Among many problems that impede medical appointment attendance, access to transportationis a national issue. Appointment attendance is crucial for patients' health and wellbeing.Additionally, no-shows are a significant financial burden for healthcare facilities. Non-emergencymedical transportation programs have been utilized to get Medicaid beneficiaries to theirappointments when no other option is available. Recently, ride-hailing services such as Uberand Lyft have launched their own transportation services for patients. While these programs andservices have been beneficial, uptake by healthcare facilities has been hindered by financial,legal, and operational barriers. Our proposal seeks to create a decision-support platform calledTransportation 360 (T360) for healthcare facility administrators to formulate a transportationstrategy that is patient-centered, financially viable and aligned with existing workflow. This digitaltool will generate recommendations for patient transportation options and an implementationroadmap based on state and federal legal and regulatory requirements (such as the FederalAnti-Kickback Statute the Civil Monetary Penalty Rules Regarding Beneficiary Inducements) aswell as a healthcare facility's budget and patient characteristics (obtained through data securelytransmitted via electronic medical records or self-reported by an administrator in aquestionnaire). Factors taken into account in the recommendations will include eachtransportation service's geographic availability, pricing model, cancellation fees, experienceworking with safety-net healthcare facilities, implementation support, ability to integrate withelectronic medical records, reporting capabilities, modes of communication with patients,languages supported, and technical support provided. Characteristics of the healthcare facility(e.g., location, number of sites, target metrics of success, hourly wages of relevant staff),patients (e.g., familiarity with texting or smartphones, no-show rates) and payers (proportion ofpatients with each type of insurance and reimbursement rates offered by those insurers) willalso be considered. Our team will compile a knowledge base to be used with features includinga return on investment calculator, an interactive compliance checklist, and an operationsplanner. A state-by-state reimbursement claims form helper will be available to assist healthcarefacility managers with navigating the Medicaid claims reimbursement process to reducepayment denials and errors. In Phase I, we will a) Conduct JTBD interviews with a diversesample of healthcare administrators and staff members who are representative of our intendedend-users; b) Develop a proof-of-concept prototype that is capable of showcasing the keysystem functions (ROI Calculator, Compliance Checklist, and Operations Planner) and reflectsthe end-user requirements gathered from the JTBD interviews; and c) Demonstrate thefeasibility of using T360 to support staff's decision-making regarding transportation offerings. InPhase II, we will expand T360 into a minimum viable product (MVP), implement a 12-monthrollout at participating facilities, and assess the impact on patient attendance, NEMT claimsubmission, and successful NEMT reimbursement.
Public Health Relevance Statement: PROJECT NARRATIVE Patients often report lack of transportation as a reason for missing their medical appointments, which negatively impacts their health. Non-emergency medical transportation and ride-hailing services have been used to address this challenge, but financial, legal and operational barriers limit the adoption and implementation of these services for patients by health facilities. We propose a web-based tool for healthcare facilities that includes a return on investment calculator, an interactive compliance checklist, and an operations planner to generate recommendations and an implementation roadmap for adopting patient transportation assistance services.
Project Terms:
