From 15 Taxis to 200 Vehicles: Jeremy Scalzi of M7 Ride on Building a Trusted NEMT Fleet

Jeremy Scalzi is Director of Business Development at M7 Ride in Connecticut, Vice Chair of the NEMTAC board and a board member of the Transportation Alliance. He was, in his words, born into the business: his father founded the company in 1987. In this episode he talks with Jeff from Naveera about how a taxi company became a 200-vehicle NEMT and accessible transportation operation, and what he has learned growing it.

From 15 taxis to 200 vehicles

M7 started with 15 taxis in West Haven and has grown to around 200 vehicles statewide, with about 160 drivers. Jeremy came to it by a roundabout route, through tech sales at a fintech company in New York and legal work at a transportation practice, before returning full time during COVID, when most of the fleet sat parked waiting for trips to come back.

The company has done NEMT work through the state Medicaid program since 1988, a year after it was founded. What changed its shape was the arrival of Uber and Lyft. Weekend taxi demand largely disappeared, and state rules on pricing meant M7 could not compete on fare. So it leaned into what it could do that an app could not: it owns its vehicles and trains its drivers from a physical base, which Jeremy argues translates directly to higher-acuity riders who need help getting from a door to a vehicle and back.

Wheelchair-accessible service took longer. Jeremy describes a 12-year effort, from 1997 to 2009, to get legislation passed allowing Connecticut taxi companies to provide it.

Diversify before you have to

M7’s Encompass program, a government-subsidized, low flat fare for seniors and people with disabilities on local trips, was designed around the company’s own data: most trips were short enough to stay inside a rider’s community. It launched during COVID and now runs about 6,000 rides a month across three transit districts. Rural microtransit followed. Jeremy’s rule of thumb, borrowed from someone else: if you see a vehicle with passengers in it that is not yours, you should know how to do that business within a few months.

Not every bet stuck. In 2011 M7 converted a large part of its fleet to compressed natural gas, in side-entry MV-1s that let wheelchair passengers ride up front. The vehicle was discontinued and fueling stations stayed scarce, so the fleet moved off CNG. Electrification, Jeremy says, waits until range makes it practical for drivers.

Service levels are a training problem

Most of M7’s growth, as Jeremy tells it, came from solving problems for the facilities it serves. Curb-to-curb did not fit every hospital or skilled nursing facility, so the company added curb-to-curb with assistance, door-to-door, door-through-door and person-to-person. A nurse on the third floor should be caring for patients, not walking one down to the lobby.

Launching those levels was the hard part, and not because of selling them. A driver who leaves the vehicle and walks a passenger any distance takes on real liability. M7 built its training on NEMTAC guidance for non-invasive assistance, and uses telematics footage to spot-check drivers on more sensitive trips, so a problem is corrected before it becomes a complaint.

Advice for providers at any size

• Starting out: Medicaid transportation is the usual way in, because there is always more need than capacity. Direct accounts come next.
• Before adding accounts: move every trip into one centralized dispatch system. Running vehicles on each broker’s own driver app works until a driver calls out and someone has to learn a different app mid-shift. Prepare to scale before you scale.
• Already established: if your dispatch system does not fit, change it rather than staying out of fear of the switch.
• Dispatch policy: flag riders with a history of no-shows and confirm with them in advance. One cancellation caught early can save the trips around it.

Keeping 200 vehicles organized

Jeremy’s list for a fleet this size starts with notifications, so dispatchers see a late driver before the trip is late. Then routing that gets pushed: try the extra trip that seems to fit, and reassign if it will not. M7 attaches attributes to every driver and vehicle profile and qualifies each trip against them. On the monitoring side, telematics driver scores give the high-level view, but the more useful tool is a short checklist of must-haves checked on every spot check: seat belts, passenger name, destination, and proper assistance.

Why M7 drivers are independent contractors

M7 has used an independent contractor model from the start, carried over from taxi culture, and Jeremy says drivers still prefer it when asked. They set their own schedules, some take months off to visit family overseas, and they choose which work to take. Accounts with extra requirements, such as exclusion screening for medical work or M7 logo wear, are opt-in. Initial training runs about three days, with online modules and check-ins, and he finds the standard it sets carries over into accounts that do not require it.

He is not worried about autonomous vehicles or robots replacing that. His answer is that nothing replaces a friendly hello and a driver who connects with the person in the back seat. M7 thinks of itself less as an NEMT company than as a social determinants of health company: getting people to appointments, but also to senior centers and parks, because reliable transportation is what makes aging in place possible.

NEMTAC, TTA and what comes next

Jeremy describes NEMTAC as the industry’s education and standards body. On its tech committee, he says, simply defining the word “trip” took about six hours, because providers, brokers, payers and hospitals all use the terminology differently. The Transportation Alliance, formerly the TLPA, is where operators learn from each other how to run and grow the business.

His ask of the industry is to match riders to providers qualified for them. A rider who can walk to a car may be well served by a lower-cost option. A dialysis patient who needs assistance should go to a provider that has invested in the training and technology to do it properly, and that provider has to be paid enough to sustain it. Given what missed dialysis treatments cost when transportation falls through, he argues that sending those trips to qualified, trustworthy providers would save far more than it spends.