Incredible Initiatives and Progress
Optimism in the Face of Adversity PAGE 7 Using NEMT to Solve for COVID-Related Obstacles PAGE 21
NEMTAC Advisory Board Updates
Summer 2020
PAGE 24
ALSO
TTA's Virtual Spring Conference Focuses on NEMT Success
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NEMTAC Advisory Board Members
I am excited to share this special issue of NEMT Today with you. We just celebrated our second anniversary at NEMTAC and it is hard to believe how far this organization has come in such a short time. In addition to some fantastic articles about our industry, we have asked the Chairpersons overseeing our Advisory Boards to provide an update on the incredible initiatives and progress they have made recently. As our organization grows, I have been fortunate to work with a Board of Directors that have provided us with exceptional leadership. Gail Bauhs with TripSpark has been a trusted resource for us over the past year. Her years within the industry have been valued immensely by the Board. She recently decided to retire from her role at TripSpark and as a NEMTAC Board Member after over 25 years in the NEMT industry. On behalf of the NEMTAC Board, we wish her a happy retirement and safe travels. The Board is pleased to announce the addition of Julie Correll as our newest member. Her extensive experience over the last 30 years as a practicing attorney and 7 years within the NEMT industry is impressive. She most recently served as the Chief Compliance Officer for LogistiCare and was responsible for implementing policies and procedures, enforcing standards and operationalizing best practices enterprise-wide. With Julie’s background providing executive counsel to companies with significant transportation, safety and regulatory compliance issues, we welcome her expertise as NEMTAC creates standards and best practices for the NEMT industry. Finally, with the pandemic hitting the world as hard as it has and the uncertainty of travel, NEMTAC decided to postpone the Annual 2020 NEMTAC conference. We are excited to announce that our conference will be held once again at Talking Stick Resort in Scottsdale, Arizona on January 6-8, 2021. We are optimistic that the new year will bring new beginnings and we are thrilled to be kicking off the new year starting with our annual conference. Please stay tuned for conference updates on our website,www.NEMTAC.org. Thanks,
Melissa Jankowski Executive Director
How to Stay Productive When Working from Home
Using NEMT to Solve for COVID-Related Obstacles
A Letter from NEMTAC's Executive Director
Optimism in the Face of Adversity
Breaking Down Walls and Building Bridges
Chris Kelly Board Member
David Marhoffer, Board Member, not pictured
Peter Hicks Board Vice President
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How Omni-Channel Payments Help During the Pandemic
Veyo Prepares for a Post-COVID Reality
13
How RountingBox is Stepping Up During the COVID-19 Crisis
Julie Correll Board Member
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Eliot Kalter Board Member
3
Embracing the New Normal
Michael Shabkie NEMTAC Founder / Board Treasurer
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30
32
10
16
19
Table of Contents
37
Growing Your Transportation Business via Technology
5
Board of Directors
24
Telehealth Impact on NEMT
Header
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Advisory Boards
Accreditation Michael Shabkie and Eric Lane, Co-Chairs Carlos Ayestas, Priority Transportation Services Dori Boyle, Idaho Department of Health & Welfare Mindy Ginsberg, FR Conversions Stan Gitin, Clarion Medical Sarah Hope, Vertical Identity Background Screening & Drug Testing Melissa Jankowski, NEMTAC Eric Lane, Bankers Insurance Valeris Lefler, Feonix Mobility Rising Michael Pinske, AmeriCare Mobility Van Michael Shabkie, NEMTAC Jim Smith, JC Paratransit Solutions Roddrelle Sykes, 3rd Millennium Insurance William van der Linde, Old Dominion Transportation Group Scott West, NEMT Solutions, LLC Compliance and Regulatory Michael Shabkie and Dan Reid, Co-Chairs David Aboudi, Aboudi Legal Group Maggie Adams, EMS Financial Services Michael Adelberg, Faegre Drinker Biddle & Reath LLP Gautam Aggarwal, MD, Arizona Complete Health Laura Fleet, SendaRide, Inc Crystal Ford, Orange County EMS Melissa Jankowski, NEMTAC Martha Kendall, Tennessee Carriers David McDonald, QMAC Consulting Jennifer Place, MAS Mark Porterfield, Careavan Transports Dan Reid, Grove Transit Michael Shabkie, NEMTAC Kevin Teasdale, Secure Medical Transportation Certification Peter Hicks and Jim Adkins, Co-Chairs Kelly Addy, Clear Choice Express, LLC Jim Adkins, SouthStar Emergency Medical Services Howard Berkowitz, H&S Personal Car Service & Consulting, Inc Zackary Clemons, Solutions Medical Transport Peter Hicks, NEMTAC Melissa Jankowski, NEMTAC Miriam Manary, Univ of Mich Transportation Research Inst Courtney Muchugu, United Transportation Group Ray Shanahan, CareerCert Cris Sierra, ComfortCare Transportation Resource and Conference Peter Hicks and Travis Draney, Co-Chairs Stephanie Barton, TripSpark Medical Mike Chatelain, Risk Services of Louisiana, a Leavitt Group Co Travis Draney, Nonpareil Care, LLC Peter Hicks, NEMTAC Melissa Jankowski, NEMTAC Manuel Leon, Alivi Tammy Mihm, State of Tennessee Misti Mills, Two M Insight Group Marcus Norton, Mobility Support Solutions Jason Stempin, VMI Technology Myron Hammes, Chair Kyle Archer, Passio Technologies Arthur Attal, Via Tony Bradshaw, Bradshaw Consulting Services (BCS) Dominic Buono, UZURV Holdings Inc Sufian Chowdhury, Kinetik Healthcare Solutions, Inc Imran Cronk, Ride Health Myron Hammes, Schedule Viewer Melissa Jankowski, NEMTAC Venkata Marella, HB Software Solutions (HBSS) Brendan McNiff, Roundtrip Anantha Rao, Wellryde Ben Salter, SafeRide Health Joe Tovar, TripSpark Medical
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By Ryan Thorne, CEO, Thorne ELITE Transportation
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While the majority of NEMT providers have endured difficulties over the past few months, many remain optimistic about the future of our industry – and for good reason. The optimism we possess is not solely based on the reopening of our communities, but predicated upon the successes that our industry realized during these difficult times. Our industry may have experienced setbacks in volume and revenue generation, but we also sought new opportunities to connect with one another. Many industry leaders took to their keyboards and virtual meeting rooms in an effort to share their struggles and to develop solutions. Conferences that we looked forward to attending in person were not canceled, but brought to the computer screens of NEMT providers across the country. The learning never stopped because we are an industry comprised of resilient people. We saw a network of providers – in many cases competitors – coming together for the good of an industry. We took the focus off of ourselves as individuals and combined our efforts to create meaningful and groundbreaking conversation. While every provider had a valid excuse to pull away from a damaged industry, the majority chose instead to take a seat closer to the table. Innovative practices were developed to care for those impacted by COVID-19. Personal Protective Equipment (PPE) protocols were employed to keep our providers and our customers safe. We took meaningful steps to better our industry – not just during the pandemic – but for many years to come. Within Thorne Elite Transportation, we saw an opportunity in the midst of the chaos. We provided additional educational opportunities for our NEMT providers, both hands on and via our partnership with CareerCert. We spent greater time on disinfecting procedures and made sure that we were communicating all pandemic-related updates to our team in a timely and efficient manner. Exceptional communication is required to keep the workforce engaged. Many of our providers complimented the leadership team of our organization for their efforts in conveying information. Even when there were not many updates to provide, having a management team that remained open and available unified our team. We will look back on these months as a critical moment in the history of NEMT. I encourage everyone: instead of focusing on the disruptions we experienced, focus on the evolution that occurred within our industry. And while the hardships that we have endured should not be discounted, our focus must remain on the future in front of us. Optimism is the key to success and sustainability in our industry.
I applaud those providers who have contributed to the reemergence of our industry. I believe there is a greater appreciation of NEMT providers across the healthcare continuum because of these efforts. Let us not lose steam or motivation to do good and progress as an industry. While our communities re-emerge, so too shall we. The need for our services will continue to rise, and we must take on the challenges presented to us with a reignited passion and will to succeed. In the words of Benjamin Franklin, “While we may not be able to control all that happens to us, we can control what happens inside us.” I implore you to remain optimistic during these times and the days ahead. Continue to collaborate and share with one another. Together, we have an opportunity to advance an industry like never before. Ryan Thorne is the founder and CEO of Thorne Ambulance Service and Thorne ELITE Transportation, based in Greenville, South Carolina. Combined, these services respond to more than 20,000 requests for service annually. Ryan is a nationally registered paramedic, writer, and public speaker, having spoken at medical conferences across the country.
Optimism in the Face of Adversity ... continued
Surviving the Pandemic As the nation begins to reopen its services, NEMT service delivery will also be revived. The question to ask is, how much of a recovery and when will the recovery begin. Elective surgeries have resumed, and medical offices are opening to in-person appointments. For the transportation provider who has seen a 70% decline in service, very few may return in the short term of three to four months, with up to 75% of the declined amount returning by the end of 2020. The question remains: will we see service levels back to the height they were prior to the pandemic? Most areas are not going to open until they go into what is considered a phase 3, which includes the availability of a vaccine to manage COVID-19. That may not happen until sometime in 2021. Until then, transportation service will be on a slow ascent to a semi-normal state. This means, the rise to pre-pandemic services may never be seen. This does not mean that all is lost for the NEMT service industry. While people transportation may not return to 100% any time soon, the opportunities to continue and expand alternative services to support those people will increase. Demand for delivery services will remain strong, whether it be for meals, grocery and personal items, or medications. In some areas, pharmacy trips have continued, following telehealth visits as well. Companies will endure by working with the community, healthcare providers, brokers, and more to continue finding new ways to provide non-traditional NEMT services and come out on the other side of the pandemic, ready to once again transport people. What will the new normal look like? It will be similar to how service is currently provided as areas begin to reopen to service. A reduction in shared rides, use of protective equipment for drivers and passengers, and cleaning vehicles after each passenger are now the norm. Transportation is resilient and is a critical component in the delivery and stability of the healthcare system and will continue to be in the future. Without it, much of healthcare could not take place. Following the pandemic journey from here to there will demonstrate transportation is more essential to the system than telehealth.
The NEMT business has seen declines over the last 3 months – as much as 70%-90% in some areas. While the USA is starting to reopen, it is unclear when things will return to “normal” – that is still very much a moving target. One of the impacting factors to NEMT service will be the continued use of telehealth services. With the arrival of COVID-19 and subsequent stay at home orders, telehealth has become a prominent service in the healthcare arena. What is telehealth? Most of us are familiar with the term telemedicine. Telehealth is essentially the same thing but moves beyond the medical arena to include behavioral health. It is the functionality of speaking with a healthcare provider (physician, nurse, technician, healthcare aide) over the telephone or by using a computer to have a face to face conversation about your personal healthcare needs. This has become very common across the USA, with the Center for Medicare and Medicaid Services (CMS) making temporary changes to requirements, allowing healthcare providers to invoice state and federal entities for their time. Researching the origins of telehealth shows the service has been around for over half a century. Probably one of the earliest and most famous uses of hospital-based telemedicine was in the late 1950s and early 1960s when a closed-circuit television link was established between the Nebraska Psychiatric Institute and Norfolk State Hospital for psychiatric consultations. RN Advice/Help telephone services emerged in earnest in the 1990s with the introduction of more HMO model healthcare as a way to triage the care needs of patients, allowing them to call and ask questions prior to going in to an emergency room. This was introduced as a cost savings feature that has declined in use over the last decade because of medical insurance reimbursement limitations. Due to COVID-19, this service has been re-introduced in a way that has the potential to remain as a function of healthcare service. How and Why has Telehealth Grown? While many areas have seen a decline in the use of NEMT by upwards of 75% since mid-March, telehealth and virtual care have seen an increase of 160% since the summer of 2019, according to the Blue Cross Blue Shield Association’s COVID-19 National Pulse Survey. This shows the decline in transportation services are lower than the increase in telehealth services, which is a good indication of the importance of NEMT services on the healthcare industry. The increase in telehealth has been over many months, while the decline in NEMT has been in the short term. Many individuals appreciate the quick and easy access to direct conversations with their healthcare providers. According to a story from the Newark Advocate, the following comments were provided, expressing this exact sentiment: Think of it: You don’t have to miss work. You don’t have to find transportation or spend money on gas to drive Downtown to see us,” he said. “Wouldn’t it be great if you could live in Portsmouth and can hop on the phone and see an allergy specialist at Nationwide Children’s Hospital? I think patients will soon demand this option. The advantages to the healthcare system are multifold. Systems can respond to physician shortages in one area and have them contact patients in areas at a great distance. The advantage for the patient is a more intimate conversation with the physician, who is in less of a rush, as they do not have anyone physically waiting for them. Physicians can also be accessed from their own quarantined locations. These factors improve the healthcare delivery system in ways we are only just beginning to understand. How does telehealth impact NEMT? With the increasing use of telehealth services, those who would normally have attended a medical appointment in person have not had to. Instead, they talk to the doctor over the phone or computer, in the comfort of their home. This has resulted in a significant decrease in the need for medical transportation services. Telehealth services are easier now to provide for medical professionals. Health and Human Services has taken steps to simplify this process. For example: HIPAA-covered healthcare providers may, in good faith, provide telehealth services to patients using remote communication technologies, such as commonly used apps – including FaceTime, Facebook Messenger, Google Hangouts, Zoom, or Skype – for telehealth services, even if the application does not fully comply with HIPAA rules. (https://www.hhs.gov/coronavirus/telehealth/index.html) With the HIPAA requirements relaxed, the potential for patient information to be compromised increases. However, the importance of encouraging the continued relationships between healthcare providers and patients is critical to ensuring the well-being of all involved. Many providers and brokers are continuing transportation services for those who are not able to participate in the telehealth explosion. Trips for dialysis and many cancer treatments have continued due to the critical life-saving procedures indicated to these patients. Routine surgeries were cancelled, pharmacies provided mail-order assistance, methadone was given out weekly instead of daily, and unless there was a critical need to use the hospital (such as a heart attack or childbirth), the medical system shut down. As a result, the need for transportation declined substantially.
By Kris Lyon, Senior Business Development Manager, TripSpark Technologies
By Rachel Wells, Account Executive, Melwood Global
From contracting opportunities to social media marketing to winning that RFP and more, The Transportation Alliance’s Virtual Spring Conference on the emerging opportunities in non-emergency medical transportation (NEMT) covered it all. This year’s Spring Conference was supposed to be held in Boston focusing exclusively on NEMT and contracting opportunities for today’s transportation executives. Alas, the world was put on pause from the COVID-19 pandemic and TTA had to make the unfortunate, but necessary, decision to cancel its in-person conference. Despite the stay-at-home orders and social distancing, TTA was determined to provide its members with the latest must-know NEMT information. So, on May 21, 26 and 28, TTA hosted three virtual NEMT workshops. Below is a brief description of the information given during those extremely successful and highly informative online sessions. Opportunity of the Decade: NEMT and the 'Silver Tsunami' TTA President-elect Nick Cambas of United Taxi in Florida, and Michael Shabkie, NEMT advisor to TTA, kicked off the virtual workshops with an overview of the multi-billion dollar business that is NEMT, and why now is the time to jump into this work. For starters, let’s look at just how big this industry is. Here are is a statistical break down of NEMT’s impact on Medicaid-funded transportation: Total Medicaid spending for NEMT for all states: $3 billion Total annual Medicaid NEMT trips: 105 million Medicaid spend on NEMT: 0.6% of total Medicaid spend Average Medicaid payment per trip: $28.57 Shabkie described what is commonly known in the NEMT business as the “Silver Tsunami” to the audience, explaining that Census Bureau data shows older people will outnumber children over the next 10 years. To put that in perspective, it’s estimated that one in every five Americans will be of retirement age by 2030. Even more important, 20 percent of Medicare recipients require wheelchair-accessible vehicles. Until recently, transportation was not a covered benefit of Medicare. As of this year, the CHRONIC Care Act opened the doors for Medicare Advantage plans to offer medical transportation benefits to members. With NEMT no longer being viewed as a “commodity” but rather a critical component of the healthcare system, there is no better time for forward-thinking transportation providers to earn their seat at the healthcare table. Meanwhile, technology companies have taken an increased interest in the NEMT industry over the last few years as they are seeking to coordinate transportation services. This tech model depends on developing a robust transportation network of NEMT companies to provide services. This means that there are opportunities for both vendors and operators in developing a strong NEMT market. Cambas also highlighted how TTA has been advancing the NEMT industry, including the association’s collaboration with the Non Emergency Medical Transportation Accreditation Commission (NEMTAC) on developing a nationally accredited NEMT education program.
TTA’s Virtual Spring Conference Focuses on NEMT Success
TTA's Virtual Spring Conference ... continued
NEMT B2B Contracting Opportunities The next workshop, presented by TTA member Bill Scalzi of M7, Connecticut’s largest for-hire transportation company, and Melissa Jankowski, of NEMTAC, served as an introduction to facility-based marketing, an important tactic in the NEMT business. This workshop had two goals: first, to give TTA members valuable ideas to assist them in developing contracts with healthcare facilities and second, to provide strategies that help develop relationships and contracts within facilities that require NEMT services. The speakers emphasized that in order to begin B2B marketing, NEMT providers need to do a little introspection. Before you can pitch yourself to an outside business, it’s best to understand what your competition is doing so you can show what makes your services unique. From there, NEMT providers can restructure their marketing materials—including website design, advertising flyers and a marketing pitch. Next is the ever so important art of “branding.” For NEMT providers, branding is more than just a business name—it includes what community services your business aligns with, what pricing structures you use in the face of an emergency, and how your business fills service voids within its community. Scalzi went on to discuss the best tactics to implement when approaching a healthcare facility about forming a business partnership—reminding the audience that the best referral for any new business relationship should come from first-hand references. Jankowski also covered the importance of driver appearances, website design, social media presence, public relations, and more in terms of branding and marketing. The workshop wrapped up with advice on how affiliating your company with accreditation programs, charities and business membership groups like TTA helps your business stay up to date on important developments in the transportation industry, in the medical and healthcare industry and in your community. Finding, Evaluating and Responding to NEMT RFPs The final session presented by TTA member Robbie Werth of National Express, and Michael Shabkie, TTA’s NEMT advisor, focused on an essential aspect of the NEMT business: winning Requests for Proposals, or RFPs. From finding RFPs to submitting responses and successfully winning the bid, understanding the RFP process is vital in winning NEMT business. Werth kicked off the presentation highlighting the best websites to find RFPs for NEMT contracts, including medical and educational institutions. Following this, attendees were shown several examples of solicitations before seeing a breakdown of the different types of bids available: Request for Information (RFI), Request for Quotation (RFQ), and Request for Proposal (RFP) which would include assurances, a technical proposal and a price proposal. Werth advised attendees that it is very important to understand the RFP incumbent—the company that currently holds the contract for such services. By knowing the details of the incumbent’s current contract and transportation system, you can better prepare your own RFP submission. Werth also discussed several aspects of RFPs on which responders must focus: reading and understanding RFP language, paying attention to evaluation criteria, and specific insurance requirements. Shabkie then provided “tips and tricks to developing award winning responses,” by giving the audience detailed advice on creating a proposal database, writing a clear and concise summary, and more. Throughout each of the three presentations, attendees had the ability to submit questions. Each of three workshops concluded with a live questions and answers section. While not every question could be answered during the allocated one-hour session, all presenters took extra time afterward to answer all submitted questions in writing, which registrants then received the following day via email, along with a copy of all conference PowerPoint presentations. While this year’s Spring Conference did not occur as originally planned, the very positive response and attendance at these virtual workshops were extremely encouraging. There is clearly an appetite for such pragmatic sessions focused on giving members the crucial tools they need to win new business in the NEMT space. Are you a member of TTA? If not, there is no better time than right now! Members of TTA not only receive discounted prices to conferences and conventions, they also receive the most up-to-date, top industry information through the association’s daily and monthly e-newsletters and real-time updates on TTA’s exclusive members-only platform, Workplace. We are also offering an amazing new deal to 50 lucky new members, who can take advantage of our new scholarship program that pays for 66 percent of your entire 2020 dues! Fill out your application today and save substantial dollars immediately. Building on the success of this virtual conference, TTA is preparing for an unforgettable Annual Convention & Expo by moving ahead with its plans for Mobilize 2020 in Atlanta this year! Be sure to mark your calendars for November 7-9 for what will be the most important membership meeting in the association’s 103-year history. We can’t wait to see you there!
In the new post COVID-19 Pandemic world working from home (WFH) is now the new normal. How can you work efficiently and stay focused?I use 6 steps that help me stay on task and optimize productivity and I would like to pass them on to you. Maintain a routine You probably had your office routine down pat – walk in the door at 8:55, say hello to your employees and co-workers, check your emails, make your coffee at 9:45, take lunch at 12:15, and so on – and then found your morning routine scattered to the winds when you had to work from home. One of the best ways to get back into a productive mindset is to create a new routine for yourself and stick to it. "Stick to routines whenever possible” If you get up at a set time because of a commute, keep that time. Shower, get dressed, eat breakfast, etc. All these rituals can help put your brain in work mode." You can set strict working hours for yourself to help you create a routine. Keep in mind that you may finish your tasks earlier in the day than you might have in the office since you will have less distractions. "Say that you're going to be at your desk by a certain time in the morning and adhere to it.This will get you moving and not sucked into watching TV while eating cereal." Be patient First and foremost, remember that this is a big transition for both yourself and your team as everyone learns how to effectively work from home. Try to take things one day at a time and allow yourself a learning curve to figure out what works and what does not.Your work hours may shift and there will be more or different types of distractions around that you will have to adjust to. Set boundaries If you previously commuted to an office, there was a clear and definable boundary between your home and your work, which made it easy to separate the two spaces. Now, work and home are one and the same, which can cause some mental gymnastics when you are trying to be productive in your living room.“Setting boundaries can be a challenge”.You need to make sure you have one place that you consider your workspace. It doesn't have to be an entire room, but make sure you're not confusing your office with your leisure space, Physical boundaries are important, but so are social boundaries with other people in your home, as you are all social distancing together. Don't be surprised if your significant other, child or roommate assumes that because you are home, you're available to spend time with them. "Lay down the ground rules as soon as possible so that there's no room for confusion about your availability." When you have completed your work for the day, remove yourself from your work as much as you would if you were still leaving the office at the end of the day. Close your computer and leave it in another room as you go about your evening activities. Respect your time and your co-workers' time as well.Do not jump up from the dinner table to respond to an email or calls unless it is crucial that you answer. Find effective ways to communicate Shifting to all-virtual conversation is difficult no matter how tech savvy your team is. It is easier to lose meaning and nuance, and harder to feel human connection. Unlike normal office environments where you can just talk to people and see their body language, when going back and forth unlike in emails and text, you need to focus on concise, coherent and well-thought-out ways to communicate. A good baseline rule is to always assume a positive intent. This means no one ever reads a message thinking the other party is trying to be rude, short or inconsiderate. Try to engage your team in casual conversation at certain points throughout the day or as you deem appropriate. Suggest that your team have a weekly check-in or town hall over video conferencing where everyone can come together and chat informally about how things are going, or to help keep productivity up. As an organization, the best tip is a daily video conference call.Make sure you ask 3 simple questions to everyone including yourself.What are you working on today?What did you complete yesterday?What is on your agenda for tomorrow? These simple questions allow us to confirm that everyone is staying on task and making progress. At the same time, a sense of shared purpose is also fostered.
Be flexible and realistic Life has definitely changed for all of us in 2020, it would be ludicrous for anyone to expect business to carry on as if nothing had changed. Many people have had their lives turned upside down and are trying to juggle working, caring for children, worrying about the health of friends and family and the future of the economy all at once. It is OK to be flexible. There are so many productivity myths and discussions around what productivity looks like, but during a global event of this magnitude, it is OK to take 10 minutes to read the newspaper or listen to a podcast. Set your boundaries around your team members and work obligations as well as your responsibilities outside of work, including childcare, pet care or meal prep. This will help you prioritize those tasks and carve out time for them without feeling guilty that you are not actively working. You can also expect to have fewer hours where you are actively working, since you are out of an office environment and can flex your schedule to work best for you. Remote work also allows you to work to the fact that not everyone shares the same peak hours of energy and focus.If you can get that flexibility, have that conversation with your team so they are aware. Take breaks In an office, breaks are often organically built into the workday such as an employee asking a question, or taking a walk to grab lunch.However, when you are working from home, you might find yourself hunched at your workspace for five hours without moving or speaking to anyone.This can be detrimental to both your productivity and mental health. Try to schedule breaks throughout your day.Set your day and include alarms on your phone to remind you to walk around, hop on a video chat, eat a snack or take a lunch break. Breaks help you stay focused and keep you energized. Taking a break gives you an opportunity to refresh your brain.Go for a walk, work out, spend time with family, clear your mind. [Just] do something else and then get back to work. Being successful is not about putting in more time; it's about putting in productive time." Howard F. Berkowitz is the Managing Partner for H & S Personal Car Service & Consulting, Inc. is a public transportation consulting firm specializing in improving operational management, comprehensive analysis, financial performance and quality of service. We bring over 30+ years of public and private transportation experience and a network of industry associates to each assignment. Contact Howard at (561) 719-5541 orconsulting@handspcs.com Calendly Scheduler: https://calendly.com/hs-consulting/consultation
By Howard F. Berkowitz, Managing Partner, H & S Personal Car Service & Consulting
By Todd Revolt, VP of Business Development and Partnerships, VectorCare
Building a business under “normal” circumstances is hard enough. Throw in a global pandemic, a recession and a shift in business opportunity, and it becomes back-breaking, frustrating and downright exhausting. Due to all of these cumulative market forces, NEMT providers should consider how to become increasingly agile and take a page from other industry’s playbooks to not just survive but thrive in a constantly shifting industry. Warren Buffett, in a 1995 letter to shareholders, wrote that "In business, I look for economic castles protected by unbreachable moats." By a “moat”, Buffet references companies that are untouchable by virtue of enduring competitive advantage. Companies with well-designed moats can still remain top competitors in their industries 5, 10, and 20 years into the future. How can you build a competitive advantage that remains a decade from now? Or ensure that, no matter what industry changes take place, you can pivot to remain an industry leader? A good place to start is a tried and true SWOT analysis. A SWOT analysis allows you to identify your business’s Strengths, Weaknesses, Opportunities, and Threats. Take a look at the following diagram and begin answering the questions listed… Have you written down your answers? What services do you offer the best? Where are your weak points? What opportunities do you see in the market? Clearly one threat to your business is our current pandemic but what other threats to you see today and on the horizon? Once you’ve identified your resources, experience, your concerns and your opportunities in this quadrant, what’s the next step? Rather than merely trying to focus and expand on your company strengths, it may be worth taking a look at your weaknesses. Think about the services you don’t offer today but could offer. Service the healthcare system needs in time of crises or when we’re not in a time of crises.What are they? Can you deliver home health services? Covid-19 testing? Can you offer delivery services?
By Luis Castillo, President and CEO, Ensocare
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Breaking Down Walls ... continued
Hospitals face a wide array of challenges in their quest to take care of COVID-19 patients. And while these difficulties have been covered ad nauseum across all manner of healthcare publications, there’s one topic I haven’t seen covered to such a wide degree. This is despite its impact on patient care, patient experience, hospital revenue and readmission risk. I’m talking about the multitude of ways in which non-emergency medical transportation (NEMT) can be used to support COVID-19 patient recovery. More widespread availability of NEMT for COVID patients has the potential to save lives, reserve emergency resources for those who need them and provide safe pathways to primary care for the chronically ill. I want to talk about how contracting with NEMT providers for various services can positively affect your facility and reduce the possibility that patients boomerang back to the hospital upon discharge. Transporting Patients The most obvious benefit of an NEMT partnership is the ability to transport patients to and from the hospitals and between varying levels of acuity. When a COVID-19 patient needs transportation to the hospital, it’s typically because of a deterioration of condition or a lack of adequate personal transportation. Because those patients also can’t rely on public transportation given the viral transmission risk, most incoming hospital traffic will arrive via ambulance. NEMT providers come into play once the patient has stabilized and is ready to be discharged from the hospital. And to be perfectly blunt, there is a downright lack of vehicles with the expertise, personal protective equipment and infection control procedures available to ensure safe, appropriate transport of a stabilized COVID-19 patient. Prior to the pandemic, much was made of partnerships between healthcare systems and ride-share companies like Uber and Lyft. These partnerships were a great idea that sought to address one of the key social determinants of health, that of transportation. But the onset of the pandemic led to a multitude of rideshare vehicles shutting down. And even if they weren’t taken out of commission, those vehicles certainly weren’t capable of the types of infection control necessary to protect drivers. In fact, many NEMT vehicles, not just those related to rideshare partnerships, lack those kinds of precautions. What this means is that patients who are technically recovered enough to leave an acute care setting, but who don’t have someone to transport them, become stuck in a hospital for much longer than they otherwise would need to be. This creates capacity issues, particularly if your area experiences a spike in COVID cases, and it ultimately presents patient recovery risks and revenue shortfalls for your organization. Getting Where You Need to Be on Infection Control In your area, there may actually be a number of NEMT providers who want to be part of the solution but simply haven’t encountered a situation quite like this (who has?). In these instances, and where the regulatory landscape allows, some hospitals have actually found success by working closely with NEMT providers to offer their insights and guidance into things like infection control in order to get those services back online. Acute care providers are uniquely positioned to provide guidance on the steps NEMT providers will need to take in order to protect themselves and patients during transportation. The first step should be ensuring providers are staying up to date on the latest guidelines from healthcare authorities. The CDC has a fantastic guide to disinfecting non-emergency transport vehicles. Many states have also released their own resources targeted toward this information. Your own experience is its own valuable resource. Consider scheduling an informational webinar where you talk about the types of infection control procedures you use at the hospital and that could be adopted to a vehicle. Alternately, reach out individually to NEMT agencies you’ve utilized in the past to see where they stand with infection control procedures and offer your consultative services to get them to a point where they’re capable of accepting your COVID patients. Consider a certification program where those transport companies, who may also be feeling a financial pinch because of COVID-19, can meet certain thresholds to demonstrate their capabilities and get on your hotlist of preferred providers. Being able to rely on NEMT providers for the transportation of stabilized COVID patients has a lot of upside for your organization. It frees up emergency resources, such as ambulances, for those patients truly in need. It has the potential to reduce length of stay and free up bed space, as
Looking at the current roadmap for healthcare, we’re seeing a massive uptick in telemedicine services and a new hospital-at-home model of care. To thrive and build a competitive moat in the coming years, NEMT providers should look to pivot and begin offering a wider range of services. After a telemedicine call, a patient may need a home health visit, vaccine, transportation to a local clinic, or DME delivery. If you find yourself unable to invest in the resources to offer a wider range of services, community partnerships can be a powerful tool.Find businesses where you aren’t as strong and partner with them. You don’t deliver home health services? No problem, you can still offer the service if you partner with a provider in your area that offers those services. Perhaps you don’t offer sedan car services, partner with a company that does. There are complementary businesses to yours: businesses that are looking to connect and retool during these down days. A strong network of back-up providers allows you to position yourself as a “one-stop-shop” of services to clients without stretching your resources. Another area to look at is technology. It’s amazing how often we still run a business on phone, fax and paper. It’s not sustainable. Not during “normal” times and definitely not if you want to be successful in the 21st century where time is one of our most valuable resources. How can you leverage technology to better your business? Need to shorten your billing cycle or find a technology that lets you easily schedule services with other businesses? Find a business that offers you a reasonably priced solution that scales across multiple services and leverage it. Scale is a term I’ve heard and used my entire career: it can admittedly come across as a meaningless business buzzword. Quite simply, companies who build with scale in mind are able to grow exponentially with minimal resistance. You can take on more business, more customers and more tasks without missing a beat. How do you grow with minimal resistance? Partner. Again, it comes back to finding the right partnerships. Go back and look at your SWOT analysis to discover partnership opportunities. Learn where there is an opportunity or a threat: oftentimes I find they overlap considerably. Talk with your customers, talk with other providers. Share your learnings, and the information you gather. Don’t hoard it. It reminds me of the old saying, ”If you want to go fast, go alone. If you want to go far, go together.” When you share your knowledge, share your successes and failures, you become trusted, and a source of knowledge. Then a strange phenomenon occurs when you share your experience…. people share their experience with you too. You grow, you learn, you build friendships, you build partnerships, you build a better way forward, and you build a better business beyond your castle…you build an unbreachable moat and a successful business that can scale for years into the future.
Using NEMT to Solve ... continued
you won’t have to wait 14 days to ensure the patient is no longer contagious. This then creates a better patient experience, as they get where they need to go without a substantial wait in an acute space. Addressing the Social Determinants Just as important as transport out of the hospital is ensuring the patient’s condition doesn’t worsen to the point where they need to be readmitted. And this is yet another way NEMT can be enlisted to aid your organization’s fight against COVID. Proper deployment of NEMT resources can help patients stay healthy by targeting social determinants of health. NEMT can be relied upon to ensure the delivery of things like groceries, medical supplies, prescriptions, and other items that can make a large difference in a patient’s recovery. Some states won’t even allow you to discharge a patient if they don’t have two weeks of groceries available, and leaning on NEMT to guarantee this access can remove that barrier. Even if your NEMT providers don’t have the protocols in place to transport COVID patients, they can help you solve for disparities in social determinants of health. It’s become clear that the very people most at risk for COVID-19 are those who also don’t have access to resources others might take for granted, and by addressing these, you can boost the path to recovery beyond what would otherwise be possible. Consider working with NEMT providers to schedule pick-ups and deliveries on those basics that will help the patient recover. Doing so can massively reduce the risk of readmission. Communication We’ve emphasized previously how important it is to regularly interact with your post-acute network to gauge their capacity and their ability to accept COVID-19 patients. This is just as true for NEMT providers, whether those transporting patients or those providing services aimed at addressing the social determinants of health. You should communicate regularly with your providers, and you should have a system in place that lets you quickly schedule pick-up and drop-off of patients and the supplies they need to continue on their path to recovery. Ideally, you’d be able to monitor these rides in real-time and use the data to make even more strongly informed decisions about your NEMT providers in the future. Transportation is a struggle in the COVID-19 era, but hospitals are getting creative with how they’re safely discharging patients. I hope these tips will help you as you evaluate NEMT and its role at your organization. About the Author Luis Castillo has more than 30 years of experience in healthcare information technology. Prior to joining Ensocare, Castillo served as senior vice president at Siemens Healthcare, where he was in charge of IT sales, service and marketing. He was responsible for developing alternate markets, sales strategies and sales channels in order to grow the healthcare information technology business.
Over the last 2 years, the Accreditation Advisory Board (AAB) has been hard at work setting the bar high for NEMT providers by developing world-class standards. The standards for accreditation have been pored over for the last 24 months and NEMT providers seeking accreditation will be the best in class operators that bring the industry out of the shadows and into the healthcare continuum of care. As part of the development of these standards, the AAB has created a process by which we assess and score the degree to which a NEMT provider meets the highest standards of an operator. The scoring tool is designed to recognize the best in class NEMT provider and will be the standard that high-quality providers of transportation seek to operate under. The Accreditation Advisory Board launched a pilot program with the selection of 5 organizations of varying sizes. The AAB has proven that the NEMTAC standards are applicable regardless of the size of the organization. In the coming months, the Accreditation process will roll out to a deep waitlist of organizations seeking to be recognized as honoring the highest standards of care in the NEMT industry. The AAB has developed a network of thought leaders in the NEMT industry to further the acceptance of NEMTAC standards as the industry benchmark for ensuring that NEMT service is offered in a reliable, accountable and safe way. These thought leaders are leading the charge for change in the industry with the AAB driving discussion at the broker, local, state and federal levels.
NEMTAC Technology Advisory Board has been reflecting on its accomplishments over the last two years. We have been blessed to have some of the most forward thinkers in the industry on our advisory board. During our 1st meetings, we talked about some of the challenges faced by transportation providers and how technology might be a solution. After several lengthy discussions, we decided to focus on trip cancellations, which usually are not reimbursed to the transportation provider, and on-time performance, which is a barometer on how well the industry is doing. Several of our members are software vendors, so they were able to provide the advisory board some aggregate data to help establish baselines in the industry. Once we established baselines, we focused on what technologies are available to help transportation providers to better manage these 2 issues. We decided to focus on mobile technology for drivers and advance trip reminders for passengers (notifications reminding the passengers they have transportation scheduled) in an effort to reduce the number of dry runs in the field. The NEMTAC Technology Advisory Board has presented NEMTAC detailed recommendations on both, with white papers explaining the advantages to the transportation provider to adopt these technologies. Our ongoing project is to create an aggregate database of all trips in the industry into a centralized database managed by NEMTAC so the organization can do consolidated reporting identifying trends and outcomes. This project will be deployed in 2021. Overall, it has been an exciting time for the Technology Advisory Board, and we look forward to the future! Thank you, everyone, who has supported the NEMTAC Technology Advisory Board.
Michael Shabkie and Eric Lane, Co-Chairs
Resource & Conference AB Accomplishments
Myron Hammes, Chair
Accreditation AB Accomplishments
NEMTAC Resource and Conference Advisory Board has been reflecting on its accomplishments over the last two years. For starters, we have brought leaders in the NEMT industry together as we share in the goals to improve, educate, and bring awareness to the NEMT industry. Last year we had our inaugural conference in Scottsdale, AZ with over 35 vendors and almost 400 attendees, overall it was a resounding success. With the challenges of the COVID 19 pandemic, we have moved our September 2020 conference to January 2021. This change meets many of the needs requested by the industry, allowing travel restrictions or limitations to be lifted, more time to budget for the conference and allowing those smaller organizations who can't afford to leave their markets to participate on their own terms. When we planned the initial conference, we had many requests to live stream the sessions, making it more accessible to the industry. We wanted to, but frankly, we did not have the resources leading up to that initial offering. We had already planned to have a bigger and more exciting conference for this year, now it will altogether be a bit different. We are taking the opportunity to expand our reach and influence by offering a Hybrid Conference to allow NEMT companies of all shapes and sizes to participate. For those who are able to attend our 2021 conference in person, we will have opportunities such as hands-on mobility device securement training, NEMT 101, a lei'd back luau and much more. For those who participate in the virtual offering, we will have an interactive virtual link to various sessions, a virtual exhibit hall, and opportunities to participate as much as possible while maintaining a safe social distance. Our goal is to expand the knowledge shared with demonstrations of the new safe social practices. We want you to continue to provide safe transportation to the passengers who depend on you. Thank you, everyone, who has supported the NEMATC initiatives.
Certification AB Accomplishments
Peter Hicks and Jim Adkins, Co-Chairs
Technology AB Accomplishments
Peter Hicks and Travis Draney, Co-Chairs
From the earliest concept of the organization, the development of professional standards, a certification has been essential to the vision of NEMTAC. Over the past two years, the Certification Advisory Board (CAB) has worked to review standards used by brokers, states and other organizations alike to determine where there was common ground. The members of this advisory board are a patchwork of professionals from across the industry, strong voices from providers and payors alike, we forged together to launch the very first Certified Transport Specialist (CTS) course. We have heard from the community that several other educational areas need to be addressed, one of these being a Conflict Resolution course specific to the NEMT industry. We have spent the last couple of months working on this 30-45-minute course which we will begin offering in August of 2020. This course addresses moments when interactions between the passenger and transportation specialist become tense and provides tools to help recognize situations of concern then de-escalate them before they cause problems. This course will be offered to individuals or organizations that would benefit from this type of training. The 1.0 version of CTS was launched during the keynote of the Inaugural NEMTAC Conference in September of 2019, since that time nearly 500 people have been certified, we celebrated our first organization with 100% of their staff being certified. It has been a very exciting year! With each student providing feedback on the modules, we are now working to refine the course, by removing duplication, adding features and elements to make the educational experience richer. We have also received feedback from other organizations which will help us to tailor the course to ensure the essential elements remain mandatory while segregating elements that may be optional to make them available at no additional cost. Where we have had significant feedback has been the concentration of CTS on the ambulatory passenger interactions. Ambulatory trips are the bulk of the transports completed by the industry. We recognized that there are many resources for securement both nationally and regionally, so we focused on where we saw a need. As we work through the year, we have other offerings that we will announce as they come closer to maturity. We have not established a timeline for 2.0, however, it's planned for release by the end of this calendar year. We have appreciated the open and honest feedback the industry has brought to the advisory board. We encourage you to reach out to the board members, to send us emails, or even pick up the phone and call us to give us your thoughts. We are here to raise the bar of our industry together. NEMTAC.org
Michael Shabkie and Dan Reid, Co-Chairs
Compliance & Regulator AB Accomplishments
As we're reminded that NEMTAC is approaching its second anniversary, it seems like yesterday that the first Compliance and Regulatory Advisory Board (CRAB) meeting took place. Yet given the events of 2020, it also seems like a lifetime ago. Despite the global pandemic and financial crisis that has wreaked havoc on our industry, the CRAB group has continued to meet and carry on the work we started just 2 years ago. As we begin to roll into our 3rd year, a quick look back at what CRAB has accomplished is in order. CRAB’s work early on was done in combination with the Accreditation Advisory Board as the two groups worked together to create the standards for accreditation. In hindsight this was an obvious and necessary move as both boards were still adding to their rosters, and, in reality, it would have been very difficult to develop compliance initiatives before we had established what needed to be complied with. In early 2019 we had made sufficient progress on the accreditation process and added enough members to the boards that we separated the two boards so that CRAB could pursue our own objectives. Our first product was a Compliance Guideline. We realized that as the industry continues to grow, many small and/or new NEMT companies don't fully understand or appreciate not only the importance of complying with Federal and State laws and regulations but how and which regulations may apply to them. The guideline, now completed and available as a resource, gives NEMT companies the starting point for this critical aspect of their operations. CRAB also set forth to create a database of credentials and requirements of the various brokers and “new wave brokers” (the latter including companies like Kaizen, RideShare and others). The dual goals of this project are to not only provide a resource for NEMT companies looking to work with these entities but also to establish a common ground of requirements among the regulatory bodies and brokers which will ultimately support a credentialing warehouse to streamline the process for NEMT providers to maintain credentials with multiple brokers and/or transition to a broker as contracts change. This project is a long term project and continues to progress. We have identified other areas of importance to providers and have set forth to create resource documents in specific areas: Employee vs Independent Contractor – a resource guide has been created to identify the high-level pros and cons of each business model, and give a NEMT provider key items that must be considered and resolved before selecting an operating model. Insurance Guideline – This is one of the more complicated and difficult areas for any NEMT company. Requirements vary not only by State but by a carrier as well. A working draft of an Insurance Primer and Overview for NEMT Providers is under review by CRAB and will be available soon as a resource. Much acknowledgment needs to be given to Eric Lane for his input on this project. NEMT State by State – We have an in-progress effort underway to identify four key components for a NEMT provider to determine what they need to do to operate in a particular state: Does the State use a broker for Medicaid and/or Medicare NEMT? Does the State require a NEMT provider to have any special licensing or certification to operate? Are NEMT drivers required to have any special endorsements on the driver’s license or any other training to operate as a NEMT driver? What are insurance requirements a NEMT provider must carry to operate in a particular State? This state-by-state guide will be a valuable resource to NEMT providers once the information has been accumulated. Our goal is to provide not just the answers to these four items, but the links to where the information can be obtained for each state so that providers can make sure they have current information. Operating in the “New Normal” – Everyone has felt the impact of the COVID-19 pandemic. As we emerge from the immediate crisis we all know that a new normal will emerge. This will take the form of new safety procedures that become a permanent way of life for NEMT providers to steps every provider should take to ensure when the next emergency rolls around we have the necessary tools and processes in place to be able to most efficiently operate. CRAB is pulling together a working document that guides “best practices under the new normal” as well as steps every provider should take to make sure they are positioned for the next crisis. CRAB will continue to identify areas of compliance and regulatory issues that NEMT providers must consider to operate at a “best practice” level. These topics will run the gamut from issues providers need to know to avoid fines and penalties from regulatory authorities to best practices to ensure the safety of employees and passengers and policies and procedures every provider should have in place to operate at “best in class” standards. We look forward to this 3rd year of NEMTAC and hope to continue to provide valuable resources to our community. We welcome any suggestions for areas we should consider, and we hope that you all continue to remain safe.
Advisory Board Updates ... continued
By Sarah Kunstal, Director of Marketing, Veyo
Sipes also pointed out the movement toward increased in-home treatments for everything from dialysis to substance abuse, and how that could open up the opportunity for transporting equipment, and possibly healthcare professionals, to patient homes. No matter the situation, Sipes believes – now more than ever – it’s vital for NEMT providers to innovate with the changing times ahead. “There are going to be some great opportunities to come out of this crisis for those who are able to pivot. Necessity is the seed of innovation, after all. Some are going to do it; some aren’t,” said Sipes. Sipes admits that he and Veyo are hoping the recent uptick continues northward, but that they are preparing for whatever the future holds. “The increases in May appears to be continuing, but whether or not that continues, or plateaus, remains to be seen,” he said. “A lot depends on (the possible COVID-19) second wave, and what happens if that hits.” “There are so many external dependencies, like do healthcare providers continue using telehealth? Will the methadone treatment process, where instead of a patient going in daily to get their dose, some have been giving patients the option to receive a week or couple weeks of doses, continue beyond the crisis?” As Sipes said, right now it’s a time to prepare and be sure that opportunities are not missed. He’s working hard to make sure Veyo is on that path. “We literally designed a technology platform, a vertically integrated platform, designed for NEMT management,” he said. “In addition to our fleet of professional drivers who meet requirements of every state, they also utilize our technology that lets them know what each patient needs. We feel those tools have us ready to face any challenges ahead.” Article first printed in The Transportation Alliance.
In trying to figure out the impact—and the road ahead—for non-emergency medical transportation (NEMT) providers during the COVID-19 crisis, a good person to touch base with is Stan Sipes, executive vice president of business development at Veyo. The San Diego, Calif., based company provides NEMT brokerage services to Managed Care and state agencies in six states. Pre-pandemic days, they were managing some 34,000 trips daily. But those numbers have fallen since the virus hit the United States, like all transportation usage worldwide. “What we saw, as well as what the industry saw, was a significant slide,” Sipes said. “When you saw healthcare providers cut back to critical care only, or begin to move to telehealth, there was a natural degradation of anywhere from 30-to-50 percent of trips no longer being necessary through NEMT.” Veyo currently manages contracts for customers in Arizona, Connecticut, Virginia, Florida, Michigan, and California. When Arizona was one of the first states to ease lockdown situations, Veyo was curious as to what the impact might be on NEMT utilization, and early results have shown a promising increase in trip numbers. “We are beginning to see an uptick as the healthcare providers expand their in-office services, which started in early May,” Sipes said. “Arizona was one of the first states that officially began to reopen, and to some extent all states are beginning to take steps to lessen the restrictions to the stay-at-home restrictions. While we have seen an uptick in most markets, it is tough to predict what NEMT utilization will look like over the next few months and into 2021. “Will volumes get back to pre-COVID numbers? I don’t think anyone really knows at this point,” Sipes continued. “With the introduction and expansion of telehealth, there will be a shift in how people access healthcare. However, there are several aspects of healthcare that still require in-person care and NEMT.” Sipes cautioned that any reports coming out of Arizona that trip counts are already at pre-COVID levels are simply untrue. But he also sees other NEMT-related opportunities. “Arizona is experiencing an increase, but certainly not near the pre-COVID time. We are watching our data daily, and preparing for whatever the situation requires..” So Sipes is trying to peer into the future to see what it holds. They feel one thing that should rise is a new demand to use logistical services to support the “new normal.” Veyo, said Sipes, already sees NEMT having to provide more flexible solutions as health systems face a growing need to meet their patients in their communities and homes. As an example, they have created a specialized fleet of drivers and vehicles that are able to provide COVID+ patients NEMT transport to critical care. It took an amazing amount of collaboration between Veyo, their customers and the regulators to put this together, and it is likely that this service will be of value beyond the current crisis. “We’re calling this a trend toward ‘Reverse NEMT.’ Instead of delivering the patient to their healthcare services, NEMT will need to adapt to move healthcare services to the patient,” he said. “Delivering goods, pharmacy, and food to patients … as well as supporting telehealth with logistical services. Not every patient has telehealth capability, so that might be an opportunity for an organization to deliver that technology and support, whatever it may be.”
How RoutingBox is Stepping up During the COVID-19 Crisis
As we all continue to navigate our way through this global pandemic, it is becoming clear that things may never be the same as before COVID-19. The needs and requests of passengers are changing daily. For example, a dialysis patient who is usually quite happy to join others on the ride may not want to multi-load anymore as this patient is immunocompromised and, therefore, more susceptible to contracting COVID-19. As a transporter, you need to adapt to these concerns and find an efficient way to not multi-load passengers. To keep your drivers and passengers safe, your staff needs to follow enhanced safety protocols which includes adding ample time to disinfect the vehicle between trips. Safety is and, has always been, paramount in our industry. The primary focus of safety concerns has traditionally revolved around your passengers. New safety protocols must also include your drivers. How do we make sure our passengers get to where they need to be, while keeping them safe and essentially protected against COVID 19? What can we do as transporters to not expose the immunocompromised? RoutingBox was created by NEMT for NEMT, so it is no surprise that our software has a solution built-in for these very questions. Our customers are using our proprietary Route Optimization algorithm to accommodate major business changes and make their routes as efficient as possible. This powerful tool considers multiple parameters with exponential calculations to help you adapt quickly.Some examples include – late tolerance, the distance you want your drivers going between trips, whether or not to allow multi-loading and more. Because you need to adapt daily, you are able to edit these criteria as needed. You can adapt quickly for a situation like multi-loading by switching it on or off as needed. With a couple clicks, Route Optimization takes all of your trips and strings them together to generate the most efficient routes. It does this while considering all your selected parameters. This incredibly robust tool was the culmination of years of transportation industry experience, customer input, research, testing, and development. Every aspect of RoutingBox is set up to streamline your day and to minimize your work efforts. Perhaps more importantly, our expert customer success team is available to help you through every step of the process. At RoutingBox, we pride ourselves on being the most forward-thinking company in the NEMT space. For this reason, when the pandemic hit, we did more than help our current customers. Just like you, we knew that we had a duty to do our part in helping the communities we serve. In May, RoutingBox embarked on a partnership with New York State Senator Leroy Comrie to help get COVID-19 testing to essential volunteer workers throughout Queens. In May, The Senator and his team facilitated a first-of-its-kind mobile COVID-19 testing unit with a fully-equipped Medical Bus. During their inaugural three-hour event held at a food pantry in Springfield Gardens, the Senator and his team were able to administer more than 100 tests. Due to the success of their first event, The Senator’s team was asked to expand their testing efforts to more than 50 locations across Queens. By using RoutingBox, the team will have access to sophisticated analysis reports and be able to compile all necessary data with just a few quick clicks. Because RoutingBox automatically tracks their Medical Bus and keeps comprehensive records for potential auditing, the team can focus on their core mission rather than record keeping. This partnership between RoutingBox and Senator Comrie illustrates one of our core beliefs– that we can accomplish great things by melding technology and good public practice. The Senator’s team is helping save lives and improving the communities they serve by using advanced technology tools created by RoutingBox. As a software company in the service industry, it’s our pleasure to partner with the Senator in his quest to get testing to his district. It’s not just our pleasure, it’s also our responsibility and we will continue to do so.
