Roundtrip sees new ways to grow as CMS opens door to NEMT for Medicare Advantage members

A number of healthcare startups have seen an opportunity to make the Non Emergency Medical Transportation program for Medicaid patients more efficient. Ridesharing companies Uber and Lyft have also expanded into the NEMT space. So the news that CMS officials are making changes that could lead to ridesharing services for Medicare Advantage members to travel to doctor’s appointments or to get a ride to a pharmacy or clinic means these companies stand to benefit.

CMS announced last week that it was “reinterpreting the standards for health-related supplemental benefits in the Medicare Advantage program to include additional services that increase health and improve quality of life.” The changes reflect some of the provisions in the budget agreement by Congress in February.

Roundtrip CEO and founder Mark Switaj confirmed that his business would benefit from the changes, although he conceded that how these changes would work in practice is “still unfolding”.

“This will clearly benefit our organization as we offer a transportation solution that caters to Medicare Advantage members and would allow for this unique population to gain access to transportation and promote betterment of health,” Switaj said. “The definition is still unfolding, though CMS is now clearly setting the stage to allow CMS-funded programs, particularly Medicare Advantage programs, the flexibility to define offers that will improve outcomes.”

He added: “A transportation benefit would be an example of one such primary health-related benefit. People who get to the doctor, pharmacy, and other health-related services stay healthier.”

Switaj noted that Roundtrip has diversified its partnerships to include a collaboration with city paratransit groups as one way to expand its customer base, starting with Greater Richmond Transit Company’s paratransit programs. GRTC’s CARE program provides curb-to-curb paratransit services to individuals with disabilities who may not be reasonably able to use GRTC fixed route bus service, according to Roundtrip’s website. Through the collaboration with Roundtrip, the CARE program has rolled out an on-demand service that serves 5,600 people. The previous iteration required CARE riders to schedule their rides days in advance.

Through the CARE On Demand program, riders receive text messages when their ride is approaching and when it has arrived. The messages include the name of the driver, the model vehicle they are driving, and phone number to reach them at.

“Neighboring communities around Richmond, Virginia have reached out to us,” Switaj said. “There’s no reason that we can’t do this [in Philadelphia] for the SouthEastern Pennsylvania Transit Authority, DART, and other cities’ paratransit groups.”

Want to learn more on how to leverage transportation as a Medicare Advantage benefit to improve outcomes? Get more information here