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Immediate and long-term improvements include new program model managed by local health care non-profit CareOregon in 2020

Nov. 6 (Portland, Ore.)—Today, Health Share of Oregon and CareOregon announced plans to improve Ride to Care, Health Share’s non-emergent medical transportation (NEMT) program. Plans announced today include the selection of two new vendors for network management and dispatch management starting in 2020, and immediate steps to address reliability and performance.

In October, Health Share announced that it would transition administration of Ride to Care to CareOregon to support better integration of the NEMT benefit. CareOregon has developed a new model for the program, in which the three core functions of the NEMT program-call center management, network management and dispatch management-will be provided separately by organizations with expertise and established systems in each area, with oversight and coordination by CareOregon.

Today, CareOregon issued “intent to awards” to local non-profit Ride Connection for network management and ComTrans Community Transport for dispatch management services.

"Non-emergent transportation is a vital service for Oregon Health Plan members," said Eric C. Hunter, CEO of CareOregon. "We are excited to bring on partners with such a depth of experience and track record delivering transportation services locally."

Ride Connection has more than 30 years of experience coordinating and providing rides for older adults and people with disabilities in the Portland metro region. The organization has expertise in network management and deep connections with the region's transportation partners, social service agencies, community members, and stakeholders.

Likewise, ComTrans Community Transport has 24 years of experience scheduling and dispatching vehicles for non-emergency medical transportation.

"We know that the current NEMT model isn't delivering for patients or our transportation providers," said Maggie Bennington-Davis, MD, Interim CEO and Chief Medical Officer at Health Share of Oregon. "Doing right by our patients and drivers is our top priority, and we are confident that these changes will better meet our members' needs."

In addition, Health Share submitted a corrective action plan to the Oregon Health Authority on November 1 to address performance issues and improve ride reliability between now and April 2020, when the administration of the Ride to Care Program will transition from GridWorks to the newly contracted vendors under CareOregon’s management.

Key elements of the action plan include:

1. Addressing provider no-shows by auditing the past no-show rates of each transportation provider; reviewing all grievances; and meeting with providers to assess and mitigate specific issues leading to no-shows.

   
   

2. Addressing on-time ride performance by auditing the past on-time performance of each transportation provider; meeting with providers who are not meeting standards to assess and mitigate specific issues; and pre-scheduling “predictable” rides (for dialysis, chemotherapy, etc.) 30 days in advance.

   
   

3. Reducing call center wait times by assessing staffing levels and training plans; hiring and training additional staff as necessary; implementing improvements in the Interactive Voice Response (IVR) system; and providing on-site oversight of the call center function.

   
   

4. Addressing member grievances by auditing all past grievances; addressing acute unresolved issues that have been identified in grievances; and engaging the regional Disability and Aging Services Advisory Committees to make recommendations for better serving vulnerable populations.

Jeremy Koehler, one of Health Share's leaders, will be embedded at Gridworks between now and April 2020 to monitor operations, implementation of the corrective action plan, and the transition of service to the new vendors. Koehler currently serves as Health Share's Director of Behavioral Health, and has extensive professional experience in crisis response and call center management.

Health Share is submitting weekly and monthly reports to the Oregon Health Authority detailing progress on the corrective action plan measures.

To ensure continuity of services during the transition, there will be an overlap period while the new model goes into effect. CareOregon will phase in its services with a soft launch beginning in early 2020, and Health Share's current contractor GridWorks will remain in place until March 31, 2020. The CareOregon model is expected to be fully operational by April 1, 2020.

Giới thiệu về CareOregon

CareOregon is a nonprofit community benefits company involved in health plan services, reforms and innovations since 1994. We currently serve more than 275,000 Oregon Health Plan/Medicaid and Medicare members. By listening to our members and exploring innovative solutions with our providers and communities, we help Oregonians prevent illness and live better lives. Every day, we strengthen our communities by making health care work for everyone.

About Health Share of Oregon

Health Share of Oregon is the state’s largest Medicaid coordinated care organization (CCO), serving OHP members in Clackamas, Multnomah, and Washington Counties. Our mission is to partner with communities to achieve ongoing transformation, health equity, and the best possible health for each individual.

Health Share was founded and continues to be governed by eleven health care organizations serving OHP members: Adventist Health, CareOregon, Central City Concern, Clackamas County, Kaiser Permanente, Legacy Health, Multnomah County, Oregon Health & Science University, Providence Health & Services, Tuality Health Alliance and Washington County.