How to get seniors to the doctor?

Much has been made of the “silver tsunami” which threatens to overwhelm federal entitlement programs in the coming years, but the medical transport industry is also bracing for a deluge of patients and grappling with ways to get seniors to the care they need.

Hospitals often struggle to find transportation for seniors who are brought to their emergency rooms but are not sick enough to be admitted and need to return home. If the patient does not have family or friends to assist with transportation, the hospital seeks out community assistance. At the same time, communities that do provide transportation services for seniors are facing budget constraints.

However, in order for a senior to “age in place,” an approach to senior care that is favored by Washington for its cost efficiency, he or she must be provided with options for getting to the doctor. “It is really stark how much money we save with just a little bit of investment in seeing to it that aging in place at home can happen and be a viable option,” notes Federal Transit Administration administrator Peter Rogoff.

Medicare currently provides reimbursement for ambulance service only, and some states require that a patient being transported via ambulance be taken to a hospital’s emergency room. Consequently, if an ambulance is called to the home of a senior whose condition does not warrant a trip to the ER, the medical technicians’ options are limited. Either they must abandon the patient to find his own way to the doctor or take him to an inappropriate place for care (the ER), which is also the most expensive place.

Accountable care organizations, which are due to be phased in as part of the Affordable Care Act, may offer a solution to the problem, as these organizations would receive a fixed sum in exchange for a patient’s overall care needs, which would include medical transportation.