Transportation broker

Definition

A middleman a state may put between Medicaid and the operators, usually paid per member per month.

Why It Matters

Federal rule lets a state run its transport benefit through a broker instead of paying operators directly, and which model a state uses decides what kind of business this is. Under a broker the operator has one customer, a bid cycle, and a price it did not set; without one it bills the program. The same rule bars a broker from running trips itself or sending them to a provider it has a financial tie to, outside narrow exceptions such as a rural area with no other provider, so the obvious consolidation is mostly closed off. Establish the model in the target's own state before pricing anything.