August 25, 2011

LogistiCare: Employee Salaries, Reviews, and Interviews

August 14, 2011

Non-Emergency Medical Transportation Company Opportunities - Markets for an Ambulette Company

by Gary Shelton

If your business enterprise is on the list of contacts that is presented out in conditions where by such enquiries are received then you can choose up some easy organization not having a great deal hard work.

Medical transport is a vital support required for ferrying individuals to the medical related centers and again to their residences, article- therapy. Numerous personal and nonprofit and organizations deliver assist to this sort of patients. There are a variety of organizations in the United States that offer cost-free or low charge journey for critically sick clients.

Air Med ninety was the first countrywide conference of flying organizations for public gain. This is how Air Care Alliance came into becoming. The Air Treatment Alliance is an business that is the representation of public benefit flying. It states the importance of effectual get in touch with and teamwork amid organizations that present flights for health and the service of the public. They acquire guide of voluntary pilots to fly their aircrafts. It has a listing of member organizations that provide free of charge air transport.

AirLifeLine is a business that gives you no cost air transportation up to a distance of 1000 nautical miles. They need the individual to be mobile enough to enter and disembark the aircraft on their individual. They confirm whether or not the affected person is truly monetarily not fit to bear the compensated transport service. The individual also needs to be in a affliction steady plenty of to fly in a non-pressurized airplane, with no any medical related support or professional medical personnel to show up at to them.

Miracle Flights for Children is an organization, which caters to the requires of small children only. They organize flights by volunteer pilots for critically ill little ones. Due to the nature of this operate, some states will also call for firms in this community to be registered with native overall health authorities.

There might also be other paperwork that desires to be completed such as registering your small business identify, obtaining a small business license (potentially more if you serve multiple counties) and zoning criteria if you operate a residence enterprise.

Motor vehicles and Equipment

It is widespread for healthcare transportation expert services to obtain frequent vans, either new or applied, and then have them fitted out to suit particular requirements consumers. Company entrepreneurs normally start off out with a person auto and little by little add to their fleet as their organization grows.

The finest vans for an ambulette have a superior lifted roof and doorways. Access is generally on the facet of the auto but can also be at the rear.

Some operators nevertheless use manual lifts to support them get wheelchair travellers into and out of their vans. However, you will need to be ready to supply a more quickly, a lot more skilled services if you have a modern day hydraulic raise put in.

As soon as inside the van, wheelchairs can be fastened to a variety of securing gadgets so that they do not transfer about through transit. Automobiles also call for customized seatbelts for wheelchair bound travellers. You can also enhance the quality of your provider if you have some comforts like Tv and air conditioning.

A decent sized van that is thoroughly kitted out will need to be ready to transport 4 wheelchair bound passengers at a time as properly as have further seats accessible for caregivers.

About the Author:

AR is a provider of non-emergency medical transportation and essential elderly transportation services this sort of as a medical professionals appointment rides,professional medical lab transportation and other travelling requirements in Atlanta Georgia.<a href="

Before Choosing Elderly Medical Transportation Service

by Karen Jhonson

As the age is increasing, the ability of the body decreases gradually. Body getting slow in almost all activities. Transportation is one of the things which make the body tired more than any other. As the survey indicating that most of the seniors are living today without family. Many are not at a place where any family members are available nearby them. Medical transportation is a concern for the seniors when any critical situation occurs or when needed to go for the regular medical checkup.

There are many medical transportation companies are available today in the market which are providing emergency and non-emergency medical transportation services for the elders. It is one of the most reliable sources for the senior citizens for the safe medical transportation. There are some other resources available for the medical transportation for the elders from which some of them are discussed below.

It is advisable to take the medical transportation service from the professional service providers rather just rely on taxi or other transportation sources because the vehicles used for the medical transportation by them are highly equipped with good facilities like the vehicles have wide doors and/or are equipped with special lifts or ramps for wheelchairs and scooters. Wheel chair vans can become essential when the patient is not able to walk or handicapped especially in the case of elderly transportation it becomes a handy facility.

Medical transportation options for seniors include government-funded programs, nonprofit organizations as well as for-profit businesses. They range from public buses to one-to-three-passenger vehicles. The vehicles have wide doors and/or are equipped with special lifts or ramps for wheelchairs and scooters. Individualized transportation companies provide door-to-door service for seniors that can be booked in advance.

Many hospitals are providing elderly medical transportation services. One of the main drawbacks is that they are providing only in some of the specific area limited service within the range of hospital.

There is also some of the hospital or companies providing medical transportation services by air. It can be very helpful when the transportation is needed for a very long distance and within a quick time. The only thing matters in this service while choosing is its cost.

There are also some charitable programs available for the elderly medical transportation. Many church and charitable organizations provide medical transportation service for the elders almost free or at very low cost. This can be a good source of the medical transportation for low-income seniors who can't afford medical transportation services.

Hence today there are many options available for the medical transportation for elders. It is now easy to take medical treatment time to time for the elders. Elders can feel them themselves more secure in terms of transportation regarding medical issues.

This article has been provided courtesy of Ark Angel Transport is a Non Emergency Medical Transport Services in Florida, USA offers a wide range of medical transport, long distance medical transport services, elderly transportation, handicapped transportation, hospital transportation and medical patient transportation.

Caremore Members In Tucson Will Benefit From Medical Transportation Services

Author: Anne Milo

For more than a decade, American Logistics Company, LLC, (ALC), a full-service national transportation company, has partnered with CareMore Health Plan, senior healthcare organization, to provide the non-emergency medical transportation benefit to plan members throughout Southern California. The company recently announced that CareMore Health Plan has expanded its contract with ALC to include the Tucson, Ariz. market. In January 2010, ALC began transportation services for CareMore members in Tucson, Ariz.

'Over the years, ALC has had the privilege of growing our business alongside CareMore Health Plan, adding new markets as the company expands its reach within Southern California and neighboring states,' said Craig Puckett, president, American Logistics Company. 'We are excited to now be able to expand our reach into the Tucson market, and pleased to provide CareMore the same high-quality, cost-competitive, non-emergency medical transportation services we offer to their members in other regions.'

ALC's operational model and capabilities affords a number of key benefits that made for a smooth transition for CareMore's non-emergency medical transportation benefit for its members in Tucson. The ALC advantage includes pre-screening of drivers, extensive training programs, certification, insurance requirements, and verification that all drivers adhere to local and/or state permits and licensing requirements.

'One of the things we appreciate most about ALC is their ability to deliver transportation services that are specifically tailored to each market that we enter,' said Leeba Lessin, president of CareMore Health Plan. 'Because demand for our transportation benefit varies by market, we also appreciate the flexibility afforded by ALC which enables us to customize the number of trips we need on a daily, weekly or monthly basis to meet that demand.'

About American Logistics Company

American Logistics Company (ALC) is a full-service national transportation company serving the paratransit, non-emergency medical and school transportation sectors. The company leverages state-of-the-art dispatching technology to manage a fleet of dedicated and non-dedicated vehicles across the United States, providing high quality, innovative transportation services that raise the bar for efficiency, cost-effectiveness, driver safety and accountability.

ALC currently serves more than 100 municipalities, medical plans and school districts, managing more than 50,000 trips per month, with an on-time record averaging 97% and satisfaction rating averaging 98%.

Article Source:

About the Author: Anne Milo

August 13, 2011

Long Distance Medical Transportation Guide

Author: Mark J. Goldstein

When confronted with the task of transporting a loved who is bed ridden or confined to a wheelchair great distances one can find themselves lost.

The first thing that you as the 'guardian' needs to figure out is the distance. This will help in determining both the comfort needs of your loved one and it will help decide the method of transport required.

There are no exact answers to whether air or ground transport is best. Ground transport is certainly cheaper and air is certainly faster. A good question to ask yourself is how long will the transport take both by air and by ground. Then look at the needs of your loved one. Will they be able to tolerate that given amount of time in a transport vehicle? Also will traveling by air cause undue stress to your loved one? Always consult your doctor before utilizing medical transport by air.

Once you have decided on your mode of transportation. That is whether your loved one will be transported by air or ground medical transportation then you can start asking the question of what to transport them in.

There are three classic methods to be transported in. Going by patient need from the bottom up. The lowest needs patient would be classified as an ambulatory patient. These patients are able to walk to the transport vehicle and are very good candidates for air travel. The next level would be those who are confined to a wheelchair. These patients are able to sit upright for the duration of the transport. As a rule of thumb, most patients don't tolerate sitting in a wheelchair more than about three hours especially if they have any kind of sore areas on their back or bottom sides. The last mode of transport is by stretcher. Transport by stretcher is the preferred method for any transport over three hours. If a patient can't tolerate a wheelchair or is bed ridden then this is the only method for medical transport.

Once you have determined your method of medical transportation and determined whether your loved one will be going as an ambulatory patient or in an wheelchair or stretcher then your ready to search for your long distance medical transportation carrier. I have linked to a few good ones in this article but you can enter a simple search for long distance medical transportation and find more.

Last but not least it is important to plan ahead. Book the transport after you have everything in place on both the pick up address and the destination address. A lot of medical facilities require notification prior to receiving patients. Make sure to have all medications prepared for transport and if your loved one requires any special equipment such as oxygen the make sure to notify the medical transport company that you choose.

If you follow this article as a guide line you will find that it will take much of the stress out of a seemingly difficult scenario.

Article Source:

About the Author

I am a medically trained professional. I have nearly a decade of medical experience in both emergency and non-emergency based fields. I tend to write articles to guide the lay person through medically based problems that I understand are difficult. Feel free to ask questions!

Long Distance Medical Transportation Explained

Author: Kristopher Brown

In the field of medical transportation the primary divider among services is emergency or non-emergency. In an emergency situation you should always contact your local emergency service and act as quickly as possible. In this article we focus on non-emergency long distance medical transportation. That being said, moving a patient over any distance requires skill and careful planning. Moving a patient or loved one over a long distance increases that stress. There are many providers offering just as many levels of service. There is no right or wrong level of service, only the level of care the patient requires. The safest way to go about planning a long distance transport is to find a service that provides the level of care your patient or loved one requires. Every level of service has its benefits and with a careful assessment of the patient and effective communication with the patient's doctor you will find the right service. The purpose of this article is to stratify the two main types of long distance medical transportation available and explain when a patient would benefit most from each.

