Chelsea, a peer driver for five years and a UnitedHealthcare member, transports a behavioral health patient to work.
UnitedHealthcare Community & State and Johnson County Mental Health Center (JCMHC) in Johnson County, Kansas, are partnering on a year-long pilot that provides behavioral health patients with wrap-around transportation services. These services help these members get to work, school, social services, and employment, as well as mental health and medical appointments.
The UnitedHealthcare pilot, developed by the Dartmouth's Heath Care Executive team consisting of several UnitedHealthcare leaders and administered by the Community & State myRide team, kicked off last October and helps assess the broader impact of transportation on patient outcomes, well-being and health care costs. "It also informs how UnitedHealthcare provides user-centered non-emergency transportation benefits for Medicaid members.
These services help these members get to work, school, social services, and employment, as well as mental health and medical appointments.
The pilot supports workforce development opportunities throughout the country," said Flora Castillo, vice president of transportation, Integrated Health and Social Services. It's important to keep in mind that the people served through this program often have had a long-term set of challenges because of their conditions. Many of them have never been able to drive a car and most never had enough money to own one.
"This whole person care approach requires not just the utilization of innovative health care management, but supportive service interventions that impact both a person's health and the quality of their life."
Dr. Jeffery Brenner, Senior Vice President Integrated Health and Social Services at Community & State shared that, "Improved healthcare cost outcomes, as well as improved quality of service, are objectives that can be achieved through an extensive implementation of preventive care, early intervention strategies and evaluating the individual ways the social determinants of health affect individuals. This whole person care approach requires not just the utilization of innovative health care management but supportive service interventions that impact both a person's health and the quality of their life. Homelessness, isolation, lack of education or employment are barriers to wellness that a whole person approach must address to create successful outcomes." A key component for maintaining and achieving successful member outcomes requires making sure that getting the patient to and from medical care and these related activities is essential.
"All of those things might lead to an unnecessary Emergency Room visit. That's what we're trying to get in front of."
JCMHC, a participating accountable care organization (ACO) selected by UHC, is a leader in treating the whole-person – an approach that Community & State believes is critical to helping improve health outcomes for our members. One of the unique aspects of JCMHC is their commitment to creating employment opportunities for behavioral health patients who want to work, and the wrap-around support through the innovative mobility management strategies. Their transportation program employs patients as consumer peer drivers. Their experience as a patient is utilized as a tool to help others. These services are provided through a fleet of 40 2017 Nissan Sedans.
"The leveraging of peer-to-peer engagement between provider and member is tremendously valuable in contributing to an elevated member experience; wherein the provider has 'walked in the shoes of the member' is a model which National Medtrans will collaborate with the UnitedHealthcare Community Plan in Kansas to expand, as well as seek to replicate with community based organizations in additional markets," shared Andrew Winakor, executive at National MedTrans.You may recall that late last year, UnitedHealthcare and National Medtrans joined forces where UnitedHealthcare acquired the non-emergency transportation provider.
"The leveraging of peer-to-peer engagement between provider and member is tremendously valuable in contributing to an elevated member experience; wherein the provider has 'walked in the shoes of the member."
For the drivers as well as for patients, it also provides a way to socialize and build their own community and social support network.
As Austin Pittman shared with a reporter from the Kansas City Business Journal, at a recent update on the pilot, "You can make all the doctor's appointments that you want to in the world, but if you can't get to them, you might miss that specialty appointment or might not get to the pharmacy to get your prescription filled," he said. "All of those things might lead to an unnecessary Emergency Room visit. That's what we're trying to get in front of."
Even though there's public transit in parts of Johnson County, jobs are often located far from bus service. People do use the bus when it works out and Johnson County staff work to make that happen, but for people working off a bus line, lack of transportation is a significant barrier. The Non-emergency Medical Transportation (NEMT) program is an option for Medicaid plan members to get to and from medical care. The service requires a three-day advance scheduling, but it does not service urgent needs and non-medical destinations related to employment, education and training, social and financial services, housing and more.
During the pilot, transportation is provided to UnitedHealthcare Community Plan members by a trained team of consumer peer drivers who have received treatment from JCMHC. These drivers are trained in crisis intervention, customer service and serve as a critical link to providing a feedback loop to the vocational rehabilitation and care management teams at JCMHC. Chelsea, a peer driver, shared she likes driving "because it's therapy and it gets me out into the community and interacting with the clients. It also helps me feel better about myself because the clients understand where I'm coming from and have experienced the same stuff." For the drivers as well as for patients, it also provides a way to socialize and build their own community and social support network.
"It also informs how UnitedHealthcare provides user-centered non-emergency transportation benefits for Medicaid members."
Community Plan members are provided transportation to clinical sites, health maintenance activities, and to the important services that we recognize as social determinants including, food and nutrition resources, employment opportunities and training, cultural, social and recreational destinations. Since many of patients with behavioral health conditions often experience difficulties communicating due to anxiety, depression, etc., the pilot simplifies the scheduling of transportation services by way of a one-call model that connects the plan member directly to the transportation staff who are walking in their shoes.
The pilot is measuring health outcomes for the members who receive peer driver transportation through JCMHC. Specific outcomes examined include the reduction of missed appointments, emergency room utilization, and the ability for members to obtain and maintain employment as well as overall satisfaction.
Receiving an update on the transportation pilot are: L to R - Jim Allen, County Commissioners; Flora Castillo, Vice President of Transportation, IHSS; Marla Gruendel, Consumer Driver JCMH Transportation Program; Dale Marsico, Pilot Manager, IHSS; Lisa Iverson*, Chief Financial Officer, C&S; Jenny O’Brien*, Chief Compliance Officer, UHC; Jean Elmer, Consumer Driver JCMH Transportation Program; Steve Klika, County Commissioner; Kevin Sparks, CEO Community Plan of Kansas; Austin Pittman, CEO, UnitedHealthcare Community & State; Corey Stoltz, JCMH Transportation Program Manager; Marsha Connor, Executive Director Community Plan of Kansas; Tim Spilker*; Regional CEO, C&S; Jason Osterhaus, County Commissioner and Maury Thompson, Assistant County Executive; and Andrew Winakor, CEO NatMedTrans (*Members of 2018 Dartmouth Master of Health Care Delivery Class).