# Pennsylvania Study Backs Keeping County-Run MATP Instead of a Statewide NEMT Broker

Canonical URL: https://nemtguide.com/news/pennsylvania-matp-broker-study/ · Updated 2026-09-28

Pennsylvania's Department of Human Services (DHS) published its Medical Assistance Transportation Program (MATP) broker study, dated June 25, 2026. Written with PennDOT and the Department of Aging, it concludes that "the evidence strongly supports continuing MATP under the improved in-house county delivery model rather than implementing a full risk broker system." The study changes no rules, so the county-by-county system stays as it is. You keep contracting with the county, vendor, or transit agency that runs MATP where you drive, and with Modivcare in Philadelphia.

## Why Pennsylvania studied a broker

Act 46 of 2025 (House Bill 749), approved November 12, 2025, added section 443.12(g) and (h) to the Human Services Code. It took effect right away. It told DHS to study using a brokerage model for Medicaid rides and gave it 180 days to deliver the study to the Secretaries of Aging, Human Services, and Transportation and to the chairs and minority chairs of four legislative committees.

The law required five parts:

1. Federal and state laws that control NEMT and other human service transportation
2. How well the current county system works for each human service program
3. Other states' models, how many use brokers, and what brokers did to public transit there
4. The costs and benefits of keeping the county model against moving to a broker, for state and local government
5. The effect on riders, including quality and availability of service

It is the state's third report on the question. Act 19 of 2019 required a similar analysis, published in December 2019, after which the three Secretaries concluded a statewide or regional broker was not in the program's best interest. A February 2022 report tracked improvements to the county model. DHS's statewide broker procurement, RFA 28-18, was cancelled under a legislative mandate, and no statewide or regional broker procurement has been issued since 2018.

## How MATP is run today

MATP gives free rides to medical appointments for Medical Assistance (Medicaid) members who have no other way to get there. The County Assistance Office decides eligibility, and the local MATP administrator verifies it. Rides go by public transit, shared-ride [paratransit](https://nemtguide.com/glossary/paratransit/), or mileage payments to members who have access to a car but cannot pay for fuel, parking, or tolls.

| Model | Counties | Who runs it |
|---|---|---|
| County as sole provider | 8 | The county is the MATP transportation provider |
| County vendor | 38 | A vendor, usually a transit agency, handles both rides and administration |
| County hybrid | 7 | The county shares the work with a vendor, often a subcontracted transit provider |
| DHS direct agreement | 13 | DHS contracts directly with transit agencies under two grant agreements |
| DHS broker | 1 | Philadelphia, which has used a broker since 2005 |

The study notes that Dauphin County was moving from a hybrid model to a DHS direct agreement. See Dauphin County's move to rabbittransit.

For paratransit, members book at least one day and up to 14 days ahead, with same-day rides for certain urgent requests. The pickup window is 15 minutes on either side of the scheduled departure time. A member should not be dropped off or picked up more than an hour before or after the appointment.

## What the study found

| Measure | Figure in the study |
|---|---|
| MATP trips, state fiscal year 2025 (July 2024 to June 2025) | About 4.1 million |
| MATP transportation-only cost, same year | About $133.5 million, an average of $32.65 per trip |
| MATP paratransit spending outside Philadelphia, same year | $64.8 million |
| MATP share of shared-ride trips and fare revenue, outside Allegheny and Philadelphia | About 34% of trips and 30% of fare revenue |
| Federal match today | 50%, because MATP counts as an administrative cost |
| Federal match with a competitively bought broker | An average of 60.2% |
| DHS savings from the higher match | $9.2 million, or $5.1 million net of added administrative costs |
| Possible job losses, estimated by the Pennsylvania Public Transportation Association | Up to 800 |

The $5.1 million net savings leaves out procurement and legal costs, transition and startup costs, and the effect on county budgets. The study says real net savings are likely negligible or even negative.

