Alaina Macia has a clear goal in mind for the company she leads: reaching $1 billion in annual revenue.

That may seem ambitious for a business that posted just under $400 million in revenue in 2015. But with her company’s current growth trajectory – and some creative new service lines – Macia’s goal is far from unrealistic.

“I always think, ‘How are we going to keep growing?’” said Macia, president and CEO. “As you get bigger, it becomes more of a challenge. But we are going to grow.”

Medical Transportation Management’s core business is helping Medicaid patients reach doctors’ offices, therapy clinics and other health care facilities. The company has expanded during its 20 years in operation by winning transportation service contracts with managed care providers.

“A lot of times we’re handling the fragile, the elderly and the disabled,” Macia said. “We have a real passion for providing access to health care and preventative services so that babies are born healthy, people’s diseases are managed and we can have lower health care costs.”

While this work still accounts for the majority of Medical Transportation Management’s revenue, a significant portion of the company’s growth in recent years has come from a smaller affiliate company that operates public transportation services for local transit agencies.

“We augment their staff and let them focus on planning, budgets and local referendums to raise transit funding,” Macia said. “We come in and we’re the operations arm for them. We make sure that services are on time, safe, the quality is high and the vehicles are maintained.”

This affiliate, called Ride Right, has already grown into a $50 million-per-year business.

“We have a huge passion for public transportation,” Macia said. “We’re a very progressive-minded company, and we believe that public transportation is linked to health outcomes. So we are a company that promotes public transportation.”

Today, Medical Transportation Management operates in 30 states and provides roughly 15 million trips per year. Combined with Ride Right, the company employs about 2,000 people, with 600 of those in St. Louis, where the company is headquartered. Revenue grew more than 100 percent over the last three years.

Macia said the company’s growth actually breeds more growth. By adding services and bringing on more talented staff, the company has gained the capacity to expand in new directions. That includes offering a new niche service that provides in-person assessments to help health agencies determine whether certain clients can access paratransit services under the Americans with Disabilities Act.

“We’ve grown outside the health care space, and that’s what we’re very excited about,” Macia said.