Custom Benefit Structures for SNPs: A New Age of NEMT

Enrollment and complex needs of special needs plan (SNP) members are only growing, and members need benefits like transportation curated for them. Learn some of SafeRide's top benefit customizations to meet their needs.

Non-emergency medical transportation (NEMT)  is a staple to healthcare helping millions of Americans get to previously inaccessible care. Millions of Americans who benefit from NEMT are some of the most vulnerable of the population, including the elderly, the impoverished, or those with complex medical conditions. This is even more common for members of special needs plan (SNP) members across chronic conditions SNP (C-SNP), dual eligible SNP (D-SNP), and institutional SNP (I-SNP). 

Every single person in this SNP population comes with their own unique story and care needs. Whether they have a complex social need, are only able to have access to a car on Mondays– or lost their license due to their age and vision, no two sets of needs on the care continuum are the same. 

If their needs are not the same, then why should their NEMT benefit be?

NEMT benefit structures have long operated off of a fixed menu where, if working with a broker, a health plan gets options A, B, or C with no substitutions or flexibility. These cookie-cutter benefit structures were originally built with fixed values at every level: trip distance, rides/month, cost, transportation modalities, etc. 

These original benefit structures lacked the ability to override for substitutions or make exceptions, an especially important component for the evolving needs of SNPs and their members. This put the health plan and the member both at the mercy of the broker. By forcing members to fit into the benefit structure rather than the other way around where the benefit structure is built around the member, it leads to a poor experience with higher levels of  grievances, member turnover, and more.

SafeRide’s custom benefit structures start and finish with the member in mind. 

When we partner with SNP, general Medicare Advantage, and Medicaid managed care health plans as well as care providers, we have the technology to customize a NEMT program and platform to meet their needs at every point along the journey. As one of the nation’s largest NEMT brokers for SNPs, SafeRide is pleased to partner with each of these leading programs. Speaking from experience, here are some of the most common customizations and needs we see from our SNP partners:

In-House or Our House

One of the earliest customization decisions we make with our SNP partners is to go in the direction of either the self-managed program or fully managed program.

With the self-managed program, the plan’s call center gets to exercise existing in-house plan expertise while our technology platform powers the NEMT experience in the background. SafeRide’s technology seamlessly integrates into existing workflows for the SNP, simplifying adoption and implementation. The complexity behind members’ needs and plan details of many SNPs makes this a great option for SNPs to have maximum oversight of their member experience– and empowers them to maintain the central source of truth for member ride experience insights and overall data.

Meanwhile, for fully managed programs, SafeRide’s call center handles the majority of ride booking calls and questions. The fully managed program approach is great for SNPs who do not currently have existing call center infrastructure to manage the NEMT booking, monitoring, and troubleshooting process internally but still want a high level of oversight of the member experience. This optionality between fully and self-managed program approaches provides SNPs with never-before-seen flexibility to make an educated decision on the structure that will best fit their members’ needs while still receiving the same level of transparency, efficiency, and analytics to properly evaluate and optimize transportation program performance and member experience. 

Omnichannel Booking

For decades, NEMT ride booking has operated in an antiquated model relying solely on the member to call into a call center several days in advance to even have a chance to have their ride fulfilled. One of the most meaningful customizations a SNP can make is to proactively identify and anticipate various ride needs based on demographic and health history, and provide omnichannel ride booking options to streamline the transportation management process. This closes the gap between the identification of ride needs and the member who needs the ride. Calling into a call center to book a ride is still a common option, but may not work for all. 

SafeRide works with SNPs to build a full suite of available ride booking and management options– including SMS texting, AI-backed phone calls, and a mobile-friendly member portal. In addition, given that many SNP members face high acuity and heavy reliance on caregivers, plans can also delegate ride management options to certain individuals and groups such as caregivers and care team members, not just the member themselves. This multi-option ride booking capability empowers SNP members to fully utilize their transportation benefits and get to the care they need.

Ride Details

Forget the outdated one size fits all model for NEMT benefits– SafeRide partners with SNPs to build and customize exactly what the individual plan and their members need, including but not limited to:

  • Ride Count - For some, a few rides a month may work, but for others with chronic conditions like cancer or kidney failure, more frequent or unlimited rides may be necessary.
  • Scheduling Control - Whether your plan offers 10 rides a month or 10 rides a month only eligible on Tuesdays, SafeRide can make it happen.
  • Distance - If there’s a specialist that members need to see 100 miles away, SafeRide can ensure they’re eligible to get there.
  • Cost - Whether your plan needs to cap trips at $30 per ride or an override is necessary for a specific circumstance, it can all be customized.
  • Transportation Modalities - While many SNP members may be able to take a low-cost rideshare ride, other member populations may have higher levels of mobility needs and need a certain transportation modality. SafeRide can customize modality options for any member population.

With traditional transportation brokers, all of these trip details were previously fixed and non-editable for certain populations within a plan, commonly referred to as a “subplan.” With SafeRide, SNPs now have the ability to fine-tune the ride details and options with custom structures for each member population across various subplans. Since any of these trip features and considerations can make or break the difference in plan experience for an SNP member, this customizability of benefit structures to meet the unique needs of members makes a world of difference. Customizing these options with members in mind helps drive greater care adherence and supports better health outcomes.

Customization Meets Member and SNP Needs

In partnership with leading SNP plans, we have the opportunity to provide a better experience for all parties (members, health plans, NEMT providers, care teams, and beyond) by designing a transportation benefit structure from scratch rather than from a fixed list of options. SafeRide’s dedication to the member experience shines through when it comes to the customization of benefit structures for SNPs. SafeRide’s flexible, industry-leading technological capabilities allow us to continue to meet and exceed the unique needs of our SNP partners.

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