The most common type of long distance medical transportation is ground service which transports the patient by automobile. Patients who are in stable condition and are able to breathe without mechanical intervention are well-suited to use these services. There are literally hundreds of services in the United States and many are very reputable. However, what you see is not always what you get, so be careful. Vehicles of every size are available and unfortunately the regulations of the industry are lenient in most aspects. This is complicated by the fact that almost any service you use will be located too far away from you to provide any in-person meeting. The safest practice with ground services is to do your homework. Get a quote and gather as much information from the website as possible. Write the companies to get photos or browse the website. Make sure the pictures are actual photos of the vehicles used. Ask about insurance coverage. General liability insurance is safe feature for a service to offer. These policies generally cover far more than standard auto insurance- covering any damage or wrong-doing on the service's behalf. Don't forget comfort, since the patient will be spending several hours on average in the vehicle, and make sure the service provides extra comfort or entertainment measures for the patient. An extra mattress and a DVD player can make a world of difference to a patient traveling long distance. A caveat to remember about comfort is getting into and out of the vehicle. Remember to choose a service that has a stretcher and allows that stretcher to be easily loaded into the vehicle. A rolling palace means nothing unless an immobile patient can be easily put on board.

The other main form of long distance medical transportation is air. Air transportation carries many of the same precautions as ground. Patients who are less stable or who are on tighter time constraints may require air transport. Remember to check into the care abilities and training of the air crew just as you would a ground crew. Airplanes are much more expensive to maintain thank automobiles so expect to pay a good deal more. It is a good idea not to bargain shop with aircraft. Make sure the service you plan on using can provide you with maintenance records on the aircraft and qualifications for the pilots. As with ground, don\'t forget to ask about getting the patient on board. An airplane can be very difficult for a mobile person to get into depending on the model. Ask the service to describe in detail how the patient will be put on the aircraft. Lastly, after choosing a safe and price effective service, do not forget to arrange transportation to and from the airport. Typically the pick-up and destination will be located several or more miles from an airport. These last few miles must still be traversed and-if not planned for-can give a trip a very rough beginning or end.

Transporting a patient or a loved-one over long distance is a lengthy process. Take the time you have and use it wisely. Research services and make them work for you. Let them know what you expect and have them get back to you. A service that does not have the punctuality or initiative to give you a quote quickly or e-mail you credentials is most likely going to perform poorly while transporting someone.

Article Source:

About the Author

My name is Kristopher Brown and I have 23 years experience as a registered nurse and 7 years as a physician's assistant. I have always believed in keeping my patients first and families and love-ones well informed. I believe in keeping public medical articles helpful, concise, and facts-based. If you have any questions or comments related to any of my articles feel free to message me.

Introduction on Long Distance Medical Transportation Services!

Author: Karen Jhonson

The most common form of transport over long distances medical transportation is in medical grounds that the patient is transported by car. Patients in stable condition and able to breathe without mechanical intervention are well placed to benefit from these services. The other major form of long-distance medical air transportation. Air transport contributes many of the same precautions, such as ground. Patients who are less stable or may exclude air pressure needed.

There are three traditional activities logged Going patient should be transported upwards from the bottom. The lowest patient must be treated as an outpatient. These patients are able to transport the vehicle on foot and are very good candidates for air travel. The next step would be too confined to a wheelchair. These patients are able to sit for the duration of transport.

Long-distance medical transport your loved one needed medical treatment and can be rushed to a remote location as very hectic and stressful. Typically, the patient in question is a medical condition that the transport of the provision on its own bans. The assessment of current physical strength and power tolerance of the patient is very important to understand whether air or ground to be used. Air travel is more expensive than land transport, but both modes have their own drawbacks.

Advantages to depend on many of factors that are as follows:

• Medical condition of the patient
• Physician's Report and a proposal
• The distance and nature of the trip (rough, noisy, dangerous, or just) is when land transport is chosen.
• Remember the time travel, air and land transport.
• scale of the crisis
• The Air Force is a fast and relatively expensive.
• Land transport is much cheaper, but many times consuming.
• That the patient can walk or just sit in a wheelchair or just lie on a stretcher.
• Cash on hand and medical insurance.
• Discover the benefits if no additional hardware, tools or medical supplements are needed.

Long-distance transport of ventilated medical intensive care patients is a very cost-effectiveness and logistical problems. In a subgroup of relatively stable ventilated patient transport on commercial flights offers advantages in terms of economic efficiency and reduce transport time and the acceleration of the trauma / slowdown after several refueling stops.

Medical transportation services are ideal for customers in a stable condition recovering from long-term medical conditions and the necessary transportation to another facility, a hospice and at home.

