An elderly disabled African American man getting out of a car and sitting in his wheelchair. His wife is helping him, holding the door. Focus on people.
Healthcare needs better infrastructure. Millions of Americans rely on transportation for basic medical appointments covered by the national safety net program that covers Medicare Advantage and Medicaid managed care. Traveling to and from a healthcare facility for dialysis treatment, radiation therapy, post-op checkups, or other life-sustaining appointments is a critical part of the patient journey. However, transportation is often a barrier for those receiving care.
Limited use of non-emergency medical transport (NEMT) causes 3.6 million people to go missing or have their treatment delayed each year. Barriers to care include vehicular access, cost, location, inclement weather, infrastructure, and illness. While everyone may experience an occasional travel accident, transportation barriers disproportionately affect rural, vulnerable and elderly populations across the country.
Accessibility plays a key role in the social determinants of health status. Persistent lack of health services leads to poor management of chronic diseases and poor health outcomes. Thus, transportation problems can have costly downstream effects on health plans, healthcare providers, and their members. Lack of transportation costs the US $150 billion a year in missed appointments. By simply making reliable NEMT more widely available, health plans can help improve health outcomes and reduce costs.
Traffic 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 downstream costs such as emergency care and readmissions. As members age (driving overall plan growth but increasing risk), they increasingly rely on health benefits (such as transportation) for consistent preventive care. At the same time, the program is simplifying the way members obtain transportation (for example, through the member portal or through loved ones) to improve member satisfaction.
More people are enrolling in Medicare Advantage plans than expected. Current forecasts predict growth of 61% over the next ten years. Rapid growth and strong reimbursements are fostering competition and innovation. Today, regular beneficiaries can choose from nearly 40 Medicare Advantage plans. Programs are increasingly offering transportation as a differentiated supplemental benefit to drive membership enrollment and retention.
Digitization of an industry that still uses fax machines is long overdue. Traditional shipping brokers rely on call center-dominated models that impede access to benefits, degrade the member experience, and provide members with unreliable shipping. Additionally, programs often lack the tools to tailor transportation to member needs, such as acuity, need, or disease status.
Collectively, these factors exacerbate existing barriers for members. Attempts by some health plans to provide traditional transportation benefits have resulted in confusion, inconsistency, high complaint rates, and even life-threatening mistakes. The clearest path to improving member access, experience, support, and outcomes is technology-first NEMT.
Transforming NEMT and its impact on healthcare
Technology is changing our everyday lives: the way we get our food (Instacart), the way we get money (Venmo), and the way we engage in work (Zoom). Why doesn’t healthcare add up as much as technology’s benefits to our private lives? Technology can help NEMT serve everyone better. A technology-enabled transportation plan can simplify and streamline the logistics of traveling to and from medical appointments for members.
A technology-first approach to addressing legacy NEMT transportation issues has transformed Medicaid managed care health plans, Medicare Advantage plans, care providers, patients, and the entire healthcare ecosystem. Combining technology with transportation unlocks value for programs, providers, members and more. The advantages of a technology-first NEMT model include:
- Use an entire ecosystem of transportation options—wheelchair vans, ride-sharing, gas cards, or public transit—to address a unified goal: helping members access healthcare.
- Empower the entire continuum of care: Payer Care Navigator teams, providers (e.g., dialysis clinics), and members seamlessly book transportation, renew transportation, and monitor care journeys.
- Utilize algorithms to optimize NEMT fleet management, including ride matching, on-demand and next-day dispatch, 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 outcomes.
Unlocking Easy Access A safe, secure journey is an essential part of the larger healthcare picture. Re-inventing reliable and predictable NEMT solutions can take a lot of stress out of individuals, especially when they are sick, old, or living alone. Ultimately, accessibility can have large downstream effects on health outcomes.
Technology-Driven Transportation Improves Member Experience and Reduces Costs
The transition of Medicare Advantage and Medicaid programs from traditional NEMT programs to technology-first NEMT programs is delivering positive results across the board. A missed medical appointment costs the provider an average of $200, and the nationwide no-show rate is as high as 30%. When members have access to reliable, technology-first NEMT solutions, they are three times more likely to keep appointments. Enabling members to book their own rides and choose the most appropriate type of transportation based on their unique needs and comfort levels helps improve member satisfaction and ultimately star ratings.
Reliable shipping significantly reduces overall healthcare costs. A transparent and efficient shipping program minimizes cost per member and eliminates fraud, waste and abuse. Unlike traditional transportation solutions, NEMT technology provides data collection, reporting and analysis – allowing health plan administrators to identify efficiency improvements, correct any wasteful practices, and drive results to the bottom line. Plus, with NEMT technology, it’s easier to expand a transportation plan as the health plan’s membership grows.
While much work remains to be done in addressing the social determinants of health, health plans can begin to improve access to care by leveraging technology-first NEMT solutions. Technology-enabled partnerships with our nation’s leading payers will give our communities the transportation opportunities they deserve.
Photo: kali9, Getty Images