AmeriHealth Caritas

AmeriHealth Caritas DC, Access2Care and Lyft team up to get patients to the care they need

INDUSTRY | HEALTHCARE

Challenge

Traditional non-emergency medical transportation (NEMT) services were slow, inconsistent, and unreliable. As a result, many Medicaid members served by AmeriHealth Caritas DC were skipping preventative care appointments, which could lead to extended hospital stays and emergency room visits.

Solution

AmeriHealth Caritas DC partnered with Access2Care, a non-emergency medical transportation (NEMT) manager that partners with Lyft, to provide convenient and reliable rides for members. The partnership improved access to preventative care and reduced stress on overburdened emergency rooms.

Impact*

  • 40% decrease in ER utilization
  • 15% reduction in low acuity non-emergent utilization
  • 12% increase in ambulance utilization
  • 45% improvement in compliance for 42 key HEDIS measures**

*based on claims analysis conducted 4 months before and after the initial ride with Lyft
**commonly used quality metrics to evaluate health plans and providers

By making sure that Medicaid members can access primary preventative care, Lyft can help decrease emergency room visits and inpatient hospital stays.

The Challenge

AmeriHealth Caritas DC, a Medicaid plan serving more than 100,000 residents of the District of Columbia, has long recognized the important role transportation plays in keeping people healthy. When patients don’t have a reliable way to get to medical appointments, they often delay preventative care until situations become urgent, leading to extended hospital stays and emergency room (ER) visits.

Traditional non-emergency medical transportation (NEMT) services offer a poor experience. Trips need to be booked at least three days in advance, with wait times ranging anywhere from 60 minutes to three hours. Often, traditional NEMT providers use multiload vehicles (either vans or sedans), which group multiple passengers together and result in members having to endure several stops and unpredictable wait times before and after their appointments. For most members, this can lead to hours of lost work, excessive daycare expenses, and missed appointments — discouraging them from using the NEMT service altogether.

“When members don’t have access to reliable or convenient transportation, they often have to take time off work and pay for child care just to get to their medical appointments,” says Keith Maccannon, Director of Marketing and Outreach at AmeriHealth Caritas DC. “That’s a very tough choice for an hourly worker, and unfortunately it often results in missed preventive screenings and delayed care, which can be drivers of poor health outcomes and increased healthcare costs over the long run.”

“We’re thrilled about the support we’re able to provide for our enrollees. Based on preliminary results, there appears to be a significant reduction in inpatient stays, ER visits, and emergency ambulance utilization for enrollees taking Lyft trips.”

Keith Maccannon

AmeriHealth Caritas DC

The Opportunity

As AmeriHealth Caritas DC considered ways to improve the member experience, they looked for convenient – and widely accessible – transportation solutions. The goal was to improve health outcomes by increasing access to preventative care programs, while also giving patients the tools they need to manage their health.

Most AmeriHealth Caritas DC members were already familiar with Lyft, so partnering with the rideshare company presented an attractive option from the get-go. “We explored other rideshare opportunities,” said Maccannon, “but Lyft was far ahead of anyone else in the industry in understanding the needs of payers and being able to meet the stringent requirements of the government programs space.”

The Solution

In 2017, AmeriHealth Caritas DC partnered with Lyft on a pilot program to get enrollees to urgent care, follow-up and prenatal appointments. In the first month of the pilot program, enrollees booked approximately 150 trips. As word of mouth spread about the partnership with Lyft, demand exploded and AmeriHealth Caritas DC quickly expanded the types of medical appointments for which the service could be used.

In 2018, AmeriHealth Caritas DC contracted with Access2Care, an NEMT manager that partners with Lyft, to oversee its transportation program. Between April 2018 and April 2019, Lyft provided access to rides for both routine and urgent medical care for more than 11,400 members. During this period, for members utilizing the service, AmeriHealth Caritas DC experienced a statistically significant 45% improvement in the compliance rate for 42 key Healthcare Effectiveness Data and Information Set (HEDIS) measures (one of the most commonly used quality metrics used in the industry to evaluate health plans and providers).

In addition to showing a strong impact on preventive care and quality measures, AmeriHealth Caritas DC observed a strong correlation between members' Lyft rides and improved healthcare utilization. Based on claims analysis conducted 4 months before and after the initial ride with Lyft, these same 11,400 enrollees experienced a 40% reduction in ER utilization, a 15% reduction in low acuity non-emergent (LANE) ER utilization, and a 12% reduction in ambulance utilization.

“We’ve seen a significant improvement in emergency services utilization for our members utilizing Lyft, which we believe is a strong indicator that this service is helping to shift utilization from emergency services to primary care — a key driver of improved utilization and cost,” said Jerome Schorr, Director of Quality Management for AmeriHealth Caritas DC.

TOP BENEFITS INCLUDE

Improved healthcare utilization

By improving access to primary and urgent care appointments with Lyft, AmeriHealth Caritas DC and Access2Care observed a 40% decrease in emergency room utilization and a 15% decrease in EMS services.

Easy, reliable rides

Lyft replaces a fractured network of NEMT service providers for over 90% of trips with Lyft drivers who follow the company’s policies of courtesy, compliance, duty of care, and timeliness.

"With Lyft, members can call the morning of their appointment, get to the doctor, get a return Lyft ride afterward, and be back at work in short order." - Keith Maccannon

Reduced cost of care

Lyft rides make getting to the doctor easier, helping to reduce costly interventions and decrease strain on emergency medical services.

"Because Lyft is so convenient, members are more likely to go to the doctor and get less costly care, rather than waiting for a situation that would require them to go to the ER, call 911, or get admitted to the hospital." - Keith Maccannon

Satisfied healthcare providers

With its improved transportation program thanks to Lyft, Medicaid plan leaders are able to prove to healthcare providers that they are a reliable partner.

“Our doctors used to complain about a 30-40% no-show rate. Today, provider satisfaction with our transportation program is higher than ever before, which means they can spend more time focusing on patient care.” - Keith Maccannon

Looking ahead

AmeriHealth Caritas DC has expanded its pilot program to all members and expects rideshare solutions to become even more convenient. “One day, members will simply open an app on their smartphone, book an appointment with their doctor, and their ride will automatically be scheduled. It will be as simple as a one-click purchase,” says Keith Maccannon. “Trends suggest that rideshare is becoming a major access improvement strategy for healthcare providers and insurers. Lyft is well positioned to be the leader in that area.”

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