Article Source:

About the Author

This article has been providing courtesy of Ark Angel Transport is a non emergency medical transportation in Florida, USA offers a wide range of medical transport, long distance medical transport services, wheelchair vans, elderly transportation, handicapped transportation Services, hospital transportation and medical patient transportation.

August 12, 2011

A Hospital Transportation Program for Patients: Changing a Culture and Reducing Cost

Author: Deborah Ziebarth

Transportation Access Important to Health Care

Health care in the United States accounts for 13.5% of the U.S. gross domestic product. Health care expenses are increasing much more rapidly than the overall cost of living index (Levit et al, 2000). Health care is not distributed equally in terms of geography creating a disparity with persons living in rural areas with lower incomes, consuming less health care than those in urban communities, with higher incomes. Medical services are of little value to those individuals that cannot access them. In the 2003 US Department of Health and Human Service's Community Transportation Assistance Project, Burkhardt reported that lack of transportation is a particular concern for rural areas, low-income persons, minority groups, and others whose access is constrained (including some older persons). For these individuals, affordable transportation options are important to access health care services.

A hospital's transportation program can play an important role in delivering patients to a medical home for prompt care to avoid minor situations from getting worse; thus reducing unnecessary hospitalizations. Early health care access reduces late staging of disease leading to unnecessary emergency department visits reserving those services for acute emergent care. According to the American Counsel of Physicians (1995), the average charge of a non-emergent visit to an emergency department is approximately 2.3 times higher than the cost of an office visit. Other sources quote even greater differences in comparative costs. An Orlando hospital reported the cost of an office visit of $55, compared to $462 for an emergency room visit.

In a National Hospital Ambulatory Care Survey (1999) data revealed that approximately 13.2% of all emergency departments' visits were actually non-emergent and unnecessary. The survey suggests that transportation access to ambulatory care and primary care sources (medical home) for targeted populations could actually decrease this number and save hospitals and federally funded Medicare thousands of dollars each year. Regular medical home access engages patients in prevention, self management of chronic disease, and counseling regarding high risk behaviors.

A dependable and reliable medical transportation program will also reduce cancellations for life saving oncology and dialysis treatments, physical therapy appointments, and cardiac rehabilitation services. Transportation as an out patient intervention helps to surmount the barriers of access to achieve longer lives of higher quality.


An ambulatory and non-ambulatory, specialized 'group' transportation service was successfully implemented at Waukesha Memorial Hospital in 1992. It was determined that any minimal charge to patients could be overwhelmed by the cost to administer a fee for transportation services, so it was provided at no cost to the clients.

The program was always intended for those who did not have another source of transportation. Maryann Day, manager of transportation, states 'the program and department grew over the years from a single van and a couple of drivers to a fleet of 37 vehicles, 45 employees, and an annual budget of $1.7 million. The number of clients grew to 4545 with trip volume reaching 60,872 annually. Over 507,910 miles were logged; enough to circle the globe more than twenty times. If transportation was requested, no one was turned away.'

The care-provider and staff were responsible for determining the patient's need for 'door-to-door' courtesy transportation. They made the arrangements directly with the transportation department. It was felt that this practice would eliminate any extra effort or added inconvenience for our patients. Hospital campus surface parking spaces were reserved for driver escort services offering a high level of customer satisfaction. Patient satisfaction was an early program driver as the hospital foundation received endowment gifts that significantly supported the program.

The non-emergent transportation service was designed for outpatients undergoing oncology treatments, multiple physical therapy sessions, or on-going cardiac rehab visits. Reliable transportation assisted patients and their families to ensure they kept their appointments, safely arrived on time, and even welcomed the camaraderie within the groups that were regularly traveling together and, or being treated for similar conditions.

Within a short period of time individual patient trips from rural areas, with limited or no transportation options, increased as clinic sites expanded and specialty services developed; i.e. behavior health, woman's health, and orthopedic joint camps. Dependable and reliable transportation helped clinic schedules to stay on time, as well as reduce cancellations due to weather or poor driving conditions. In addition to the new ambulatory surgery center activities, the 'on-demand' hospital in-patient discharges to senior living, assisted or skilled nursing home facilities rapidly increased. The ability to manage 'on-demand' services reduced the hospitals cost to board a patient an extra day, or save the patient the out-of-pocket, high cost to travel by ambulance if non-ambulatory.


Maintaining the $1.7M operating budget and $150,000 in capital expenses annually became too much to bear in 2007. Methods needed to be implemented to reduce those expenses immediately while maintaining the mission of the organization. The first step in the expense reduction program included implementing a $5.00 each way trip charge to our clients billed directly to their residence. The effort generated a reduction in trips from 60,000 per year to roughly 35,000. The corresponding impact to the operating statement through reduced resource requirements and operating income yielded a $680,000 gain. On an annual basis the department budget dropped by 40%.

Patient volumes in hospital and clinic departments were examined and found to be stable. The net operating expense of the department continued to run at $1.0M per year. In addition, concerns of servicing the most vulnerable patients were continually raised. In 2008, with the acquisition of several new clinics in rural communities, a more critical look at cost reduction was needed. The mandate was clear, to decrease the budget further by $300,000 annually.

