How Medical Rideshare Deals in Medicare Drive Quality Outcomes

Keeping a Medicare patient healthy might seem clear cut at first glance – lean on primary care, foster medication adherence, and address mental health concerns. But quality outcomes are difficult to maintain when over 3.6 million people do not receive care because of transportation issues.

Transportation is one of the biggest barriers to timely and accessible care.

Patients who cannot easily get to their primary care appointments are more likely to seek care in the emergency room, a costly and inefficient option.

And patients who are unable to refill their prescriptions in a timely manner can show lower rates of medication adherence leading to poor health outcomes.

“Transportation is the most important and one of our most used benefits. It helps ensure access to a doctor’s appointment and the ability to pick up prescriptions,” said Jerry Slowey, vice president of communications at Alignment Healthcare.   

The senior population is particularly susceptible to this social determinant of health. They are less likely to have access to reliable transportation and often rely on caregivers for rides to routine appointments and the pharmacy.

“Oftentimes, the doctor’s appointment is scheduled at a time that’s convenient for the doctor’s office, not necessarily the senior,” Slowey furthered. “The complications for seniors who are often dealing with large co-morbidity issues can be quite consequential if they are unable to actually get to their appointments or get to the pharmacy to fill their prescription.”

Improving senior’s access to care could drastically improve their health outcomes and overall experience with the healthcare industry.

“While it may seem to the under-65 market or those with easy access to transportation to not be a complicating factor, there are many times the Medicare population doesn’t have access to transportation when and where they need it,” emphasized Slowey.

And with the rise of medical rideshare options, finding a cost-effective and convenient solution to the transportation problem has become attainable. Alignment, for example, partnered with Uber Health to offer concierge transportation services to their Medicare members, aiming to eliminate the challenge of accessible transportation.

The Uber Health partnership is a piece of Alignment’s larger program, ACCESS On-Demand Concierge. The program was inspired by other non-healthcare organizations that offer the highest quality customer service to their members.  

“The program provides 24/7 access to our concierge team. You can call anytime day or night, talk to one of our ACCESS Concierge reps who can walk you through your benefits, help arrange for transportation, or help you get an appointment,” Slowey explained. “Our members’ lives aren’t just between eight in the morning and eight at night.”

The Uber Health partnership was piloted in a small member population earlier this year. Plans for the complete rollout to all Medicare Advantage health plan members in California are slated for the first quarter of 2020.

“Uber’s expertise in the marketplace as a real trendsetter, the originator of making it very easy to arrange transportation has been a really important partnership for us,” Slowey continued.

Because the tool was something many members were already familiar with, it was easily adapted and showed high levels of satisfaction amongst its users.

But despite the repeated success of these programs, many payers are hesitant to enter the transportation field. They fear the legal backlash if members use these services in emergency situations.

The Uber Health partnership is intended for routine medical appointments, specialist visits, and pharmacy trips, Slowey emphasized. In other words, the Uber Health platform serves as Alignment’s non-emergency medical transportation (NEMT) option.

The key to helping members understand this difference centers around an education of benefits. 

“We constantly iterate and reiterate that 911 is for emergencies,” Slowey articulated. “When we’re explaining the benefits to the member through our concierge team or our printed information, we explain this is a service to get them to appointments.”

In fact, Slowey hopes the program leads to a reduction in emergency department visits by getting members to take an Uber Health ride to utilize non-emergency treatment.

“Industry wide, we know that when people do not engage with their clinicians, the likelihood that their primary care will be received in the emergency room increases,” Slowey said. “The more we can help people adhere to their appointments and get the care that they need when they need it, people’s frequency of need to use the ER or transportation to the ER will diminish as well.”

With access to reliable transportation, the emergency room can cease to be a place where patients seek primary care.

The partnership also aims to reduce cancellation rates and improve member satisfaction. Alignment plans to look retrospectively at cancellation rates, examining if there is a decline after the rollout of the partnership.

“We’re hoping to see people adhering to their appointments and accessing care,” Slowey explained.

Satisfaction measures will help Alignment ensure members understand the benefit and are using it in a helpful way.

“Is this really working for our members and actually making it easier from a user experience standpoint?” questioned Slowey.

There are plenty of well-intentioned ideas that do not fundamentally help members the way developers think they will, Slowey noted. So it is important to hear the member’s perceptions of these programs.

Truly understanding the needs of the member population will help drive success in any program.

Other health plans looking to implement similar programs should ask themselves, ‘What is the best way to implement this plan? Who are the best partners out there to implement that? How do we do it in a cost-effective way that ultimately is not a burden to the overall system or the patient?’ according to Slowey.

“The number one tenet of our values is to put the senior first. That has been what’s driving all our decisions around the 24/7 ACCESS On-Demand,” Slowey concluded.