How One Payer Streamlined Dialysis Transport Logistics for Over 40k Medicare Patients

Providing reliable, safe access to transportation can be critical for many patients who receive dialysis and other recurring medical treatments. 468,000 Americans are currently on dialysis, requiring three dialysis treatments weekly. In California alone, 40,000 Medicare patients across 50+ counties require regular dialysis transportation.

With access to transportation being the third most commonly cited barrier to accessing health services, it’s crucial that “standing orders” for transportation are managed efficiently for patients, yet the dialysis scheduling process can be extremely complicated.

One of our customers, the largest healthcare provider in California, was able to use VectorCare to schedule and execute complex dialysis transportation for over 800k trips in 2020.

The Problem

Scheduling standing orders (A request for multiple, regular service requests at once. For example: Scheduling a transport for a patient to dialysis every M/W/F for 4 months) can present considerable challenges for healthcare staff and payers. Case managers must coordinate with dozens of credentialed transportation providers to match pick-up dates along with available treatment slots at local dialysis centers, then ensure that the service aligns with the patient's benefit plans. Individual patient needs (specialized equipment, level of mobility, etc) must be accounted for and confirmed via medical necessity. The scheduling process for our client was arduous, consisting of hours of faxing and phone calls each time a standing order was scheduled or renewed. In addition, the service execution had little to no transparency, leading to a considerable risk of provider fraud.

To improve their standing order transportation service for Medicare's dialysis patients, this payer used VectorCare to create a comprehensive patient-centric solution.

The Solution

This payer started by leveraging VectorCare's Trust and Hub products to create a network of local, credentialed transportation providers qualified to perform dialysis trips. Using Trust, each provider was properly credentialed and cleared to meet all state and local regulatory requirements.

Next, they used Hub to create a scheduling schema specifically for dialysis standing orders. The schema could be accessed by any nurse, case manager, dispatcher, or crew member with access to that particular transportation request. This provided a HIPAA-Secure way for all care team members to view trip information and collaborate without phone calls or faxing.

Nurses and case managers could now schedule up to 365 individual dialysis trips and broadcast to local providers within 3-5 minutes, accommodating for each patient’s specific medical needs and benefits plan. Case managers could view the standing orders as a group as well as each transportation order individually.

Once scheduled, dialysis transports were executed seamlessly by the agreed-for transportation providers. Hub’s communication tools, realtime tracking, and delivery workflows ensured transparency and efficiency. This eliminated the risk of billing fraud, and reduced costs by improving patient flow.

Measuring Success

Next, our customer defined metrics for measuring success within the dialysis scheduling process in order to improve patient outcomes and reduce costs.

A few ways they accomplished this are:

• Including data collection points within the transportation workflow such as creating a rating question for patients to rate their transport experience and provide a signature, or requiring crew members to mark when each patient was picked up, enroute, etc. This allowed them to find any timing discrepancies, areas of poor patient flow, or providers offering a poor standard of care.
  
• Utilizing VectorCare’s built-in timestamps from our Open API and Hub apps
  Hub automatically tracks on-time ratings, every timestamp along the request process, message response times and more. This client leveraged these data points to determine transportation provider performance as well as quality of patient care.
  
• Accessing additional reporting and dashboards
  Management was able to use VectorCare’s dashboards to view agent and provider performance at-a-glance, without having to download .csv files and sort through data. VectorCare's Reporting features allow for complete configurability, so admins were able to build and download any kind of report on the fly.

Want to read more from the Patient Care Logistics Journal? Check out our latest podcast episode with Rachel Smith, Practice Manager at a rural medical clinic in Murchison, AUS.