Adapting the traditional transhipment model to optimize state regional non-emergency medical transportation requirements under conditions of over-constrained routes

The North Carolina Department of Transportation (NCDOT) is the agency responsible for managing non-emergency medical transportation resources. Resource allocation is independent and inconsistent, and the costing model is complicated, confusing, and rarely used. To identify redundancies and inefficiencies, the State Legislature directed that the current system be studied and recommendations to include developing working models be made. Although a traveling salesman transportation model should be adequate, the mountainous terrain and limited routes are restricted to a northern, eastern, southern, and western corridor. Data were collected from participating county dispatchers for twelve weeks. Analysis determined that a variant of the transshipment model, a cooperative pick-up and shuttle, for the western corridor was the most appropriate. From these results, a model that coordinates transportation along all four corridors was developed. This model reduced inefficient use of scarce resources and saved, on the average, over $4,000 per county. Thus an annual savings of over $225,000 could be realized in the catchment area. As a result of this study, the state has been divided into six regions for further model development and analysis.