Starting & scaling
Every NEMT company starts the same way: a van, a phone, and a first rider. What separates the ones that get to five vans from the ones that quietly stall at one mostly isn't luck. It's trip sources, systems, and knowing which mistakes to skip.
These are stories and playbooks from operators who've made the jump. One went from zero to five vans in a year. Two came in from real estate and scaled on systems from day one. And alongside the growth stories, the unglamorous parts that decide it: hiring, picking trip sources, and planning your finances so the business actually builds your wealth.
New here? Start with Building a Scalable NEMT Business from Day 1. The rest builds on it.
How to Start a NEMT Business in North Carolina (2026)
North Carolina runs Medicaid rides through two statewide brokers plus a county DSS lane you can bill directly. The licenses, insurance, and enrollment steps.
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How to Start a NEMT Business in Florida (2026)
Florida has no statewide NEMT broker: every Medicaid plan hires its own. The enrollment, licenses, and insurance steps to launch a NEMT company in Florida.
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How to Start a NEMT Business in Texas (2026)
No statewide broker runs Texas Medicaid NEMT: each plan arranges its own rides. Enrollment, licensing, and insurance steps to start a NEMT business in Texas.
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How to Start a NEMT Business in California (2026)
California has no statewide Medicaid NEMT broker. The Medi-Cal enrollment steps, licenses, insurance, and county rules to launch a NEMT company in California.
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How to Start a NEMT Business in Georgia (2026)
Georgia has one statewide Medicaid broker since April 2026: Verida. The licenses, insurance, and enrollment steps to launch a NEMT company in Georgia.
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Building a Scalable NEMT Business from Day 1
Ray and Mac came into NEMT from real estate with tight systems and a private-pay focus. Two vehicles and 45 five-star reviews later, here's how they did it.
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Why Most NEMT Companies Struggle to Scale (And How Duet Fixes It)
Why most NEMT companies struggle to scale, and how better dispatch, operations, and backend systems reduce chaos and support long-term growth.
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Secrets of Sustainable NEMT Growth
Capital Area Transport Service's Eugene Gindin on hiring, trip sourcing, and government contracts — and why 90% of NEMT owners fail (and how to avoid it).
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How to Retire Rich from NEMT
NW Mutual's Daniel Baker and Jason Vanhorn on financial planning for NEMT operators: wealth-building, asset protection, benefits, and diversification.
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From 0 to 5 vans in one year
Gentle Turns owner Paul Muench on launching an NEMT service from scratch and scaling to 5 vans in 12 months — pricing, marketing, and lessons learned.
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Succeed in NEMT services
The Transportation Alliance webinar with Duet cofounders on five key actions to launch or scale a successful NEMT operation across multiple states.
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Filed under other topics, worth reading alongside these.
