Mark and Mark: Paratransit and Healthcare Transportation

Zack Worsham
Zack Worsham

Mark Switaj, CEO of Roundtrip, and Mark Joseph, CEO of Mobitas Advisors, and former CEO of TransDev sit down to talk shop about transportation, paratransit, and healthcare. This is the second of four installments and focuses specifically on the intersection of paratransit and healthcare industries.

Mark Joseph: “What’s exciting about Roundtrip is that you have this unique expertise and background in the ambulance business and now you’ve positioned this business to improve healthcare outcomes for folks who are using transportation services. How do you see healthcare and paratransit intersecting?

Mark Switaj: “Yeah, it’s pretty fascinating because they’re more similar than not, the more that we think about it, right? So, we’ve got healthcare which has largely shifted into outcomes-based — and even further down the pathway to social determinants of health. How do we address the reasons that folks are not getting access to healthcare, or that folks are routinely coming into an ER. Well, maybe they didn’t have access to food, or clothing, shelter—basic necessities. And then we look at the traditional paratransit, public transit, space where it was about mobility, in terms of access, but the destination for people really is, again, food, clothing, shelter, work: the things that allow them to contribute to society. So through one lens, there’s an overlap here and an alignment of focus: healthcare and outcomes; paratransit on destination. That kind of makes a lot of sense.

I think through another lens, there’s also an ability to maybe bring the two together, so we’ve got a whole network of paratransit, we’ve got a whole network of non-emergency medical transportation, and the rider — the beneficiary — might actually be able to access both programs depending on their mobility and their profile of need. Can we bring together these networks to start using some of the resources in one to augment the other. And I think that’s really where the future’s headed.”

Mark Joseph: “How do you see healthcare institutions and paratransit or transit agencies collaborating?”

Mark Switaj: “A healthcare provider might be looking to say ‘for this population that we’re looking to make sure that they’re the most vulnerable, they’re the most susceptible, how do we get them to access food and other resources that would keep them healthy and most active in the community’ — that’s paratransit. And then for medical appointments, or they need to come in for dialysis or chemo, how do we get them a wheelchair van or a stretcher vehicle that can get them to that care that needs to be provided? A traditional healthcare provider is looking to tap into all these resources so they can maximize the outcomes. And I think they’re also looking at how transportation is affecting the outcome. So, for a population that is being served, we know that by offering rides to them it results in an improvement in lifestyle and thus, outcomes… how do we begin to track that? And again, with the shifting landscape of healthcare, many healthcare providers are at risk based on these outcomes, they’re going to need that insight and access in order to improve the overall care delivery model that is in place in the community.”

Mark Joseph: ”The incentives have completely changed over the years. You know, they’re, initially as I said, paratransit was an outgrowth of this forward-thinking ADA mandate. But forward-thinking agencies, pre-ADA, had offered what they “called elderly and handicapped programs.” We were a pioneer in providing this service pre-ADA and after ADA… later, many of the healthcare institutions and non-profit organizations started to push a lot of their own riders, and their own patients, into the ADA programs in order to take advantage of that transportation service that was funded by state and federal funds, rather than their own funds.

“When I say the incentives have changed from a healthcare institution perspective — this is why your focus on outcomes is so important is because it used to be because everyone wanted the length of stay. They wanted patients in the hospital, they wanted them in the healthcare institution. They got rewarded for that. Today, we see so much more outpatient treatment, outpatient services that transportation is the key link and I think there is an opportunity to combine many of these activities and improve the service for patients and the institutions alike.