Episode 12:
Providing Transportation to Urgent Care Customers

On this edition of Just Checking In, industry expert Alan Ayers discusses the possibility of providing transportation to customers to and from your urgent care center.

The business case for providing patient transportation, NEXT on Just Checking In! Good evening I am Alan Ayers and I am Just Checking In, this time from New Orleans. I am going to be speaking to you about urgent care centers who provide transportation to their patients. Now the idea of a medical provider providing transportation really isn’t new. We’ve all heard the stories about medicaid patients using the ambulance to go to the ED for non-emergant conditions because they believe it is paid by medicaid and they may not have reliable transportation available.

If you were to travel to South Florida, In Miami they have what I call the war of the Medicare vans. Very large Medicare Advantage HMO’s like Humana and Leon health plans offer transportation via buses that you see all over the place in Miami transporting seniors to their primary care medical home. Of course certain occupational medicine providers like Nova occupational that has centers throughout Texas and the Southeast provide transportation for initial workman’s comp injuries as well as follow up. In occupational medicine providing transportation especially makes sense because the patient is not going there for their own purposes rather are going to deal with work place related issues. And if you think about an initial workman’s comp injury typically when the initial injury is approved by a payer that payer will typically authorize so many rechecks so many physical therapy visits and so if the patient decides not to come back to the center for those types of visits it is just money left on the table for the provider.

So certainly with occupational medicine with medicare and certain medicaid populations there are reasons to provide transportation to patients. Now for urgent care centers this question does come up… and by in large most urgent care centers are located in urban environments appealing to a more affluent demographic for which transportation really isn’t an issue. But there may be certain instances where it may make sense for an urgent care provider to provide transportation for instance if you are located in a resort community providing services to travelers.

On a previous segment we talked about how to reach travelers staying in hotels well if you can offer transportation to those travelers to and from your center it would just make service more convenient and provide a value add for those patients to enable them to get to your location. Now when providing transportation the issue does come up of medicare inducements. So we do get questions like can you reimburse bus fare. Could you reimburse UBER, could you pay for a taxi? Really to steer clear of any appearance of an inducement for a patient to utilize a government health plan… which is illegal under the medicare and medicaid rules it is really best that the urgent care provider provide the transportation directly. Now if it is not feasible for the urgent care center to provide a van to buy insurance to transport patients it can be very costly. Employing a driver you have to think full time salary, benefits, depreciation on the vehicle or lease cost on the vehicle. The cost of maintenance, fuel, state inspection, everything else you need like license plates… that can run $70-80,000 a year. In many cases even if there is a business case for an urgent care to provide patient transportation if you look at the number of visits per day at a reasonable margin the financial case probably isn’t there. But there is a solution… there are urgent cares that contract with taxi companies to provide taxi vouchers or taxi billing directly to the urgent care center when transporting patients. This works much in the same way that restaurants contract with taxi companies to transport people who have had a little too much to drink. Very similarly it is possible that your urgent care center can create a direct ill agreement with the taxi company if a patient is staying at their hotel or if they are at their place of employment they need to get to the urgent care center they contact the center and there should be a process either where the center contacts the taxi company to arrange the pick-up or the patient just contacts a taxi company and it just gets billed to the urgent care.

Providing a taxi voucher is really a way that an urgent care center can provide transportation without incurring the direct cost of employing a driver and owning a van yet offer a service that will help draw certain additional patients who need that transportation to the center. So that’s it for today… again my name is Alan Ayers, again thanks for tuning in if you have questions. Please email us at practice velocity we would love to address your concerns. Thanks again for just checking in this is Alan Ayers in New Orleans.