Driving Higher Outcomes for Sufferers and Well being Plans

Andy Auerbach, Chief Income Officer of SafeRide Well being

Because the healthcare trade continues to evolve, there’s a rising want for progressive options that not solely enhance the standard of care but additionally make care extra accessible. Non-emergency medical transportation (NEMT) performs an important function in serving to sufferers get to the place care is delivered. As healthcare reform efforts proceed to realize momentum, transportation advantages have turn out to be an more and more vital element of offering equitable care to sufferers. NEMT helps shut the well being fairness hole by making certain all sufferers can entry care, no matter their location, medical wants or transportation choices.

Lately, expertise has performed a major function within the development of the NEMT trade. Trendy NEMT options streamline the trip reserving and scheduling course of, introduce new modalities, enhance the general expertise for sufferers, and reduce fraud, waste and abuse (FWA). For many years, the trade lacked a patient-centric method centered on effectivity, reliability, and accessibility for all populations, particularly these enrolled in Medicare Benefit and Medicaid plans.

A dependable NEMT program may help well being plans cut back administrative burden, lower the number of missed appointments, and make sure that sufferers obtain the best stage of care and help on the proper time throughout their healthcare journey. Utilizing integration companies, well being plans can combine NEMT options and applications immediately into present platforms to higher handle the member expertise and supply an additional layer of connection for members after they make the most of these advantages.  

By collaborating with progressive NEMT companions, well being plans have made nice strides to boost the general member expertise. Traditionally, the member journey was largely missed, limiting members to two-day-plus superior discover or lengthy wait instances for rides. With the introduction of on-demand ride-booking companies by way of rideshare companions like Uber and Lyft, member wants are prioritized and customized. Sufferers can e book a trip when and the place they want it; then, plans obtain real-time updates and notifications throughout a member’s trip and might make any obligatory changes as wanted. Actual-time trip monitoring helps cut back stress and nervousness for sufferers, prevents FWA, and ensures each trip has a digital file full with geolocation at each step of the journey.  

Whereas technology-first NEMT has superior quickly over the previous few years, we’ve solely begun to scratch the floor of the way it can revolutionize care accessibility. As Medicare Benefit and Medicaid plans proceed to develop, NEMT companions will play an more and more essential function in scaling transportation advantages. By working with healthcare suppliers and payers to combine NEMT advantages into present applications and techniques, we will present high-quality transportation companies to our most weak populations.

Given the proximity to high-acuity and underserved sufferers, who’re generally enrolled in Medicare Benefit and Medicaid plans, it’s essential to find out whether or not a transportation supplier has the capability and experience to satisfy the person wants of every member. In a current research, 21% of U.S. adults with out entry to a automobile or public transportation skipped wanted medical care final yr. This expertise is proven to differ relying on different components similar to race and ethnicity, family revenue, city or rural location, incapacity standing, and extra. Increasing trip modalities with choices like on-demand rides offers members the flexibleness and luxury they’re in search of in an increasingly-consumer pushed healthcare setting in addition to plans with the instruments they should shut these well being fairness gaps in accessing take care of a various inhabitants. 

By providing members advantages that work for them and their distinctive wants, plans can give attention to growing profit utilization and enhancing vital current and future Stars Rankings benchmarks like member expertise and well being fairness. When measuring a program’s effectiveness, distributors and plans should work collectively to resolve which information to seize, decide what’s working, and determine areas for enchancment. Know-how-first NEMT performs a vital function in capturing information and turning it into metrics that matter. 

Regardless of nice strides made to assist handle the social determinants of well being (SDoH), similar to transportation entry, authorities rules proceed to play a vital function in shaping the trade’s progress and affect. Numerous rules, such because the Medicaid Non-Emergency Medical Transportation Profit and the People with Disabilities Act, have positively impacted how sufferers entry care and the standard of transportation companies supplied by NEMT distributors. These rules are essential for people who could not have dependable transportation choices, particularly these residing in rural or low-income areas, and assist guarantee NEMT suppliers meet particular high quality requirements and are held accountable for offering secure and reliable transportation companies. Because the NEMT trade continues to evolve, it is necessary for suppliers to remain knowledgeable concerning the newest rules and to work carefully with authorities companies to make sure they’re offering the very best high quality transportation companies attainable. By doing so, they may help shut the healthcare fairness hole and guarantee all sufferers have entry to the care they want.

Whereas we will’t predict all of the roadblocks the healthcare trade will face sooner or later, it’s clear {that a} extra environment friendly, dependable and cost-effective NEMT answer will proceed to drive higher outcomes for well being plans and sufferers. 

About Andy Auerbach

Andy Auerbach is the Chief Income Officer of SafeRide Health, the main technology-first platform connecting sufferers to care one trip at a time.