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Serving Members with ESRD: The VectorCare Hub Roadmap to Cost Savings

August 18, 2021
by
David Emanuel

Managing the continuing COVID-19 pandemic isn’t the only challenge Medicare Advantage plans are facing this year.

During 2021, Medicare Advantage plans are also dealing with dual mandates to:

  • Cover more members with end-stage renal disease (ESRD)
  • Offer coverage for non-emergency medical transport (NEMT)

Here’s a roadmap to mitigate the rising costs of serving members with ESRD using VectorCare Hub:

  1. Prioritize the social determinants of health (SDOH). Missed appointments cost the healthcare system $150B per year. With transportation being one of the top reasons why, focusing on access to transportation is critical.
  2. Offer ride-sharing benefits to reduce reliance on ambulance services. 70% of dialysis-related transportation claims are not medically necessary but fulfilled due to no viable alternative.2
  3. Schedule and execute dialysis transportation online. VECTORCARE HUB HELPED ONE PAYER-PROVIDER reduce the average time scheduling dialysis transportation by 15 minutes per request, translating to $22.2M in annual savings.
  4. Fight NEMT fraud, waste, and abuse with visibility into transportation costs. Medicare loses $3B+ per year to fraudulent NEMT charges.3 Identify and flag potential fraudulent charges with robust reporting.
  5. Manage contracted pricing to avoid surprise bills. 39% of non-emergency ambulance services result in a surprise bill.4  Manage contracted pricing agreements and reduce surprise billing.
  6. Implement a patient care logistics solution. Imagine the possibilities a comprehensive solution can offer to meet the needs of members with ESRD that go beyond dialysis transportation, including filling prescriptions and delivering DME.

Implementing VECTORCARE HUB’S PATIENT CARE LOGISTICS SOLUTION can help Medicare Advantage plans better meet the needs of members living with ESRD while controlling quickly rising costs of providing adequate care.

CONTACT US today to schedule a demo.

Want to read more from the Patient Care Logistics Journal? Check out our latest post on how Medicare Advantage plans can uncover fraud and abuse with technology.

Sources:

https://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-4-090.pdf

https://jheor.org/article/9861-high-costs-of-dialysis-transportation-in-the-united-states-exploring-approaches-to-a-more-cost-effective-delivery-system

https://www.hilarispublisher.com/open-access/nonemergency-medical-transportation-and-the-promise-of-blockchain-applications.pdf

https://www.healthsystemtracker.org/brief/ground-ambulance-rides-and-potential-for-surprise-billing/