How Transportation (or Lack Thereof) Is Driving Up Costs for Medicare Advantage Plans

Lack of transportation is consistently cited as one of the TOP REASONS PATIENTS MISS MEDICAL APPOINTMENTS.

For payers covering seniors with chronic conditions under Medicare Advantage plans, missing medical appointments can have significant downstream consequences that negatively impact your revenue margins.

As payers take a more active role in ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH (SDOH) of their members, healthcare COSTS CONTINUE TO RISE: you cannot afford to ignore the connection between transportation to medical appointments and the cost per covered life.

Read on to learn how a solution for efficient non-emergency medical transport (NEMT) can help your members achieve better health outcomes while maximizing revenues for your Medicare Advantage plan.

3 Reasons to Prioritize NEMT Software Across the Patient Journey to Drive Down Costs

Covering non-emergency medical transport (NEMT) with a patient care logistics solution is one way to control the rising cost of healthcare across the patient care continuum. When implemented at scale, it can even help your plan increase revenue margins.

Here are three reasons your Medicare Advantage plan should prioritize NEMT solutions to realize financial gains over time.

1. Short-term at the point of care: When a member doesn’t make it to a critical medical appointment, they may be unable to refill medications or miss necessary directives from their clinician. Both of which may result in a 911 call and an ambulance ride. ACCORDING TO THE GAO, ambulance costs vary by location but range from $374-$639.  

1. Medium-term: Members with reliable roundtrip transportation are empowered to manage chronic conditions better and are less likely to require hospitalization. ACCORDING TO THE AHRQ, the average cost per hospital stay for individuals ages 65-84 is $12,600.

In addition, patient care logistics software can be used to deliver DME, food, and other services related to SDOH that your members may be lacking and are negatively impacting their health outcomes.

1. Long-term: Members with access to reliable transportation to and from medical appointments experience better health outcomes, have fewer out-of-pocket costs, and increased member satisfaction, all of which contribute to the likelihood of plan renewal. ACCORDING TO DATA DECISIONS INSIGHTS, a Medicare Advantage plan with 100,000 members paying an average of $800 per month per member that can reduce churn (or dis-enrollment) by 1%, can grow revenue by $9.6M.

Want to learn more about new technologies and NEMT? LISTEN TO MICHAEL SHABKIE, Founder of The Non-Emergency Medical Transportation and Accreditation Commission (NEMTAC), on The Patient’s Journey podcast.

NEMT Software is a Competitive Advantage

Knowing that transportation is a barrier for many of your members, offering NEMT benefits can be a competitive advantage in the increasingly crowded Medicare Advantage market.

Increased member satisfaction reduces churn and increases revenues while contributing to improved health outcomes for your members.

Learn how NEMT software can improve health outcomes for your members while increasing revenues for your Medicare Advantage plan with VECTORCARE HUB.

Want to read more from the Patient Logistics Journal? Check out the latest interview with Andrea Danes, the Global Human Services Leader at EY.