Value-Based Care: More Healthcare Transportation Options for People

People need different things. Certain patients require varying healthcare accommodations. They also have other economic backgrounds. Non-emergency medical transportation (NEMT) should be based on services requested and rendered rather than a standard set of pricing. 

Contents:

• What is Value-Based Care and How Does It Impact the NEMT Industry?
• Reimagining the Healthcare Transportation Industry
• How PMT Provides Value-Based Care
• Other Services NEMT Providers May Offer
• Conclusion

What is Value-Based Care and How Does It Impact the NEMT Industry?

NEMT Today, a NEMT publication that is a part of NEMTAC, defines value-based care as “a delivery model where healthcare providers are paid based on successful outcomes rather than for individual services.”

In the NEMT industry, service payment can be gauged by the following factors:

• On-time arrival of the driver at the pickup point
• On-time arrival of the passenger at their destination
• Patient satisfaction 
• Actual cost per trip (fuel, driver’s fee, dispatcher’s fee, etc.)

Transportation is critical for healthcare, especially for disenfranchised individuals, senior citizens, and persons with disabilities. Without adequate transportation, they cannot go to their appointments. 

According to a survey in a New York City suburb cited in the article “Traveling Towards Disease: Transportation Barriers to Health Care Access,” 30% of patients missed medical appointments due to chronic transportation problems in their area. Some 25% also said that they had a hard time cobbling together the funds to hire transportation to medical clinics.

NEMT is the answer to such problems. Often it is covered by government insurance — Medicaid beneficiaries can get NEMT services for free. 

But NEMT is not the only answer. 

Reimagining the Healthcare Transportation Industry

Because of the need to make healthcare more accessible to many people and improve the quality of typical NEMT services, it was necessary to introduce a new medical transport system: Priority Medical Transport (PMT). It is an initiative designed by Stephen Newman to improve access to medical care that bridges the gap between NEMT and emergency medical services (EMS). It is recognized above the typical NEMT provider, yet affordably below Emergency Medical Services (EMS). This has proven to be exactly what was missing in the industry.

EMS provides transportation to those who need emergency care, while NEMT is for non-emergent cases. 

What are considered non-emergency situations that merit NEMT service?

• Medical appointments
• Long-distance medical treatment
• Leisure travel

PMT provides service for patients who are in between. They don’t need emergency medical services but are still considered crucial healthcare visits. It usually caters to those with chronic, acute, and catastrophic cases - those most vulnerable and most at risk, especially those dubbed “the five:”

1. Asthma
2. Cancer
3. Chronic obstructive pulmonary disease
4. Diabetes
5. Heart disease

According to the Centers for Disease Control and Prevention, more than half the population of the country has one chronic disease, while 27% has more than one. 

Without adequate transportation, these patients will not get the care they need, which will have a negative long-term effect. 

A study shows that up to 49% of all healthcare expenditures are spent on just 5% of eligible participants or patient population. Most expenses center on reactive care, ambulance drivers, and emergency department treatments. Reactive and emergency care are all due to the lack of preventative care, which would have been much cheaper. 

PMT is a game-changer. 

What are the benefits of PMT?

1. It lowers overall health expenditures as prevention is better and more affordable than cure.
2. The treatments are preventive in nature and less invasive. 
3. It reduces hospital readmission rates.
4. It provides value-based transportation solutions. 

How PMT Provides Value-Based Care

According to hospital reports, some 3.6 million patients miss a combined 24 million appointments per year. The same report noted that facilities have 20% to 50% no-show rates. Around 25% of these missed appointments are due to the lack of quality transport. 

PMT aims to change that as it partners with the following facilities:

• Hospitals
• Chronic care facilities
• Dialysis centers
• Skilled nursing homes
• Surgical centers
• Rehabilitation centers

Through such partnerships, PMT providers deliver the preventive care that patients need. PMT also provides scheduling flexibility as it does not serve emergency cases the way EMS does. 

PMT can serve patients from bedside to bedside. Fees are not standard as they depend on the type of service requested. 

Other Services NEMT Providers May Offer

A basic service will bring a patient from their residence to the healthcare facility in a comfortable vehicle. However, the package may include an in-home assessment to ensure the treatment is showing positive results. Plus, add some hours of private-duty home care including laundry service, cleaning, grocery shopping, bathing, and more. 

A higher-value service may include personalized finance consulting. A much higher-value service may include extended hours of private-duty home care and transportation credit. 

NEMT providers may receive additional profit from providing value over volume and quality over quantity. Those passengers who value the service and comfort may even request a luxury NEMT service.

Conclusion

Transportation is a huge barrier that prevents many from getting access to healthcare. Now that the value-based care model is the industry focus, those in the transportation sector must transform their business models similarly. 

Those who need medical care will need EMS transportation, while non-emergency patients can call for NEMT. But for those who have chronic, acute, or catastrophic illnesses requiring multiple doctor visits, PMT is a new healthcare industry player that promises many benefits