Every year, 3.6 million Americans forgo medical treatment because they lack transportation.
By and large, these patients are older, poorer, and more likely to be chronically ill. Most Medicare and Medicaid patients have a non-emergency medical transportation (NEMT) benefit, but many do not know how to take advantage of it. And those who do frequently find the service to be slow and unreliable. In the worst cases, they even experience fraud or abuse.
In 2016, CareMore Health, a physician-founded and -led care delivery system serving more than 150,000 patients in 10 states, began a pilot program to offer its patients with more reliable NEMT.
CareMore had provided patients with wheelchair vans and other specialized transport for years, but after receiving numerous complaints from patients that the services were inadequate, CareMore sought out a solution to improve the transportation program. The pilot was so successful, after just a few months CareMore expanded the program systemwide.
The biggest innovation has been its partnership with on-demand ride service Lyft.
Previously, CareMore had contracted with a specialized broker to coordinate and dispatch private cars, taxis, or other vehicles to bring patients to medical appointments. Lyft rides are more readily available and tend to be more responsive, which significantly reduces wait times for patients.
Lyft works closely with CareMore to maintain a positive patient experience: Drivers receive a special alert for these calls, flagging them as healthcare-related and noting any special requirements the patient may have.
And the company has offered senior sensitivity training to drivers as well – teaching them, for example, that patients with mobility issues need more time and assistance get into a vehicle. Scott Rinefort, senior director of product design at CareMore, says, “The Lyft drivers react very well to [the training]. It gives them the perspective that they need to think about this a little bit differently than other rides."
From the patient's perspective, nothing about the experience has changed, except the wait time. They still book their ride by calling the CareMore member service team, which handles all the technical and logistical details.
Each CareMore center has dedicated Lyft parking spaces and a tool that allows staff to see the status and location of all patient rides coming to the office or heading home — and the patients know that. Staff can even call the patient to confirm they arrived safely home.
CareMore considered offering patients an app, but ultimately decided that would not work for their senior patient population. The organization also wanted more control over the all-important patient experience. “The reason we were able to ramp it up so quickly was that the experience of booking did not change," Rinefort says.
Since the beginning of the pilot, CareMore has been able to shift 91 percent of its curb-to-curb rides to this program – more than 7,000 per month. Lyft drivers are on-time 92 percent of the time and have reduced wait times by 45 percent. And Lyft rides cost CareMore 39 percent less than other ride options, according to Rinefort.
Most important, patients are overwhelmingly pleased – surveys show 98 percent of patients who have used the service are "satisfied" or "very satisfied" with the service. And CareMore has heard anecdotally that patients feel better able to access care because of the program. As Rinefort says, “Getting there is half the prescription."
Lia Novotny is a contributing writer to athenaInsight.