Should You Adopt the Value-Based Concept in NEMT?

Discriminating consumers know the value of quality. And they're willing to pay more for it. Unfortunately, quality isn't always a top priority for non-emergency medical transportation (NEMT) companies. Instead of focusing on value, their business models look at ride volume.

This is exactly what the value-based concept in NEMT addresses. It suggests that NEMTs should render services based on value versus volume.

Let’s get to know the concept a little better. What is value-based contracting in healthcare? And how does it compare to volume-based services?

Contents:

• What Is Value-Based Care in Modern Healthcare?
• Shortcomings of the Current Volume-Based Fee-for-Service NEMT Models
• What Is a Value-Based Model in NEMT?
• Benefits of Value-Based Service for All Parties
• Implementation Challenges
• Conclusion: Investing in Health, Not Rides
• Frequently Asked Questions

What Is Value-Based Care in Modern Healthcare?

Value-based care is exactly what it sounds like. It highlights value and the performance of healthcare providers. It also emphasizes the patient experience. The framework involves a collaborative approach between medical teams and healthcare entities. The goal is to help patients meet their medical and nonmedical needs.

For example, doctors can ensure that transportation has the necessary medical equipment. This elevates the care journey by ensuring that the rider will have their medical needs met.

Shortcomings of the Current Volume-Based Fee-for-Service NEMT Models

Value-based care addresses the pitfalls of the more popular volume-based model:

Prioritizes Volume

Volume-based NEMTs use the number of trips as a key performance indicator (KPI). But it doesn't examine their efficiency, personalized care, and reduced waiting times.

Lack of Coordination

Volume-based pricing doesn’t ask healthcare companies like NEMT brokers, transportation providers, and medical facilities to work together. The lack of coordination leads to subpar services, where the client may suffer.

More Expensive

Volume encourages NEMT companies to accept trips that aren't efficient or cost-effective. This could lead to longer routes, more wear and tear on vehicles, and higher fuel consumption.

Volume-focused medical transportation businesses may overlook the quality of their services.  They may also neglect the needs of their clients.

What Is a Value-Based Model in NEMT?

In NEMT, the value-based concept challenges transportation providers to market, administer, and gauge their services based on patient outcomes instead of volume. It emphasizes higher quality of care, cost reduction, and superior patient outcomes.

Higher Quality of Care

Enhancing NEMT services must be an industry-wide priority. Nonprofits and regulatory bodies can encourage companies to improve quality by setting benchmarks. An excellent example is NEMTAC, or the Non-Emergency Medical Transportation Accreditation Commission. The nonprofit promotes “rigorous standards and best practices to ensure safe, reliable, and high-quality non-emergency medical transportation.”

NEMTs can also improve their services by:

• Investing in driver training, including educating employees on the basics of patient care
• Improving vehicle standards with clean, comfortable, accessible, and reliable transportation
• Prioritizing timeliness and reliability through smart routing systems and real-time tracking
• Enhancing communication with clients. They can share reminders, the expected time of arrival, and updates in case of delays
• Collaborating with healthcare facilities to better understand patient needs
• Soliciting customer feedback and monitoring outcomes

This benefit elevates the role of NEMTs as a vital component of the healthcare system.

Cost Reduction

Reducing costs while increasing quality may sound counterintuitive. But cost efficiency is a realistic long-term benefit of value-based care. Raising standards means raising efficiency. That means minimizing no-shows and missed appointments while growing customer satisfaction. With time, reliable NEMTs could have healthier passengers, leading to lower healthcare expenses.

Lower operational expenses can be realized through:

• The elimination of redundant services. This helps them avoid unnecessary trips, adopt efficient scheduling, and better resource allocation.
• Fewer hospital readmissions since passengers can follow their treatment plans
• Predictable pricing through bundled services. They  can also be based on outcomes instead of charging per mile or minute
• Streamlined routes, minimal delays, and fleet maintenance, which reduce operating costs

For these reasons, a value-based approach ensures the long-term viability of NEMTs.