Medical Transportation Team Developed

A transportation team was assembled that represented multidisciplinary and intradepartmental perspectives to assess impact from clinical staff and external community stakeholders. There was representation from transportation, nursing, community benefit, oncology, out patient services, financial, operations, and medical. The following options and financial assumptions were presented and discussed at length.

  1. Eliminate adult day care trips for daycare services (7495 annual trips), affecting 102 individuals. At $28.50 per trip the total cost of services amounted to $213,607 expense reduction. The $5.00 trip charge revenue would be lost. This would result in a net expense reduction of $176,132

  2. Eliminate clinic trips (4017 annual) affecting 642 individuals. At $28.50 per trip the total cost of services amounted to $114,485 expense reduction. The $5.00 trip charge revenue would be lost. This would result in a net expense reduction of $94,400

  3. Eliminate both day care and clinic trips equating to $270,532 expense reduction.

  4. Increase the charge on all remaining trips $5.00 to $10.00 per one way trip. This would save the system $350,000.

Pros and cons were identified. The pro was achievable savings. The cons were considered to be staff and patient confusion regarding eligibility and destinations, the plan may adversely affect those in true need of service, and create an unfair burden on external stakeholders groups providing transportation services. It was decided to explore other alternatives such as a strict rider eligibility screening, focus on clients truly in need, and standardize and centralize screening. Even though budget reduction and timing was uncertain there was support to explore alternatives.

Community Benefit Perspective

With a community benefit perspective on the team, the need for transportation access was discussed in light of most vulnerable patient's needs. The goal of ProHealth Care's community benefit initiatives is to improve the health and quality of life among the underserved, uninsured, and individuals with language and cultural barriers. The methods of improving health and quality of life include a combination of targeted health outreach programs, community health education, client focused self-care management programs, and culturally appropriate services that are provided by community-based nurses (parish nurses and community outreach nurses) and lay health promoters. Community partner sites provide entry to the targeted population and include churches, public schools, social service agencies, low-income and senior housing, and the Hispanic Community Health Resource Center.

ProHealth Care has been a catalyst in promoting health and access to care for the most vulnerable individuals as well as advancing services to improve the overall health of the community. Unique elements of the CB program include:

  • Connecting the uninsured and underserved to health care services

  • Developing community-based collaborative initiatives

  • Providing culturally-appropriate health care services including bilingual staff

  • Providing effective outreach efforts with a focus on primary care and prevention

  • Implementing programs for targeted populations

  • Enhancing hospital leadership and commitment

  • Developing a shared vision and trust among community partners

  • Financial support from both hospital foundations

Envisioning medical transportation as a community benefit initiative helped to reframe the discussions. Negative impact of decreasing access and creating increased transportation barriers for non-English speakers, isolated seniors and uninsured or underinsured families was foremost in discussions. As research supported, loss of transportation could result in decreased access to a primary health care, to life prolonging treatments or services, and to frequent visits for individuals with multiple chronic diseases.

Several considerations or next steps were recommended by the transportation team: 1) Identify regional medical transportation standards, 2) identify and organize an easy to use list of other local transportation resources available to patients, 3) collate community data that captures service area and demographic program utilization, 4) facilitate community advisory sessions and staff surveys, and 5) perform a literature review related to key concepts such as qualification, mobility, cost, hours of operation, low income criteria, pickup/drop off, and interventions used for discouraging misuse. It was suggested that a special task force form with members from transportation, community benefit, and high utilization internal departments. The goal was to create and use a transportation screening process supported by a communication plan and a system\'s policy. The screening forms development framed the task force effort.

Work of the Task Force

Identification of community standards were sought by exploring what other hospital systems in the region were doing along the lines of transportation. Several offered taxi vouchers where taxi services were available, a couple offered ambulatory transportation by volunteer drivers when available; restricted to short distances. No other hospital system in the area was found to offer a specialized para-transit service as was provided by ProHealth Care. In addition, there were other local transportation programs provided by non-for-profit organizations, for-profit businesses, and the County. We contacted these resources and collated data regarding cost, operations, application and screening processes. An updated list of transportation providers was developed with criteria, cost and contact information for staff and patients. Day, states, 'Our thought was that the clients that rode the transportation system for convenience were able to find alternative means of travel and have been unaware of other transportation services offered.'

Inquiries were made of all departments with unusually high usage. Responding, staff felt transportation use was appropriate. They stated that indeed other transportation options were discussed with patients. It was suggested that a discussion of other available and possibly more appropriate transportation resources occur earlier in the scheduling process. A concise and easy to use screening tool, with scripts and a system's policy was key to staff compliance. In addition, a patient transportation survey was sent to front-line staff who routinely scheduled transportation regarding process and procedure. The survey suggested that patients and staff may be confused by centralized transportation scheduling. Staff supported the point-of-care scheduling process and stated that they were willing to thoroughly screen patients before scheduling transportation. A survey was also sent to community based nurses. The responses supported maintaining door-to-door service and keeping cost low. Patient stories were shared. One nurse spoke of patients isolated in rural areas where no other transportation service existed. Nurses stated that elderly relied on the hospital's transportation program when they were no longer able to drive. Transportation was used for labs, treatments and clinic appointments. Many felt that the costs for one way trips were too costly for those patients needing multiple trips per week.