It gives several reasons to stay with counties:

- **Capitation risk.** A broker paid a fixed capitation rate per member keeps what it does not spend. The study warns that this can lead to stricter trip approvals, tighter schedules, and heavy use of the cheapest rides, and that brokers kept being paid during COVID-19 when few rides ran.
- **Shared rides.** Most counties use shared-ride paratransit for MATP, so Medicaid riders can share vans with riders from senior and disability programs. Pulling MATP trips out could raise fares or cut service for those programs and reduce federal transit formula funds.
- **Other states.** Seven states use only in-house management, 20 use only brokers, and the other 23 and DC use other approaches, often through health plans. Pennsylvania is one of three states that combine in-house programs with a state-contracted broker. States that moved to brokers saw litigation and procurement delays, more complaints and missed appointments, and unstable provider networks, especially in rural areas.
- **Stakeholders.** Feedback from counties, transit agencies, Area Agencies on Aging, and rider advocates was nearly unanimous against a broker. DHS also held listening sessions on March 24 and March 27, 2026.

Modivcare, the Philadelphia broker, was the notable exception. It argued that a statewide broker could work with careful contract design, fair rates for public transit, performance reporting, local partners, and separate rural plans.

## What happens in Philadelphia

Philadelphia keeps its broker model. DHS has tried to rebid the contract several times: RFA 35-21 and RFA 01-23 were cancelled after bid protests, and RFA 06-24 was on hold during litigation when the study was written.

The study compared Modivcare's Philadelphia data for 2023 to 2025 with the 2016 to 2018 period. Complaints averaged about 1.9 per 1,000 trips, up from 1.3. Paratransit rose from 25% to 40% of trips, and public transit fell from 74% to 59%. Average rider satisfaction fell from around 90% to 82%. See our [Modivcare guide](https://nemtguide.com/brokers/modivcare/) to join its network.

## What it means for providers

Nothing in the study changes a rule. It is a report to the three departments and to legislative committee chairs. Outside Philadelphia, MATP work still comes through local contracts:

- **One county at a time.** Each county, its vendor, or a transit agency under a DHS agreement decides who gives MATP rides. The study notes that MATP administrators can add their own contract requirements for transportation providers.
- **Long trips are the known gap.** Health systems have moved care into large central campuses, and some rural counties lack specialists, so more riders need out-of-county trips. For those, the provider and the MATP administrator may need to negotiate a premium trip rate.
- **Records.** Under 55 Pa. Code 2070.24, counties and their prime contractors keep client files, trip logs, and other MATP records for four years from the end of the fiscal year in which transportation activities end, and longer while an audit or appeal is open. The county may require you to hand over records or to ask in writing before you destroy client records.
- **New standards are coming.** DHS and PennDOT are rewriting the MATP Standards and Guidelines to set more statewide rules, and PennDOT now reviews MATP policy changes before they take effect.

## What providers should do now

1. **Find who runs MATP in your county.** It may be the county, a vendor, or a transit agency. Our [Pennsylvania guide](https://nemtguide.com/states/pennsylvania/) lists the multi-county agencies and explains Public Utility Commission authority and subcontracts.
2. **Ask about long-distance and out-of-county trips.** The study names these as the hardest rides for counties to cover.
3. **Know the service rules.** Plan around the 15-minute pickup window and the one-hour limit before and after appointments.
4. **Keep your trip logs and ask before you destroy them.** Every MATP model is subject to reviews and audits by DHS, the Auditor General, and federal auditors, and your county answers for the records.
5. **Watch for the new MATP Standards and Guidelines.** The rewrite is meant to set more standards that apply in every county.
6. **In Philadelphia, apply to Modivcare.** It held the MATP contract there as of the June 2026 study, with the rebid on hold.

For how Pennsylvania's mix of county programs and one broker compares with other states, see how states run NEMT. If you are ready to bid on a transit agency's work, see our rabbittransit guide.