, riders and caregivers alike. If you’re looking to navigate this fragmented and hyper regional industry, here a tip: you have options. 

Your decision starts by choosing the right level of transportation and should be based on the needs of the rider. This is simple to understand once you know what you’re looking for and comes with a slew of safety and financial benefits.

The most common types of NEMT transportation are Wheelchair Vans, Companion Rides, and curb-to-curb rideshare/taxi services. These transport types each serve unique needs and play an important role in the NEMT ecosystem. Since rideshare is well known, we’ll focus on the assisted options: Companion Rides and Wheelchair Vans.

So, when should you choose one over the other? The answer depends on a variety of factors, including a rider’s mobility, the level of assistance required, medical equipment, and urgency.

What Are Companion Rides?

Companion Rides are a specialized form of transportation that offer support beyond traditional curb-to-curb transportation. This assisted rideshare service provides Door-Through-Door service and is generally considered a great in-between level of transport for individuals who need a little extra help. Companion Rides are operated by a trained Companion Driver – these individuals offer light physical assistance, can fold/unfold or steady a wheelchair or walker, help riders navigate stairs, the curb or other hazards and ensure a safe transition into or out of a vehicle.

Companion Drivers serve individuals from a number of industries including Paratransit Agencies, Health Systems and PACE Programs. This means that these drivers undergo the routine screening and training to abide by each regulatory body to maintain FTA, CMS, and PACE compliance. The nearly 30 hours of training, conducted by EMT’s, prepares drivers to effectively support riders throughout their journey. 

Similar to traditional rideshare, Companion Rides are conducted using the driver’s personal vehicle, meaning no specialized equipment is provided for this ride type.

Who Are Companion Rides For?

Companion Rides are designed to support:

• Ambulatory Individuals: This means riders who can stand and pivot, but may need a steady arm or assistance with stairs.

• Older Adults: who require extra support with daily acts of living like getting to and from healthcare appointments safely.

• Disabled Individuals: Individuals with mild physical or cognitive impairment who may require light assistance.

• Post-Surgery Patients: For individuals who are ready to be discharged (go home) but can not leave the hospital alone, a Companion Driver is a great resource.

• Healthcare Discharge Scenarios where patients need someone to ensure they safely transition from the facility to home, but can’t drive themselves.

TLDR: If you need light assistance or can stand and pivot from a wheelchair, you’re likely a good fit for a Companion Ride. Companion Rides are a lower cost alternative to a wheelchair van. 

Benefits of Companion Rides

• Door-Through-Door service: Drivers assist with coats, bags, and doors, and ensure the rider is never left alone at drop-off. For medical appointments, Companion Drivers will escort a rider to the first check in desk, but will not go further. 

• Consistent & Comfortable: Companion Drivers are consistently paired with riders based on the language(s) they speak, star ratings, and favorite drivers (noted in the app). This consistency addresses loneliness and builds trust for both riders and drivers. 

• Cost-effective: Companion Rides cost less than a wheelchair van.  

Wheelchair Van Service Overview

Wheelchair vans are modified vehicles that are equipped to transport riders who use wheelchairs or other mobility devices. They include ramps or lifts, tie-downs, and extra space to accommodate wheelchairs safely.

These vehicles are operated by professionally trained drivers who understand how to secure wheelchairs, assist with transfers, and follow ADA compliance protocols. Onward builds networks of wheelchair van providers for our health system, PACE and Paratransit clients. To maintain CMA, PACE, and FTA compliance, these providers must undergo advanced training, similar to Companion Drivers, to join the network. This strict compliance is the cornerstone of Onward’s industry leading safety and quality standards. 

Who Are Wheelchair Vans For?

Wheelchair vans are best suited for:

• Individuals with limited or no mobility who use wheelchairs full-time.

• Patients with post-surgical limitations that prevent them from sitting in standard car seats.

• Riders with chronic conditions requiring specialized seating or access.

• Riders with Electric Wheelchairs or Scooters needing reliable, lift-equipped service.

TLDR: If an individual is unable to stand and pivot, uses an electric wheelchair or scooter, and isn’t confined to a bed or require an ambulance, they are likely a fit for a wheelchair van.

Benefits of Wheelchair Vans

• Full ADA compliance: Vehicles meet regulatory standards for wheelchair accessibility.

• Medical-grade safety: Secure harnesses and restraints ensure safety during transport.

• Perfect for motorized scooters: Motorized wheelchairs and scooters are often heavy and don’t fold into the back of a vehicle easily. Safely securing the wheelchair and rider are both important functions of a wheelchair van operator. Vans can handle larger, motorized wheelchairs or scooters that wouldn’t fit in a standard vehicle.

Key Differences at a GlanceThe Value of an NEMT Ecosystem

In our +20 years operating healthcare transportation, the most important lesson we can share is that it's not a one size fits all job. The healthcare and accessible transportation industries need to be structured like an ecosystem with everyone playing their part. EMS providers, Transit & Paratransit agencies, NEMT providers, rideshare, taxi, and volunteer driver pools all play a critical role in ensuring that our community members have reliable access to safe transportation. 

Unfortunately, the most commonly overlooked part of this ecosystem is NEMT. By building an NEMT network within a larger transportation ecosystem, you can healthcare networks, transit agencies, and senior living communities can:

• Reduce costs

• Improve access to care

• Reduce health system length of stay

• Decrease appointment no-shows

• Increase patient and rider satisfaction

It all works in concert.  

If you’re ready to elevate your transportation strategy, need to build a NEMT provider network or want to ensure that your riders, participants, and patients receive the right ride at the right time, we’re here to help. 

Contact us today to learn how our customized solutions can improve outcomes, reduce delays, and transform your transportation network. Let’s make every ride safe, supportive, and smart.