An advisory session was held with Spanish speaking patients. Inquires concerning transportation expectations were discussed. They commented that they counted on the program and were concerned that the process to schedule was difficult with forms in English. The transportation cost and their inability to 'pay the bill' created barriers. When they thought they owed the hospital money they no longer sought out transportation services. Barriers to transportation were reported to be financial, lack of family support [daycare], lack of car use and public transportation programs, language, and ability to read.

Literature Review

A conceptual matrix was created to collect and collate key themes from a literature review. Key themes included criteria for qualification, mobility, cost, hours of operation, low income criteria, pickup/drop off, and interventions used for discouraging misuse. The literature review revealed ten similar programs providing non-emergent hospital transportation services.

  • Criteria: programs required a referral from a physician, or were developed solely for seniors, or designed specifically for rehab and behavioral health visits. Most insisted on an enrollment process or prior authorization before appointments.

  • Mobility: All but one program provided wheelchair assistance but one program required in/out independence.

  • Cost: most were free, or provided transportation vouchers through the physician's office, or were reimbursable. Many were supplemented financially through county or state programs. The programs that charged, fees were based on miles traveled or regions or towns inside of service areas. One limited the number of times you could ride per week.

  • Hours of operations: most were M-F 8-5pm but some limited to certain days or limited hours.

  • Low income criteria: programs used a financial assistance fee scale based on Federal Poverty Guidelines (FPL) and insisted on prior enrollment.

  • Pick up/Drop off: most offered bus or van services with designated routes or pick up sites. Very few programs offered door to door services.

  • To discourage misuse: programs limited how long a van would wait, charged additional fees for missed appointments, and most insisted on prior registration.

Screening Tool

The development of a new screening tool (Exhibit A and Exhibit B) guided the work of the task force. The decision was to keep the one-way trip charge ($7.50) just above community standards to act as a dis-incentive for individuals who were qualified to use other options. Keeping transportation cost affordable for all patients and providing a reduced rate for those truly in need was the goal. Federal Poverty Guidelines (300 were used to determine greatest financial need. Easy qualifiers for transportation discounts were those patients that already received a discount rate for services referred to as 'Charity Care'. The discounted rate was set at $5.00. Other options discussed were voucher programs, allowing others [family members] the ability to gift the cost of transportation. It was decided to place the financial screening application directly on the back of the screening/schedule form for easy access. One central location where decision-making regarding discounts were desirable and the Hispanic Community Health Outreach Center was chosen for its central location and bilingual staff. The Center is a community-based department and community benefit initiative of the hospital. Decisions regarding transportation discounts are solely based on application data reported to keep administration hours manageable.

Mobility and special needs have been a priority since the transportation program began in 1992. The vans are equipped with wheel chair lifts and wheel chair securing systems. Drivers are specially trained and certified to assist those with mobility limitations and patients are encouraged to bring a care giver or to request an escort service at no additional charge.

The reason for transportation or acuity was mentioned as an important consideration and weighed accordingly. Providing access to clinic (medical home) and medical treatments, therapies and labs produced important revenues. Access to prevention and educational events, as well as visitor's requests were important but did not produce the same level of consideration.

Communication Plan

A formal policy was created to standardize practice and procedures throughout the organization. It was used to frame communications to all internal departments at leadership and staff meetings.

Purpose of the policy was to create a standard method of:

  • Screening PHC client/patient for transportation services to and from PHC owned and staffed facilities within the designated service area based on need.

  • Informing client/patient that transportation services are provided for a fee, and billed to their primary address (or other) at end of each month.

  • Creating trip request(s) with specific, accurate details for each trip.

  • Screening for transportation services at reduced fee(s).

The policy states:

Specialized grouptransportation service is provided for a fee to individuals who do not have other transportation options. To assist patients that require multiple trips within a one month period, a maximum billing limit (or ceiling) is set at 16 trips per month.

The screening process requires all client/patients to be screened by the initial screener/care-provider department using the approved PHC Transportation screening and request form.

In addition to a formal policy, information regarding updates was placed in iNet/Huddle pages, Websites, and on posters in vans. An easy to use 8x5 Transportation Pocket Guide was updated. The guide's table of contents includes:

  • A quick reference to scheduling transportation which contains frequently asked questions
  • Guidelines for patients
  • Call script for internal staff
  • Screening tools
  • Approved service area Zip Codes
  • Approved area service map
  • Other service transportation service providers
  • Waiver form
  • Glossary
  • Service recovery job aid

Outcomes and Summary

The chart below illustrates the results since the inception of the expense reduction process. Alignment of patient volumes across the system remains steady yet transportation operating expense has decreased. In spite of the reduction in trips there is a high level of confidence that services are provided to those truly in need and other patients are finding alternative methods of transportation.

