For patients with special conditions and needs, traveling to doctor appointments is a major hurdle. Even if transportation options are available, inconveniences can lead some individuals to periodically skip necessary care to avoid frustration.
Health insurers in the US commonly offer non-emergency medical transportation (NEMT) for enrolees who need it. But traditional transit vendors are often slow and expensive. For example, Medicaid (the US insurance plan for low-income individuals) spends about $3 billion annually on NEMT.
CareMore, an integrated health insurer and care delivery system that provides care for enrolees in seven US states found that its patients often faced significant wait times with its existing transit services. So it looked at options outside of traditional health care transportation and built a partnership with the ridesharing service, Lyft (an Uber competitor in the US), to make NEMT faster for enrolees and more affordable for the insurer.
We spoke to CareMore's Dr Sachin Jain, CEO, and Scott Rinefort, Director of Product Design, to learn more about the new service offering, how they've adapted the programme along the way, and the results they've seen thus far.
Dedicated teams power a streamlined, patient-centred process
CareMore and Lyft built the new service with the patient perspective in mind at every step—starting when individuals request a ride.
Since many of their enrolees are unfamiliar with smart phones (or don't have them), CareMore set up a dedicated transport call team to intake patient requests. The representatives collect information about the location, destination, timing, and any special needs.
CareMore then transmits the information to its transportation benefit manager, which works with Lyft to schedule the ride.
Refining the rider experience for the elderly
While ridesharing services are growing in popularity, they're relatively new to the health care space. CareMore specifically trained their customer service representatives to introduce the new programme to patients as a modification to the existing NEMT benefit, rather than as a new, unfamiliar technology.
CareMore also worked with Lyft drivers to tailor the service to their elderly patients. For example, some patients felt uneasy distinguishing the Lyft cars from other neighbourhood cars. To assure individuals that they are getting into the right vehicle, CareMore developed a placard with their logo for drivers to place in the car window.
CareMore also leads senior sensitivity trainings for Lyft drivers, to educate them on how to interact with this elderly client base. Rinefort told us that the training events are "uniquely amazing sessions, and the drivers have been so receptive to addressing real patient needs." They also discuss how to meet the specific patient preferences, such as asking if they have a favourite route they like to take.
Faster, cheaper, better—and still going strong
The programme was initially run as a pilot among a subset of enrolees in California. The pilot resulted in shorter wait times, lower costs, and higher satisfaction when compared to traditional NEMT, according to data published in JAMA. The data was based on 497 NEMT rides between May 2016 and June 2016.
Key results from the pilot include a 30% decrease in wait time (from 12.5 to 8.8 minutes), 32% decrease in cost per ride (from $31 to $21), and 80.8% patient satisfaction in the Lyft programme.
Because of these promising results and continued good performance, CareMore is expanding the programme to more of its populations.
CareMore credits much of this success to Lyft's attitude toward the partnership. "You can't dismiss how important it is to have a partner that is willing to embrace the hurdles of working in the health care space. They didn't flinch at the mention of patient privacy laws—because they had already tasked a team to start addressing that," says Dr Jain.