Technology transportation puts health plans in the driver's seat to improve outcomes - MedCity News

An elderly African American man with a disability gets out of a car in his wheelchair. His wife helps him, holds the door open. Focus on the person.

Healthcare needs better infrastructure. Millions of Americans covered by the national safety net programs, Medicare Advantage and Medicaid managed care, rely on transportation to access essential medical examinations. Traveling to and from a healthcare facility for dialysis treatment, radiation therapy, a post-operative examination or other life-sustaining appointment is a critical part of the patient journey. Yet transportation is often a barrier for people receiving care.

Limited access to non-emergency medical transport (NEMT) contributes to 3.6 million people missing or delayed care each year. Barriers to care include access to a vehicle, cost, location, inclement weather, infrastructure, and illness. While anyone can experience the occasional travel accident, transportation barriers disproportionately affect the nation’s rural, disadvantaged, and older populations.

Access to transportation plays a key role in the social determinants of the health landscape. A persistent lack of health services leads to poor chronic disease management and poor health outcomes. Consequently, transportation issues create costly downstream consequences for health plans, health care providers, and their members. Lack of access to transportation contributes to the $150 billion cost of missed appointments in the US each year. By simply making reliable NEMT more widely available, health plans can help improve health outcomes and reduce costs.

Transportation attracts more members

The nation’s leading health plans are taking action. Soon, more than 50% of Medicare Advantage plans will offer transportation benefits. Plans focus on preventive care to avoid subsequent costs such as emergency care and readmission. As members enter plans (which drive overall plan growth but become increasingly risky), they increasingly rely on health benefits such as transportation to access consistent preventive care. At the same time, plans simplify how members can access transportation (eg, through member portals or through relatives) to improve member satisfaction.

Enrollment in Medicare Advantage plans is ahead of projections. Current forecasts predicts growth of 61%. over the next decade. Rapid growth and stable cost recovery encourage competition and innovation. Today, the average beneficiary can choose from nearly 40 Medicare Advantage plans. Plans increasingly offer transportation as a differentiated fringe benefit to drive enrollment and member retention.

Digitizing an industry that still uses fax machines is long overdue. Legacy transportation brokers rely on cumbersome call center models that block access to benefits, degrade the member experience, and provide unreliable transportation to members. Additionally, plans often lack tools to tailor transportation to a member’s needs, such as acuity, need, or medical condition.

Taken together, these factors exacerbate existing barriers for members. Attempts by some health plans to provide a traditional transportation benefit have resulted in confusion, inconsistency, high complaint rates, and even life-threatening errors. The clearest path to improved member access, experience, capabilities and outcomes is the technology NEMT.

Transforming NEMT and its impact on healthcare

Technology is transforming our daily lives: how we access food (Instacart), how we access money (Venmo), and how we engage at work (Zoom). Why shouldn’t healthcare reap the same benefits that technology brings to our personal lives? Technology can help NEMT work better for everyone. Technology-driven transportation programs can streamline and simplify the logistics of getting members to and from medical appointments.

NEMT’s technology-first approach to legacy transportation problems is transforming the ecosystem for Medicaid managed care health plans, Medicare Advantage plans, care providers, patients and all of healthcare. Merging technology with transportation unlocks value for plans, providers and members. The advantages of the first technology NEMT model include:

  • Using the entire ecosystem of transportation options—wheelchair vans, carpools, gas cards, or public transit—to address one unifying goal: helping a member access care.
  • Empower the entire continuum of care: payer care navigation teams, providers (eg, dialysis clinics), and members to seamlessly book transportation, update transportation, and monitor the journey to care.
  • Using algorithms to optimize NEMT fleet management through trip matching, on-demand and next-day scheduling and driver dispatch.
  • Create the highest level of reporting transparency across the value chain, from real-time vehicle tracking to integrating member experience metrics into electronic health records (EHRs) and more to reduce costs and help improve results.

Unlocking easy access to safe and reliable travel is an important part of the bigger healthcare picture. Rediscovering a reliable and predictable NEMT solution eliminates significant stress for the individual, especially if they are ill, elderly, or living alone. After all, access to transportation has a huge downstream impact on health outcomes.

Technology transport improves the member experience and reduces costs

Medicare Advantage and Medicaid plans transitioning from traditional to technology-based NEMT programs are achieving positive results across the board. Missed medical examination costs an average of $200 per provider, and the no-show rate is up to 30% nationwide. When members have access to reliable, technology-based NEMT solutions, they are three times more likely to show up to meetings. Empowering members to book their own rides and choose the most appropriate mode of transportation for their unique needs and comfort level helps increase member satisfaction and ultimately star ratings.

Reliable transportation significantly reduces overall healthcare costs. A transparent and efficient transportation program minimizes costs for each member and eliminates fraud, waste and abuse. Unlike traditional transportation solutions, NEMT technology provides data collection, reporting and analytics – allowing health plan administrators to identify efficiency improvements, fix any wasteful practices and drive the bottom line. In addition, with NEMT technology, it is easier to scale a transportation program as the number of health plan members grows.

While there is still much work to be done to address the social determinants of health, health plans can begin to improve access to care by using a technology-first NEMT solution. Partnerships with our nation’s leading technology-based payers will provide our communities with the transportation options they deserve.

Photo: kali9, Getty Images

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