With the geographic service areas of the system expanding to include both urban and rural communities, a non-emergent medical transportation service between owned/staffed facilities and the patient/customer's residence was developed in 1992. Inherent to service expansion, an internal and external culture of transportation entitlement grew.

Fundraising efforts helped to ease the financial burden of transportation operations but the mandate was clear, decrease cost while maintaining quality and mission. In 2007, with the implementation of a fee for service, patient trips decreased. In 2009, further budget reductions were necessary. A multidisciplinary and interdepartmental transportation committee was formed with community benefit representation. With a task force effort the transportation program was reframed. The culture of entitlement was changed to a culture based on transportation need for those patients that met three screening priorities: acuity, mobility, and financial. The priorities created a clear message for staff during point-of-service screening and provided a supportive environment for the most vulnerable in a culturally sensitive way. A clear communication plan that included a formal policy and an easy to use 8x5 transportation pocket guide was initiated. Leadership meetings, iNet/Huddle pages, Websites, and posters in vans were all vehicles used to announce the change.

Just one year later, patient volumes across the system remains steady yet transportation operating expense has decreased. In spite of the reduction in trips there is a high level of confidence that services are provided to those truly in need and other patients are finding alternative methods of transportation. Financial mandates, quality of service and mission deliverables have all been met.


Bindman, A. B., Grumback, K., Osmond, D., Koraromy, M., Vranizan, K., Lurie, N., Billings, J.,and Stewart, A. (1995). Preventable hospitalizations and access to health are. Journal of American Medical Association, 274(4), 305-311.

Burckhardt, J. (2003). Benefits of transportation services to health programs. Community Transportation, 26-38. US Department of Health and Human Services Community Transportation Assistance Project.

Centers for Disease Control and Prevention (1999). An ounce of prevention…What are the returns? (2nd ed.).Atlanta, GA: US Department of Health and Human Services, CDC

Health Care Financial Management Association. (2001) Hospital Benchmarks.

Levit, K.,Cowan, C., Lazenby, H., et al (2000). 'Health Spending…: Signals of change.' Health Affairs, 19: 124-132.

Exhibit A

Date: ____________________ Re-screen prior to_____________________

Name (person completing form):_____________________________________




Transportation service is provided for a fee to individuals who do not have other transportation options. ----- (Please see back for fees)

1. Are you currently receiving Medicaid/Title 19 benefits? No___ (Proceed to next question) Yes____If yes, Meda-Care Vans may be a less costly solution for you. Would you like the number for ride information? The number is ___________. No____ (Proceed to next question)

2. Are you able to get in and out of a passenger vehicle or taxi with minimal assistance? No_____ (Proceed to next question) Yes____ Would you like someone to contact you to help determine what other transportation options may be available to you? Yes____ Refer to transportation resource person. No____ (Process request using web/fax)

3. Do you possibly have another source of transportation for some _____ or all_____ appointments such as a family member, friend or neighbor? We have valet parking at Waukesha Memorial Hospital and Oconomowoc Memorial Hospital to assist you. No____ (Process request using web/fax)

Request to Transport

CLIENT'S INFORMATION: ¨ Non-English speaking, call interpreter at ______

Language type if known: ________________________

Transport Information:

Last Name:____________________________________First Name:_________________________Middle Name:______________DOB:_____/____/______


Name of Facility:___________________________________________________

Emergency Contact:__________________________Relationship:_____________Telephone:_______-________-___________

Billing Information if other than above:

Last Name:______________________FirstName:______________________MiddleName/Initial:___



PURPOSE: The reason you are requesting the ride? ¨ Dr.'s appointment ¨ Treatment, therapy or surgery

¨ Radiology and/or lab services ¨ Other_________________________________________________________


  • Do you have physical limitations?........... Yes_____(Non-Ambulatory Schedule W/C van) No _____(Ambulatory)

  • Do you require the use of a wheelchair?.. Yes_____ No_____

  • Do you have your own wheelchair?........ Yes _____ No_____ (We\'ll provide one) Size: Std ____ Wide ____ X- Wide ____

NOTE: We are unable to safely transport you on a scooter, ultra-light wheelchair or some motorized wheelchairs.

  • Do you use crutches, cane or walker?...... Yes_____ No_____

  • Will you have an escort?.......................... Yes_____ Name:______________________________No_____

  • Escort Special Needs: W/C or other:_____________________________________ (Note there is no charge for an escort)

  • Isolation precautions required?................ Yes_____ (Describe i.e. MRSA)______________________________________ No_____

  • Use portable oxygen?.............................. Yes_____ (Please check supply) No_____

  • Blind or visually impaired?...................... Yes_____ No_____

  • Hearing impaired?..……………………………………Yes_____ No_____

  • Speech impaired?..…………………………………….Yes_____ No_____

Any other special needs we should know about? (i.e. cannot be left alone; wanders; nausea, weakness, etc.) _______________________________

Transportation to department:_______________

Facility: WMH/OMH/PHCMA/OTHER___________­­­_______





***Reminder: This is a group transportation service; we ask that you please be ready one hour before your scheduled appointment time to ensure on-time arrival and departure times can be met.

