Our health is made up of so much more than what happens in our doctors’ offices. All the outside forces that impact how we live and take care of ourselves and our families—our social determinants of health (SDoH)—leave an indelible mark on our bodies and our minds.
There are tools to help people address these social determinants of health, and they require resources: investments in housing supports, healthy food, affordable childcare, and better transportation. In best-case scenarios, public and private organizations work together to promote and provide these crucial resources.
At SafeRide Health, we work with health plans, managed care organizations, community-based organizations, and state Medicaid agencies to help people who are experiencing barriers to transportation—an estimated 1 in 4 people. They might not have a car, or a nearby bus route, or a trusted friend or family member who can drive them to their doctor’s appointments, pharmacy, or other health resources. But they still need to go—and often it’s for life-sustaining care such as dialysis treatment, chemotherapy, or substance-use treatment.
Helping people get to care keeps them healthier. And when people are healthier, they cost the entire healthcare system less: They can avoid acute problems that could land them in the emergency department and manage their chronic conditions better. One study, for example, found that people who didn’t have access to a vehicle were 2.5 times more likely to make preventable ED visits as those who did have a vehicle.
At SafeRide, we recognize that addressing SDoH often increases non-emergency medical transportation (NEMT) utilization. However, we are also focused on ensuring that the right people are getting the rides they need. Addressing fraud, waste, and abuse in the system helps balance out those costs.
Prevention & Control to Maximize Appropriate Utilization
Fraud, waste, and abuse (FWA) includes a wide range of wasteful and even illegal practices that cost the healthcare industry billions of dollars every year. The NEMT industry is not immune from these practices and costs, but better technology and targeted resources can make a big difference in reducing them.
SafeRide Health has multiple processes in place to ensure that transportation providers are operating legally and that health plan members are using their transportation benefit appropriately—that they’re going to approved destinations, traveling appropriate distances, using the right type of modality, and not exceeding the number of rides that their health plan allows.
We work with each of our partner health plans to tailor our Prevention & Control efforts to meet their goals and priorities. These efforts are aided by a network that is nearly 100% digitized, including GPS tracking capabilities, as well as a team that is trained to spot irregular patterns in utilization.
The results of these efforts are measurable. For example, when we took over NEMT service for one managed care organization, our team flagged a quarter of reviewed rides in just the first two weeks as potential FWA, and 65% of reviewed gas mileage reimbursement trips as potentially wasteful or fraudulent. By taking various interventions, we have been able to reduce the overall utilization rate of that plan by 5% while reducing the average cost per trip by $4—a 20% reduction in the unit cost of the program—without impacting complaints and grievance rates at all. In fact, complaints and grievance rate for that plan was just 0.13% for all rides in the first half of 2024.
By identifying suspected cases of FWA, SafeRide is helping to control costs and prevent FWA (both intentional and unintentional) from driving up the cost of healthcare for everyone. At the same time, we’re focused on making sure that every health plan member who needs transportation for care gets it—and that they have a positive experience from the moment their trip is booked to the time they return home.