Delivering Greater Access than Ever Before to New Jersey Medicaid Members

Posted by Steven Linowes in nemt, Blog , member stories on 30.Apr.16 | 0 Comments

In 2009, the New Jersey Department of Health and Human Services (DHHS) adopted a broker model to manage healthcare transportation for Medicaid members. States have the option to either manage transportation themselves, allow managed care organizations to manage it for them, or to hire a third party broker. Statewide broker systems have proven to reduce costs 10-15% over fragmented models while at the same time increasing access. The public-private partnerships are designed to meet federal standards, make sure fragile patients have greater access to needed health care services while saving taxpayers money. New Jersey was looking for a vendor who could deliver on these service goals as well as have the ability to expand the program as the Medicaid population grew.

As part of New Jersey’s oversight for the program, they mandate specific metrics related to on-time performance, enforcement of driver training standards, minimum levels of driver safety checks and consistent, strict adherence to financial and operational reporting to protect against fraud. Those mandates ensure regulatory accountability and operational oversight. When LogistiCare was awarded the contract after a lengthy selection process, these mandates became a cornerstone of LogistiCare’s service delivery and have been consistently applied throughout the state for the last six years.

Growing to 1.6 million members
The first task at hand was to centralize the transportation network system, creating new efficiencies and applying consistent metrics across the state. Change is taxing on any state transportation network, but when it starts scaling at a rapid rate in the middle of a transformation, the challenge becomes exponentially more difficult. There was no way to predict where demand would increase before it happened. New Jersey’s first brokered program now conducts 4.5 million health-related trips per year and covers 1.6 million NJ FamilyCare members, a figure that grew by more than 60% in just six years. It’s a very sophisticated, high oversight transportation system that was not easy to create and would be difficult to replicate—and its own members have given LogistiCare good marks based on a new third party report by IPRO.

This recent independent audit reports that NJ FamilyCare members said more than 90% of rides were completed safely, courteously and on-time. This audit presents what is the most realistic member assessment of service quality to date. The report measures performance data and direct member feedback and is based on more than 450 member interviews. It’s a very accurate look at member satisfaction across the entire program. However, in striving for consistent, quality service, continued proactive improvements and measures will always be critical to our success.

Always improving service to keep people healthy
Together, both LogistiCare and the state of New Jersey take extensive proactive measures to help ensure continued success. The state of New Jersey independently researches the performance data we report every month against member and health care provider feedback. The extra measure ensures the program is working to their high standards and helps uncover what isn’t so it can be fixed.

It’s not at all acceptable for any ride to be late, let alone missed. LogistiCare strives for 100% of our trips to be on time, although we recognize that weather, traffic, and the unexpected needs of our riders can’t always be predicted. Yet, despite extraneous factors, we are dedicated to finding ways to better the service we can control. If a ride is cancelled, we want to know why so we can work with our partners to eradicate it. It’s important to us to recover the trips that have deficiencies so we can keep members healthy. With the help of our partners and the state of New Jersey, LogistiCare has sought to continuously provide better service by enacting:

• Mandatory corrective actions for any transportation provider that falls under quality performance standards.
• Detailed reports on performance encompassing all aspects of the operation for New Jersey.
• Quarterly audits on cancellation data to ensure accuracy which is used to reconcile and resolve any service issues.
• Ongoing one-on-one outreach to healthcare providers and partners to assess and resolve service quality and issues – including visits      with more than 500 unique providers in 2014 alone.
• Expansions to add service center staff and vehicles across our transportation network to meet growing demand. We now employ 200    people at our Edison, NJ service center and manage a network of more than 175 small businesses across New Jersey to assign and          provide transportation.
• Collaborative efforts with members, advocacy groups and community leaders to provide innovative solutions for troubled areas, such    as a pilot project that reduced service issues for members in particular housing units to less than one-tenth of a percent.

With thoughtful response to growth; new partnerships with advocacy groups, community leaders and health care providers; and continued trusted support from DHHS and NJ FamilyCare members statewide; we’ve built a strong program for New Jersey. A program that surpasses state requirements and delivers safe, quality, consistent transportation to members who are largely satisfied according to third party research. We look forward to meeting and exceeding even higher standards in the next phase of transportation services for NJ FamilyCare members—ensuring their care while designing smarter rides that ultimately save taxpayer dollars.

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