Research has shown that social and economic factors, which includes access to transportation, accounts for around 40% of our health and well-being (Measures & Data Sources). The reason transportation plays such a pivotal role in improving health and well-being is because of the barrier it represents to accessing healthcare services in a timely manner. In emergency medical situations, a quick call to 911 and the blue lights will come rushing. However, in the case of non-emergency situations, for example getting to and from pre-arranged appointments, individuals will be required to arrange their own transport, preferably cabs. 

There may be a number of different reasons why some patients would find this a genuine challenge: physical or mental hindrance, elderly or vulnerable, young children not able to travel alone, or isolated, remote areas where public transport is very limited. 

Without adequate patient transportation, medical appointments may be missed or delayed, which could result in poorer patient outcomes, as well as incurring additional expense and burden on the healthcare system. In fact, a recent study showed each year 4% of children in the US (approx. 3 million) miss medical appointments because of unavailable transportation (Transportation Barriers to Child Health Care Access), and 3.6 million people miss or delay their medical rides and care (Access to Health Care & Non-Emergency Transportation: Two Missing Links). Read more about the impact of missed medical appointments on patients and hospitals in our next blog in the NEMT Series.

The Demands and Challenges of Non Emergency Medical Transportation (NEMT)

It’s pretty clear, from the stats above, that being able to provide safe and reliable patient transportation is key to ensuring access to, and the smooth operation of, healthcare services. However, there is a sharp distinction between basic transportation (bus, cab, metro, lifts with friends or family members, etc.) and non-emergency medical transportation (NEMT); NEMT services go beyond basic A to B transport by providing any necessary equipment, additional assistance and care required throughout the journey, based on the patients’ needs. 

In addition, NEMT drivers, if not already qualified healthcare professionals, can be certified in professional skills and knowledge, to provide effective care to the clients they transport.

When you consider the sheer number of missed journeys, and in an ever-increasing aging population reliant on others for patient transportation, demand for NEMT is increasing all the time and you begin to appreciate the potential business opportunity for NEMT providers. But, in this fast-growing industry there are likely to be a number of associated challenges:

Poor customer service

  • In particular late arrivals or no-shows
  • Even though the NEMT program is meant to give customers freedom to choose their provider, in some states, this choice is waived due to cost-efficiencies, and the opportunity to build a trusting, more personal, relationship with the driver is lost

System responsiveness

  • Regular slots tend to work well, but NEMT programs often can’t accommodate short-notice or time-sensitive transport
  • Last minute changes to schedules, locations of care requirements results in many calls and skilled coordination

Data collection & oversight

  • Inadequate data collection may conceal the volume, extent and quality of NEMT services
  • Financial penalties for under-performing providers could lead to ‘creative’ reporting of self-monitored compliance

Fraud or Abuse

  • Falsely claiming or charging for medical rides that didn’t happen
  • In one extreme case of fraud, NEMT provider was jailed and fined almost $475,000 for billing for medical rides attributed to dead people

The Impact of COVID on Transportation

In the world today, where ‘shielding’ and self-isolation has become the norm, the impact of coronavirus on general transportation cannot be overstated; the options for independent travel are severely limited and potentially high-risk for the vulnerable, and even help from friends and family is reduced to lower the possible spread of infections. Especially now, when the general public are being called forward to receive the COVID vaccine, it is crucial that no appointment is missed lest a single COVID vaccination goes to waste. Like a lot of industries during this time, even Non Emergency Medical Transportation services are having to adapt rapidly to the increase in telehealth virtual appointments and by implementing risk mitigation strategies, such as routine testing of drivers, decontamination procedures between patients and the use of personal protective equipment (PPE).

Transport Network Companies (TNCs) that use a ride sharing model for their cab services, such as Lyft or Uber, are stepping up to explore ways to support telemedicine, and home health, by offering technical support for logistics, delivering food parcels, non-prescription drugs, sanitizing materials, and personal care products to those in covid quarantine at home. TNCs could become the cornerstone in helping NEMT programs meet the current challenges in non emergency transportation. Increasing the availability of this type of service, while not being able to provide everything, will ensure we can keep moving people and things to where they need to be.

NEMT Software Evolution

Although the NEMT industry is organized around the Medicaid program, using brokers or privately-owned medicaid transportation businesses, there are over 40 programs in the US that provide NEMT funding, the fundamental principle being that investing in non-emergency medical transportation in advance saves lost revenue through missed appointments, which will help to prevent deteriorating or emergency patient outcomes. 

When you stop to consider the high level of agility required to transport millions of patients each day from-to the correct locations at the correct times with the correct provision of care, you start to appreciate how a single breakdown in communication can unravel the NEMT system. Timely and accurate communication and scheduling between all the stakeholders involved, including patients, doctors, drivers, NEMT brokers and insurers, cannot be achieved through manual processes alone!

This is where intelligent software applications have evolved to ensure efficient and effective patient transportation coordination. Through HIPAA compliant non emergency transportation software, that protects personally identifiable information (PII) and protected health information (PHI), each of the challenges listed above can be addressed. 

Proof of these achievements can be found in SourceFuse’s bespoke solution for One Call called RelayRIDE, the first of its kind in patient transportation solutions, leveraging the very latest in innovative technology to effortlessly manage every patient journey.

Accurate, automated scheduling and improved communication has enabled One Call to ‘connect the dots’ between all of the stakeholders for each and every medical ride, reduce manual administration with optimized workflows through robust reporting capabilities, has ensured simple and accurate medical claim processing, and ultimately improved better patient health outcomes by getting them safely and efficiently to where they need to be.

Read the full One Call Case Story to discover how SourceFuse helped them to save their customers an estimated $40 million. Contact us below for more information and any queries you might have related to Non Emergency Medical Transportation.