Navigating the non-emergency medical transportation evolution in 2019

According to a Hughes-Cromwich & Wallace report, approximately 3.6 million adults miss or delay non-emergency medical care annually due to transportation barriers, and these patient no-shows result in serious financial consequences for health systems each year.

To combat this startling statistic, non-emergency medical transportation is evolving in an effort to overcome this barrier to care and to ensure that patients are getting to and from the care provider they need to see. The industry is seeing a spike in vendors rolling out NEMT solutions to meet market demand, but the majority of offerings available today remain very limited in capabilities.

As the full potential of NEMT continues to gain recognition, here are three key predictions for the evolution of the space in 2019:

- There will be an increased awareness of the importance of NEMT;
- Care will increasingly move beyond the traditional care settings; and
- There will be an amplified need for further insight into data around where, why and how patients are moving throughout the healthcare ecosystem.

An increased awareness of the importance of non-emergency medical transportation
Healthcare organizations are currently faced with significant challenges related to addressing and managing the flow of patients throughout the system. In fact, a recent survey found that 85% of people reported waiting between 10 to 30 minutes past their scheduled appointment time to see their healthcare provider. In order to help minimize wait times and improve patient flow, streamlined NEMT and interfacility ambulance transportation are key components. Leveraging this transport ensures that patients can be discharged at the desired time – meaning that beds that were previously filled can open up in a timelier manner for new patients. In 2019, hospitals, accountable care organizations, managed care organizations and various other healthcare settings will realize how important NEMT is to the way they treat patients and how they flow throughout care settings. After all, how do you properly treat patients if you don’t know where, how or why they are moving throughout the healthcare ecosystem?

While NEMT is critical, the current manual transport request processes in place today - requiring paperwork, taxi vouchers, phone calls and faxes - are prone to human error and can result in costly delays and longer wait times for patients. Additionally, there has recently been a spotlight on rideshare companies being used to provide NEMT. This is evidenced by a recent study conducted by the University of Kansas that found that cities with ride-sharing services saw average ambulance usage decreased by seven percent. However, these traditional rideshare models, to date, are limited in both scope and scale as they only provide transportation for ambulatory patients. This means only one level of care can be offered.

In order to ensure quality care for every patient, healthcare organizations need a more comprehensive NEMT solution that can be leveraged for all use cases, levels of care and modes of transportation. While some patients are ambulatory and do not require special transportation accommodations, patients throughout the full spectrum of care require appropriate medical transport, whether they need basic or advanced life support, wheelchair transport, etc. From ambulatory care to critical care, a provider must be able to provide the right level of transport, to the right patient at the right time.

Moving care beyond the traditional care settings
As healthcare increasingly becomes consumer-centric, more patients are being treated at home and in other tertiary care settings. Prime examples of this are home healthcare and community paramedicine, where care is being delivered directly to a patient at home or wherever is most convenient for them.

This expansion of the healthcare ecosystem means that rather than just coordinating traditional patient admission and discharge transportation requirements and processes, there are now many added logistics around managing and providing care. Today, nurses and physicians are being taken out of the traditional healthcare settings and being sent to homes and other care locations. As a result, logistics around not only patients, but also related to care providers and vendors must also be coordinated appropriately.

This new reality means that providers and payers must start to consider software solutions that are able to manage any and all logistics related to care delivery. More specifically, the industry is starting to realize the full potential of an all-encompassing platform that coordinates all transportation and communications logistics through one dashboard in an automated manner.

The need for further insight into data around where, why and how patients are moving through the healthcare ecosystem
Data, reporting and analytics are increasingly being recognized as critical to enhancing operations and efficiencies within the healthcare ecosystem. Before providing proper care to a patient, healthcare organizations want to know:

- What modes of transportation are patients using?
- What is the cost of that transport?
- What is the patient’s clinical diagnosis?
- Did the patient get treated by a physician in the healthcare system’s network, or did they go out of network?
- Specific to each facility, what was the discharge demand analysis by time of day and day of week, and what were the levels of care needed to transport each patient??
- What were the reasons for patient throughput delays?

When choosing an NEMT partner, healthcare providers should seek a platform that has the capabilities to capture data around these transportation questions and logistics. By having deeper insights into data related to discharge delays and transportation, healthcare organizations can identify negative trends before they even become problems, and make more informed operational and clinical decisions over time, including around service level agreements and contracts. In turn, healthcare providers can free up valuable clinical and vehicle resources, enabling cost savings and streamlining operations, increasing efficiencies, and ultimately, improving overall patient care and satisfaction.

2019 is expected to be a pivotal year for the NEMT space as the full benefits of the offering become increasingly recognized by healthcare organizations. As patient care scenarios and settings continue to diversify, the need for comprehensive medical transportation solutions that can support a range of use cases, levels of care and modes of transportation is more apparent than ever. Additionally, some NEMT platforms are able to offer previously unavailable and potentially invaluable intelligence related to the movement of patients throughout the healthcare ecosystem. For these reasons, NEMT is a prime space for healthcare organizations to watch in the coming months.

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