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Technology-enabled Transportation Puts Health Plans in the Driver’s Seat To Improve Outcomes

A disabled senior African American man is getting out of a car, into his wheelchair. His wife is helping him, holding the door open. Focus on man.

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

Limited access to non-emergency medical transportation (NEMT) contributes to 3.6 million people missing or delaying care each year. Barriers to care include vehicle access, cost, location, inclement weather, infrastructure, and illness. While everyone may experience an occasional travel mishap, transportation barriers disproportionately impact the nation’s rural, disadvantaged, and older populations.

Transportation access plays a key role in the social determinants of health landscape. Consistently missing health services leads to the mismanagement of chronic conditions and poor health outcomes. Consequently, transportation issues create costly downstream effects on health plans, healthcare providers, and their members. The lack of access to transportation contributes to the $150 billion price tag of missed appointments in the U.S. every 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 a transportation benefit. Plans are focusing on preventive care to avoid downstream costs like emergency care and readmissions. As members age into plans (driving overall plan growth but becoming higher risk), they increasingly rely on health benefits, like transportation, to access consistent preventive care. Concurrently, plans are simplifying how members can access transportation (e.g., via member portals or through loved ones) to improve member satisfaction.

Enrollment in Medicare Advantage plans is outpacing estimates. Current projections forecast a 61% growth over the next decade. Rapid growth and robust reimbursement are fostering competition and innovation. Today, the average beneficiary can choose from nearly 40 Medicare Advantage plans. Plans are increasingly offering transportation as a differentiated supplemental benefit to drive member enrollment and retention.

Digitizing an industry that still leverages fax machines is long overdue. Legacy transportation brokers rely on call center-heavy models that block access to the benefit, degrade the member experience, and provide unreliable transportation to members. Further, plans often lack the tools to tailor transportation to a member’s needs, such as acuity, need or disease state.

Collectively, these factors exacerbate existing barriers for members. Some health plans’ attempts to provide a traditional transportation benefit have resulted in confusion, inconsistency, high grievance rates, and even life-threatening mistakes. The clearest path to improved member access, experience, enablement, and outcomes is technology-first 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 accrue the same benefits technology delivers to our private lives? Technology can help NEMT work better for everyone. Transportation programs powered by technology can streamline and simplify the logistics of getting members to and from medical appointments.

A technology-first approach to legacy NEMT transportation issues transforms the ecosystem for Medicaid managed care health plans, Medicare Advantage plans, care providers, patients, and throughout healthcare. Fusing technology with transportation unlocks value for plans, providers, and members alike. Benefits of a technology-first NEMT model include:

  • Leveraging the entire ecosystem of transportation options—wheelchair vans, rideshare, gas cards, or public transit—to solve one unifying objective: helping a member access care.
  • Empowering the entire care continuum: payer care navigation teams, providers (e.g., dialysis clinics), and members to seamlessly book transportation, update transportation and monitor the journey to care.
  • Utilizing algorithms to optimize NEMT fleet management across ride matching, on-demand and next-day scheduling, and driver dispatching.
  • Creating the highest level of reporting transparency across the value chain, from live vehicle tracking to integrating member experience metrics in electronic health records (EHRs) and much more, to lower costs and help improve outcomes.

Unlocking easy access to a safe, reliable ride is an important piece of the bigger healthcare picture. Reinventing a reliable and predictable NEMT solution eliminates significant stress for an individual, especially if they are ill, elderly, or live alone. Ultimately, access to transportation delivers a tremendous downstream impact on health outcomes.

Tech-driven transportation improves member experience and lowers costs

Medicare Advantage and Medicaid plans making the switch from traditional to technology-first NEMT programs are realizing positive outcomes across the board. A missed medical appointment costs a provider $200 on average, and no-show rates are as high as 30% nationwide. When members have access to reliable, technology-first NEMT solutions, they are three times more likely to show up to appointments. Empowering members to book their own rides and choose the most appropriate transport type for their unique needs and comfort level helps drives member satisfaction and, ultimately, star ratings.

Reliable transportation materially reduces overall healthcare costs. A transparent and efficient transportation program minimizes per-member costs 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, remedy any wasteful practices, and drive results to the bottom line. In addition, with NEMT technology, it’s easier to scale a transportation program as a health plan’s member population grows.

While there’s still a lot of work to address the social determinants of health, health plans can start improving access to care by utilizing a technology-first NEMT solution. Technology-enabled partnerships with our nation’s leading payers will provide our communities with the transportation opportunities they deserve.

Photo: kali9, Getty Images

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