Reliable nonemergency medical transportation (NEMT) is increasingly important, largely due to the staggering number of Americans who cite transportation barriers as the cause for missing healthcare appointments. This population of approximately 3.6 million Americans includes many people, particularly older adults, who are living with at least one chronic condition.
CareMore, the care delivery system and health plan where I work, has a long history of providing rides to our senior patients who have trouble getting to their appointments. We believe that interacting often with patients, especially those with chronic diseases, drives better health outcomes and healthier lives. We do all we can to eliminate barriers to accessing regular care.
CareMore’s Medicare Advantage plans have long featured supplemental NEMT benefits for our members through partnerships with transportation brokers. Over time we found that this approach was a source of patient dissatisfaction, often because of long wait times.
In search of a better transportation experience for our patients, we contacted representatives of the ride-sharing company Lyft. Our initial meetings quickly escalated to whiteboard sessions where we jointly shared information, learned from one another, and created a partnership template. The typical Lyft call and a medical transportation call are quite different, so this early stage of our collaboration was a critical step in creating a good service for our patients.
These sessions revealed:
- Ride sharing would be a way to improve transportation services for our patients at a reduced cost.
- CareMore and Lyft shared similar goals for the program.
- Traditional NEMT brokers would continue to be a critical resource.
- Our senior patients needed a scheduling system that does not require a smartphone.
In May 2016, we began the pilot program with a limited number of our patients in specific geographies in California. The pilot affirmed that ride sharing could help us achieve our objectives and allowed us to identify opportunities to improve the program so that it better serves our patients and supports Lyft drivers. (CareMore contracts with other transportation brokers that provide services for patients with disabilities.)
For example, we leveraged CareMore Academy, an associate-training branch, to deliver senior-sensitivity sessions to Lyft drivers. The training, which includes role playing and the use of catch phrases, helps drivers be more empathetic to the needs of aging Medicare patients. The drivers are very eager to learn, and we have heard positive feedback from both drivers and patients.
Because many of our patients do not use smartphones, we maintain a phone call-based scheduling process instead of using an app. When patients call CareMore to schedule a ride, we transmit this information to an NEMT broker who then dispatches the request to Lyft or another transportation provider, depending on the type of ride needed and the location.
For when patients are ready to leave an appointment and return home, we created portable pop-up signs at designated pick-up locations outside our clinics to help drivers and patients find one another.
The pilot proved that this program is sustainable and scalable. The results, published in JAMA , showed that average wait times were reduced by 30 percent per ride, costs decreased by 32 percent, and member satisfaction exceeded 80 percent.
Because of those excellent results, we are ramping up our use of Lyft to provide more NEMT rides. Of note, 32 percent of seniors responding to a recent CareMore survey say it is just as important for healthcare providers to offer transportation to appointments as it is to monitor blood pressure.
Broader adoption of ride sharing for healthcare appointments is likely, and as capabilities expand to include more geographies, its positive impact on patient care should be significant.