Superior Patient Outcomes

Focusing on efficiency, value, and patient outcomes leads to healthier and happier clients.

• Reliable NEMT services encourage clients to attend check-ups, treatment appointments, and follow-up consultations. This prevents health conditions from worsening and supports early intervention.
• They can ensure superior safety and comfort during transport through enhanced coordination.
• Rides focus on individual needs instead of being transactional. This leads to better customer experiences.
• Value-focused metrics and a holistic approach encourage NEMT companies to offer quality services. This facilitates long-term client health.

A model that focuses on cost-per-trip can compromise positive patient outcomes. In contrast, a cost-per-outcome NEMT service employs more balanced KPIs such as:

• Client feedback
• Punctuality
• Average duration of delays
• No-show rates
• Coordination with medical teams
• Fewer emergency room visits 
• Service utilization
• Low hospital readmission rates

By caring about patient outcomes, NEMTs become more than transportation services. They become their clients’ partners in achieving health and well-being.

Benefits of Value-Based Service for All Parties

Value-based services benefit everyone—patients, healthcare providers, the NEMT industry, and payors.

Benefits to Patients

• Better healthcare access
• Preventive care rather than an emergency intervention
• Fewer missed medical appointments
• Improved safety and comfort
• More personalized transportation
• Better health outcomes

Benefits to Healthcare Providers

• More patients stick to their treatment plans
• Fewer no-shows
• Enhanced coordination and communication
• Higher patient satisfaction

Benefits to NEMT Companies

• Closer partnerships with healthcare facilities and passengers
• Predictable revenue
• Loyal customers with higher retention rates
• Opportunity to differentiate themselves through superior quality
• Greater operational efficiency

Benefits to Insurers and Other Payors

• Lower healthcare costs over the long term
• Lower hospitalization rates, fewer readmissions and emergency room visits
• Higher return on investment
• Smarter resource allocation through data

NEMTs can enjoy these advantages if they can overcome certain implementation challenges.

Implementation Challenges

Implementing value-based NEMT has its fair share of issues. These include:

Data Sharing and Integration

Data sharing and integration between NEMT providers and healthcare companies is a challenge. Communicating medical conditions and transportation needs is a must for coordinated patient care. Stakeholders must establish communication protocols that enhance collaboration.

Reimbursement Model

Value-based care entails working with insurers, healthcare systems, and government entities. They must agree on payment structures that promote quality care. Together, they can define performance metrics, patient outcomes, and potential cost savings.

Regulations and Compliance

NEMTs must also ensure regulatory compliance. Compliance training and regular audits help with this goal. Working with legal experts helps them stay updated on healthcare and transportation regulations.

Technology Requirements

Service providers need accurate and up-to-date performance tracking and reporting to improve efficiency. Software solutions like RouteGenie boost operations. It optimizes routing, dispatching, billing, and other critical processes.

Conclusion: Investing in Health, Not Rides

Approaching NEMT according to the value it provides offers several benefits. Passengers become healthier over the long haul. Meanwhile, hospitals and NEMTs can raise their levels of service. Governments spend less on healthcare.

NEMTs are businesses that must generate profits. But they also provide critical services that affect quality of life and health. When NEMTs choose value, they promote health while positioning themselves for long-term success.

Frequently Asked Questions

What Is a Value-Based Approach to Health?

A value-based approach to health prioritizes the patient’s health and well-being.  It is in contrast to fee-for-service success indicators like cost-per-ride. Healthcare companies like NEMTs re-evaluate metrics to meet clients' medical and nonmedical needs.

What Is Value-Based Medicine or What Is Value-Based Healthcare?

Value-based medicine and value-based healthcare are other terms for value-based healthcare. They refer to rendering services based on patients' individual and holistic needs. 

What Is a Value-Based Method Example?

Value-based healthcare focuses on quality service, cost reduction, and enhanced patient outcomes. An example is when a healthcare facility requests a pick-up on behalf of a patient. During the call, they can outline the necessary medical equipment. As a result, healthcare services are more convenient as the patient saves time and effort.