We just attended the National Association of Medicaid Directors Fall 2016 conference in Arlington, VA, and much of the discussion at the conference has shifted from the roll-out and initial implications of the Affordable Care Act to a focused understanding of ways to improve the delivery system and enact payment reform.
A clearly voiced question: how can we improve the delivery and cost of medical transportation services?
It’s no secret that medical transportation is a big-ticket expense for Medicaid systems. In Connecticut, for example, the coordination of medical transportation services for Medicaid eligible citizens is worth over $6 million per year, and In New Jersey, services are worth $165 million annually.[1] Cost containment for transportation is absolutely a necessity, though it must be considered in context with a larger healthcare service delivery model.
- It’s better to transport a patient to a doctor than not.
- It’s better to move a patient out of a hospital than to keep her there.
- It’s better to share ride information than to leave the ordering person guessing.
While large on their own, transportation costs for Medicaid systems are often a drop in the bucket compared to the indirect costs of a cumbersome process designed to curtail direct costs. We’ve heard the stories of routine riders “giving up” with appointments because of the burdensome process. We’ve felt the pain of hospital navigators who spend hours waiting for rides to show up, whether from a patient’s distant cousin or a transportation provider seeking payment authorization. Hospitals, payers, transportation providers — they are not to blame. The process needs to be refined, and re-balanced as healthcare has evolved.
As states across the nation look at reducing complaints and improving quality of services, innovation must be embraced and adopted as not the exception, but the norm.
Medical transportation must be easy and a “no-brainer,” so patients don’t delay their care, or worse, delay the care for someone else by inadvertently tying up a facility resource. Patients will give up on future appointments if it’s challenging to get there. Hospitals incur great costs holding patients awaiting a ride. Improving the transportation process through technology and coordination is key to curtailing overall medical care spending. We can improve the process and decrease costs for all patients.
There are systems and processes built for nearly every payer class, every patient type, and every pickup location, which unnecessarily, and inadvertently, complicate the ordering process for hospitals and patients. While initially designed to mitigate fraud, waste, and abuse, they have caused delays and increased operating costs well above the cost of transportation services.
There is a solution. Patients who routinely receive quality, on-time, easy-to-use transportation services ultimately adhere to follow-up care. Adherence to care improves outcomes and decreases the need for unscheduled emergent services so common when patients don’t comply with doctor orders. Easier transportation means compliance with the provider’s orders. For hospitals, easier transportation means decreased operating costs. Roundtrip’s technology can ease the burden and create this reality.
[1] http://www.courant.com/news/connecticut/hc-medicaid-transportation-hospital-rides-1102-20161101-story.html;