Sponsored Content
There have been many advancements in platform lifts over the years. VMI iClass lifts are the industry’s newest premier lifts that are designed for ease-of-use in the field, as well as easy to maintain and service for minimal downtime off the road. All models are equipped to operate conveniently: 1) with a wired or wireless remote or 2) with an app right from a mobile phone. The mobile phone app functions not only as a remote but also as a resource for how-to operate or trouble shoot, perform maintenance and maintain service history. There’s no other platform lift series quite like it! The VMI iClass platform lifts provide a 1000 lb lift capacity, LED lighting for added safety and multiple fail-stop measures to ensure passenger safety, such as a unique non-slip design and an outer roll-stop mechanism with anti-rattle platform blocks. CONTINUED SUPPORT AFTER THE VEHICLE PURCHASE The last thing you need is an inoperable vehicle, especially when you’re making efforts to minimize both driver and passenger exposures. Maintaining your transport vehicle has never been easier with services available with every AMS van purchase. Every vehicle is eligible for a 1-year mobility roadside assistance membership and access to Wrench fleet service where certified mechanics come to you to service the vehicle and/or lift. Mobility Roadside Assistance (MRA) will ensure that your driver has backup while on the road. Should the driver encounter troubles with the vehicle, MRA will dispatch another mobility transport van to make sure first and foremost that your passenger is taken to their intended destination (up to 25 miles). It will also dispatch a towing service to deliver the vehicle for repair. MRA also covers services commonly expected from a roadside assistance provider, such as: battery service, jump start, lock-out assistance, tire repair, towing, winching/vehicle extraction and emergency fuel delivery. Mobility Roadside Assistance is available throughout the U.S. and Canada. Wrench has partnered with VMI to extend coverage to its commercial vehicles from AMS Vans. Expert, certified auto mechanics will service the vehicles at a time and location that’s convenient for you, allowing your operation to maximize vehicle utilization and still get it serviced. Wrench mechanics will provide services such as brake adjustments and caliper replacement, oil and filter change, engine tune-up, vehicle parts replacement, A/C service, battery replacement, perform vehicle diagnostics and service platform lifts, to name just a few. Wrench is currently available in select cities within the contiguous United States. Verify availability at wrench.com/zipcheck. For more information on full size vans and iClass platform lifts, visit https://www.amsvans.com/wheelchair-vans/commercial or call 800-775-8267. For information on fleet purchases, please contact Jason Stempin at jasons@vantagemobility.com or (314) 396-9322.
Embracing the new normal is possible with the right support behind your operation. New precautions mandated by the local/city/state government are likely driving you to rethink how your transportation operation can provide services safely while still remaining competitive and cost effective. Conforming to new safety protocols may include: Physical distancing (typically 6ft) from driver to passenger or between passengers Sanitizing vehicles Disinfecting between rides Utilizing personal protective equipment Implementing an essential trip policy CDC’s Recommendations for Cleaning and Disinfection for Non-emergency Transport Vehicles TRANSPORT VEHICLE OPTIONS Vehicle selections that are most practical for small to medium sized non-emergency medical transportation are typically minivans and full-size vans. Further, of these types of vehicles, there are options for how passengers may enter/exit the vehicle: from the side or rear, via an integrated in-floor or fold-out ramp system or a platform lift. Considering the need for as much physical distancing as possible between the driver and the passenger, full size vans equipped with a platform lift is a good choice. Full size vans like the Ford Transit and the Dodge Promaster will provide the extra space needed. Additionally, these vehicles lend itself to provide the greatest versatility for transporting either ambulatory or wheelchair passengers or individuals on a gurney. Seating and floor configurations allow the greatest flexibility for maintaining physical distance between the driver and the passenger, as well as between passengers if multi-person transport is necessary. A full-size van will likely provide more securement options to safely secure your passengers with the proper restraint systems in all seating positions. When choosing a full-size van for your operation, it’s also important to verify that the vehicle is ADA compliant and meets all Federal Motor Vehicle Safety Standards (FMVSS). This will ensure necessary qualification to utilize your vehicle and capture the most opportunities for ridership, especially when payments are subsidized through government programs. ACCESSIBILITY OPTIONS Accessibility in a full-size van is created with platform lifts. Platform lift models such as the VMI iClass platform lifts are reliable and easy to use. Lift models are available as a solid one-piece, split or folded platform. The ideal model should suit your requirements based on anticipated usage. For example, do you expect to transport an equal number of wheelchair and ambulatory passengers where the lift should split to enable convenient entry and exit by ambulatory passengers? Or, perhaps you intend to accommodate both gurney and wheelchair passengers where the platform lifts should be mounted for side entry.
Over the last two decades the business landscape has changed dramatically with the advent of cloud-enabled marketplaces where service providers and subscribers have the ability to connect online seamlessly – eBay and Amazon Marketplace for consumer goods, AirBnB for vacation rentals, Uber for personal transportation, etc. Online marketplaces have made it possible for demand and supply to transact on mutually agreeable terms that provide value to both parties. Online marketplaces connect subscribers (demand) who have specific requirements with providers (supply) on the basis of capabilities, availability, and specializations. In this article we will explore the capabilities NEMT providers need to consider while selecting a marketplace technology to grow and diversify their business. What to look for in a Technology Marketplace? Large Subscriber Community A provider’s primary reason to sign up on a platform is that they wish to grow their business. A marketplace requires an active community of subscribers that a provider can serve. A good marketplace should provide incentives to existing subscribers who can refer others to the platform and help in creating a vibrant ecosystem. Frictionless Onboarding Let’s say, you found an online marketplace with a large pool of subscribers willing to subscribe to your services. However, there are several steps to complete before you can sign on to the marketplace and begin doing business. Time lost equals lost opportunities and underutilized assets. A good marketplace should let providers onboard quickly in few easy steps by verifying credentials and certifications, and it should help them list their services for subscribers. Profile Management An effective marketplace helps providers highlight their capabilities by enabling them to list qualified drivers, certifications, insurance, vehicle capacities, areas of operations, specialized transportation services, etc. It delivers functionality that allows providers to maintain their real-time availability by every transportation asset and service offered, so subscribers can get access to services without any delay. A marketplace platform should alert providers when any type of credentials and/or certifications are out of date, so they can be updated in order to reflect the most current compliance status. Matching and Contracting A marketplace that guides providers towards setting up a good profile goes only so far as its ability to present the information to relevant subscribers. Marketplace subscribers should have access to a rich search function that helps them find the most relevant providers for their needs. When subscribers are presented with a list of recommended providers, they should be able to see overall capability, time spent on the platform, service ratings by other subscribers, etc. Contextual matching and profile highlighting help match providers with subscribers. When a match is found, providers must be able to establish a contract and terms of transaction with the subscriber without delay. Easy Connect in Real Time A marketplace platform is useful when it brings providers business rather than them having to search and chase it down. An efficient marketplace regularly updates providers in real time about services that its subscriber community is looking for. It allows providers to respond to service requests and other communication in real time, so as to capitalize on available opportunities. Diversification and New Opportunities All businesses, including medical transportation, are subject to cycles of peak demand followed by lean periods. A good marketplace offers providers alternative business opportunities to utilize their workforce and assets in an effective way. E.g. NEMT providers with HIPAA-qualified drivers are preferred when it comes to delivering medical prescriptions, as opposed to regular courier services. Can the marketplace help NEMT providers pivot to handling prescription deliveries? A marketplace that pulls in subscribers with diverse transportation needs improves a provider’s chances of finding business in allied business verticals. Reviews and Ratings Any subscriber who receives transportation services from a provider should be able to rate the transaction and provide their comments for future subscribers’ reference. The marketplace must display the highest rated providers to subscribers so that a positive service experience on the platform can improve the likelihood of gaining more business.
