Addressing adoption barriers to patient transportation services

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PROJECT SUMMARY/ABSTRACT Among many problems that impede medical appointment attendance, access to transportation is a national issue. Appointment attendance is crucial for patients’ health and wellbeing. Additionally, no-shows are a significant financial burden for healthcare facilities. Non-emergency medical transportation programs have been utilized to get Medicaid beneficiaries to their appointments when no other option is available. Recently, ride-hailing services such as Uber and Lyft have launched their own transportation services for patients. While these programs and services 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 called Transportation 360 (T360) for healthcare facility administrators to formulate a transportation strategy that is patient-centered, financially viable and aligned with existing workflow. This digital tool will generate recommendations for patient transportation options and an implementation roadmap based on state and federal legal and regulatory requirements (such as the Federal Anti-Kickback Statute the Civil Monetary Penalty Rules Regarding Beneficiary Inducements) as well as a healthcare facility’s budget and patient characteristics (obtained through data securely transmitted via electronic medical records or self-reported by an administrator in a questionnaire). Factors taken into account in the recommendations will include each transportation service’s geographic availability, pricing model, cancellation fees, experience working with safety-net healthcare facilities, implementation support, ability to integrate with electronic 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 of patients with each type of insurance and reimbursement rates offered by those insurers) will also be considered. Our team will compile a knowledge base to be used with features including a return on investment calculator, an interactive compliance checklist, and an operations planner. A state-by-state reimbursement claims form helper will be available to assist healthcare facility managers with navigating the Medicaid claims reimbursement process to reduce payment denials and errors. In Phase I, we will a) Conduct JTBD interviews with a diverse sample of healthcare administrators and staff members who are representative of our intended end-users; b) Develop a proof-of-concept prototype that is capable of showcasing the key system functions (ROI Calculator, Compliance Checklist, and Operations Planner) and reflects the end-user requirements gathered from the JTBD interviews; and c) Demonstrate the feasibility of using T360 to support staff’s decision-making regarding transportation offerings. In Phase II, we will expand T360 into a minimum viable product (MVP), implement a 12-month rollout at participating facilities, and assess the impact on patient attendance, NEMT claim submission, and successful NEMT reimbursement.