Wheelchair Transportation for Hospital Discharges

The need for reliable and accessible wheelchair and non-emergency stretcher transportation for hospital and emergency room (ER) discharges is every increasing.  In addition to a growing senior and elderly population, the medical industry itself is changing, and there is no better illustration underscoring these dynamics than the need for hospitals and emergency rooms to overturn their beds and discharge patients as soon as possible.

Why are hospitals and emergency rooms so frequently overlooked by non-emergency medical transportation (NEMT) providers?  Typically, it is because the vast majority of medical transportation providers are fixated on pursuing government funded Medicaid or managed care transportation via Medicaid brokers because such a source of revenue is perceived as being "guaranteed."  

However, truth be told, the real reason most medical transportation providers default to signing up and serving as the lapdog for Medicaid brokers is because it is "easy work."  Medicaid brokers will assign trips to providers, and thus, transportation providers don't need to invest the time, effort, or skill that is necessary to solicit, introduce, and then build legitimate relationships with area hospitals and medical centers.  

The bi-product of what is a "lazy" approach towards building a non-emergency medical transportation business is such as short-term strategy is devoid of long-term value.  Medical transportation providers are completely missing the opportunity to build and establish direct-pay contracted work that bi-passes the subjugation Medicaid broker system while dramatically increasing per-trip ROI and significantly increasing the long-term valuation of the business. 

The larger dynamic that transportation providers fail to recognize is the relationship between hospitals and acute skilled care and rehab facilities.  Many seniors, people with mobility issues, and those who are post-op often need direct discharge assistance in the form of wheelchair or non-emergency stretcher transport, and once at the nursing facility, they will most likely need additional transportation for follow-up appointments.  The hospital and emergency room discharges are literally a gateway into new facilities and "trailing transportation."

Why are hospitals often prepared to pay directly for discharge transportation?  Because delayed discharges can cost hospitals a lot more money.  Consider,  according to Google,  "the average hospital costs per day average is $2,607.  However, if you require an  overnight stay, the average cost is $11,700.  Uninsured patients have a lower average cost at $9,300 per day, with Medicare hovering around $13,600."  

However, if the hospital or emergency room is forced to keep someone overnight because of a lack of reliable transportation, but the hospital is no longer able to administer and bill for direct care, the hospital is shoulder that financial loss.  As a result, in hopes of further expediting the discharge, many hospitals and emergency rooms will "up-code" the status of a patient qualifying them for stretcher transportation as a "medical necessity" so facility staff can enlist the help of an ambulance service who can bill Medicare and insurance for non-emergency stretcher transportation.

Although very common, the practice of "up-coding" a patient status is frowned upon because, in addition to being fraudulent, when the hospital or emergency room is audited by CMS, which can literally last years, the hospitals can face serious fines and penalties.

Understanding this hospital and emergency room dynamic should give non-emergency medical transportation providers increased motivation to become a credentialed vendor to provide hospitals and emergency rooms discharge service.  Providing wheelchair and non-emergency stretcher transportation is a great way for providers to expend their service offering, expand hours of operation, keep drivers working, and further penetrate local nursing and rehab facilities.