Growing your Transportation Business via Technology
Healthcare organizations are on the frontlines of the COVID-19 pandemic. Beyond their core mission of providing exceptional patient care, healthcare organizations must also ensure the smooth operation of their business operations and supply chains.Payments processing is among the core business functions at risk of being disrupted by the unfolding COVID-19 pandemic. Fifty-four percent of finance leaders say the pandemic has the potential for “significant” impact to their businesses.That’s according to a COVID-19 CFO Pulse Survey by PriceWaterhouseCoopers (PwC). PwC interviewed finance leaders in the United States and Mexico.All the finance leaders surveyed by PwC said their business already is experiencing some impact as a result of the pandemic. How omni-channel payment solutions ensure business continuity Omni-channel payment solutions help healthcare organizations minimize disruptions to their business operations, supply chains and people.Here’s how omni-channel solutions do it: Work from home support: Thirty-four percent of the finance leaders surveyed by PwC say the impact of the pandemic has been limited to specific regions, but they are monitoring developments. In many cities, staff cannot get into the office due to government restrictions, quarantine or illness. An omni-channel payment solution allows healthcare organizations to disburse funds via ACH or card simply by uploading a single payment file. Authorized users can upload an approved-payment file from wherever they are. Payments are reconciled in real-time. And any information for tax reporting is automatically tracked and generated. Business continuity: In this climate, employees and contractors want to know they will be paid. But there’s no telling when staff for some healthcare organizations can return to the office to cut checks. Automated Clearing House (ACH) transactions and reloadable debit cards help ensure that employees and contractors get paid when payroll staff are working remotely. Financial assistance also can be sent to employees through instant payments. Opportunities to free up cash: Fifty-eight percent of the finance leaders surveyed by PwC expect a decrease in their company’s revenues and/or profits this year. An omni-channel payment solution can help lessen the blow for healthcare organizations by freeing up cash on existing revenues. Rebates can be earned based on the amount of spend paid for with a virtual card. When you consider that disbursements for supplies, utilities and most other expenses can be made with a card, a healthcare organization could potentially earn sizeable rebates from cards – potentially millions of dollars. Healthcare organizations can free up more cash by paying suppliers via ACH+ transactions or Real-Time Payments (RTPs). Less change of supply chain disruption: Only 30 percent of the finance leaders surveyed by PwC are considering supply chain changes. But heading off supply chain disruptions will require healthcare organizations to help their key suppliers navigate the economic challenges brought on by the COVID-19 pandemic. An omni-channel payment solution accomplishes this by accelerating payments to suppliers (in some cases, allowing for instant payment), providing real-time visibility into the status of payments for better cash management, and delivering the rich remittance details for effortless application of electronic payments. Real-time visibility: During this uncertain time, healthcare organizations will need to carefully manage their cash and spending. Forty-eight percent of finance leaders surveyed by PwC expect to change disclosures as a result of the pandemic. Omni-channel payment solutions provide healthcare organizations with real-time visibility across the payment lifecycle, from submission through reconciliation, with all payments on a single platform. And readily accessible reports enable users to monitor cash flow and corporate spending. Easy deployment and maintenance: Combatting COVID-19 requires healthcare organizations to focus their resources on patient care. And the uncertain economic future makes it more important that healthcare organizations prioritize cost-effective solutions. While most finance leaders surveyed by PwC are optimistic about a resolution to the spread
By Phil Lugo, VP Business Development,TransCard
Easy Billing and Payment A marketplace that provides diversified business opportunities in real-time is one half of the story. The speed with which a provider can respond to business opportunities through the platform should be matched by the timeliness with which they are paid upon successful completion of a service request. Transportation businesses are often run by owner-operators with limited working capital. A marketplace should enable providers to get paid for their services on time so that they can maintain continuity and focus on providing good service. An effective marketplace helps providers set up capabilities to receive payments directly from subscribers in a timely manner. It enables providers to invoice subscribers automatically, and it makes various frictionless payment methods available to subscribers, including credit cards, pay wallets, and traditional ACH bank payments. Transportation Marketplace for NEMT Providers WellRyde is a leading provider of mobile-enabled dispatch solutions for NEMT providers in over 35 states. It supports integration with all major national and regional NEMT brokers. Over several years of working closely with the NEMT community, WellRyde has developed a deep and nuanced understanding of the needs of providers. The insights gained through this interaction has led to creation of nuVizz Marketplace where providers can seamlessly connect with transportation opportunities not only within the NEMT universe but also in the larger transportation space, including medical prescription deliveries, meals on wheels services, community-based transportation, etc. The WellRyde Marketplace enables transportation providers to diversify and grow their businesses in a sustainable way while making transportation accessible in underserved communities. For more details visit -https://nuvizz.com/marketplace/ Wellryde Contributing Authors: Pratik Jagad, Chief Product Officer Anantha Rao, Chief Technology Officer Veda Ramachandran, Vice President, Customer Success
Growing your Transportation ... continued
How Omni-Channel Payments ... continued
of the coronavirus, businesses would likely pullback on long-term investment spending if conditions were to deteriorate. The open APIs built into leading omni-channel payment solutions enable them to be deployed fast, and easily integrated with legacy practice management systems or other applications. Omni-channel platforms also eliminate the burden of managing multiple systems for disbursing funds via different payment methods. Ironclad security: There is no need for healthcare organizations to forego their security and data protection standards because employees are working remotely during the COVID-19 pandemic. Administrators of an omni-channel payment solution can restrict access to payment information and activities, mitigating the risk of fraud and safeguarding sensitive information. The funding accounts for virtual card transactions also can be kept confidential. And leading integrated payables solutions undergo strict periodic audits. Virtual cards also are plastic-less, meaning there is no physical card that can become lost or stolen. What’s more, virtual card numbers can only be used once, recipients only receive 10 of the 16 digits of a virtual card, and each transaction can be restricted by recipient, amount and time period. Lower overhead: Healthcare organizations will undoubtedly reign in spending as a result of any economic downturn caused by the pandemic. Omni-channel payment solutions reduce the cost of making check payments, as well as the number of check payments made. Customer service: Omni-channel payment platforms enable healthcare organizations to make patient refunds using any electronic payment method, even if staff cannot get into the office. With an omni-channel payment solution, healthcare organizations can automate disbursements to help minimize impact of the pandemic on their business operations, supply chains and people. Accelerating cash flow during the COVID-19 pandemic But it’s not just healthcare disbursements that can benefit from an omni-channel payment solution. The pandemic will likely impact cash flows.An omni-channel payment solution may be able to help accelerate cash flow by eliminating friction in a healthcare organization’s receivables lifecycle: Enhanced cash flow: Real-time posting of electronic payments made by consumers can significantly accelerate funds availability while reducing the amount of unapplied funds. Improved productivity: Automating the receipt, processing, settlement and reconciliation of consumer payments and acquirer fees can save accounts receivable staff a tremendous amount of time.Omni-channel payment solutions also can determine chargebacks. Accelerated cycle times: Time is money.Omni-channel payment solutions eliminate posting delays by providing robust workflow capabilities such as real-time instant messaging to the customer, automatic routing of funds, splitting of funds and routing of attachments. Support for any payment type: Offering customers the flexibility to make electronic payments via their preferred electronic method – including Real-Time Payment (RTP) – reduces the chances of receiving paper checks that might sit in a mailroom until staff return. Guaranteed funds: Once an RTP transaction has been approved by a consumer, those funds are guaranteed, and cannot be drawn back, as in the case of traditional ACH transactions. Each of these benefits of an omni-channel payment solution is compelling.Together, they provide healthcare organizations with the cash flow they need to get through the COVID-19 pandemic.
Preparing for a brighter future Ninety percent of CFOs and finance leaders surveyed by PwC are optimistic that their business can return to normal operations in less than three months if the COVID-19 pandemic were to end soon. An omni-channel payment solution can help healthcare organizations through the pandemic while equipping them with the tools they need for the future, however it unfolds.Want to learn more?Contact Transcard at sales@transcard.com to arrange a no-obligation consultation with one of our payment experts.
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NEMT Today magazine is a quarterly publication with editions in the Winter, Spring, Summer and Fall. The publication is an 8.5" x 11" vertical interactive digital publication. We are interested in receiving articles that highlight educational topics related to Non-Emergency Medical Transportation (NEMT) business operations, industry trends, compliance & regulatory, technology and customer service. Submission Deadlines: Final copy for articles and advertisement is due on the following dates: Winter issue - January 15th Spring issue - March 15th Summer issue - June 15th Fall issue - October 15th Each issue will be published approximately one month after submission deadline. Article Specifications: Furnish articles in Word files format 1000 word maximum or less preferred All font will be Open Sans 9.6 pt. All articles must be submitted with author name and title All articles must be submitted with a title All articles must be submitted with a minimum of 1 photo relevant to the article Articles that heavily promote an organization will be considered sponsored content and the editor will contact you for approval and payment
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