Exhibit B

Transportation Financial Application – optional

If you choose not to divulge financial information, our service fees are as follows:

One-way trip service fee = $7.50

All fees are billed to your home address at the end of each month.


If you qualify for financial assistance, a one-way trip is $5.00.

  • Do you receive Community Care benefits from ProHealth Care Inc.? Yes_______No_______

(Have already completed a Community Care application and are considered eligible for a reduced fee for healthcare at Waukesha Memorial or Oconomowoc Memorial Hospital.)

If yes to the above question simply fill out name, address and phone number below. You are qualified for a reduced rate and may qualify for other transportation options. If no to the above question, complete the application.


Please complete form and fax to: or mail to:

ATTN: Office telephone:


Name - First:_____________________Middle:____Last:________________________


State:________________ Zip Code:___________Telephone: _______-_______-__________

1. Average monthly income:_______________________________________________________________________

(Include your Social Security, pension, disability, wages, interest/dividends, rental income, and any other income you may receive.)

2. Average monthly medical expenses:_______________________________________________________________

(Include medicine, medical supplies, health insurance premiums, and dental, doctor or hospital bills. DO NOT INCLUDE medical expenses paid by Medicare, or other insurance or program.)

3. Total liquid assets:_____________________________________________________________________________

(Including savings, checking, CD\'s, stocks, bonds, trusts, and annuities.)

I believe the information provided in this application is true and correct. I understand that deliberately providing false information may jeopardize the receipt of services and hereby authorize ProHealth Care Inc. to verify information on this application as deemed necessary.

Signature of Applicant:____________________Relationship to Applicant:_______________

*It is your responsibility to notify us with any changes by calling

Validated by:___________________________________________ Date: ______/_______/____________­­­­­­­­­­­­­­

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About the Author

Deborah Ziebarth is a Healthcare Professional with 15 years of progressive experience in driving organizational and community improvements in healthcare industry. Demonstrated success in setting and attaining system and community goals that improved program accountability.

Provided key leadership in this five-month multidisciplinary and intradepartmental systems change project that reduced cost of patient transportation by 40 This included: screening tools, policy and procedure guidelines, staff scripts, and community pocket guide.

Rick Meyer and Maryann Day Co-authored the original paper for submission.

Medical Transportation Resources for Elders

Author: Karen Jhonson

As the age increases the ability of the one's body get decreases. It becomes a challenging task for the elders to travel by their own. To attend doctor\'s appointments and to travel to hospital for the medical inspection can become tedious for them. It is important that alternatives be available. When you aren't physically able to travel by the usual methods, you can find companies that will provide specialized transportation, no matter how far you need to go. Today there are a lot more options and companies available for the medical transportation than in past. There are lots of companies which provide various medical transportation services each provide some unique services. One can choose the medical transportation service as per his or her need with a little bit effort to find the best service as per their need.

One can check the Yellow Pages or can do an Internet search for 'medical transportation' along with your city and state. If he/she lives in a rural area or small town, local options might be limited. One can probably find ambulances and van transport services. Depending on the number of miles need to travel and the reason for the trip, these services might meet ones needs.

For emergencies, ambulances are the standard medical transportation for seniors. Ambulances are staffed with a specially trained driver, paramedics and carries emergency medical equipment.

Costs for elderly medical transportation ranges from no-cost options like government programs, such as Medicare, or low rates through nonprofit agencies. Insurance coverage varies. For the elderly medical transportation shuttle buses are funded in certain communities, and are also commonly available for seniors in assisted living communities. Driver volunteer programs exist where a volunteer will assist in driving seniors in their personal vehicle. They range from public buses to various well equipped vehicles having wide doors and/or are equipped with special lifts. These vehicles can transport items such as a scooter or wheelchair sometime called as wheelchair vans specially equipped for people with handicaps present another option for those still able to drive an automobile. Many transportation companies also provide door-to-door service.

There are also companies which provide well equipped medical transportation service with entertainment facilities like TV with cable. It provides a good options if the distance is too long to travel.

With well equipped vehicles and staff the medical transportation for elders can be the most safe and comfortable way to manage their health in a very easy and affordable way.

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About the Author

This article has been provided courtesy of Ark Angel Transport is a Non Emergency Medical Transport Services in Florida, USA offers a wide range of medical transport, long distance medical transport services, elderly transportation, handicapped transportation, hospital transportation and medical patient transportation.

August 5, 2011

Business Owner Sets the Bar High with New Endeavor

Author: High Level Studios

With over two decades of experience owning small businesses, St. Louis resident Stephen McGoff is confident he'll triple revenue at his Metro East EMT in the next year – regardless of the fickle economy. McGoff previously owned seven auto service franchises throughout St. Louis with his father, Paul. Together they managed 50,000 customers and generated nearly $6 million in sales annually. Yet in 2006, the two decided they were ready for a change and sold it all.

Paul, 75, attempted to retire while Stephen, 52, continued to manage an auto store for a year before working as a financial advisor for another two years. In January 2010, however, Stephen and Paul McGoff embarked on a new business venture and launched Metro East EMT, which serves all of Madison, St. Clair and Monroe Counties.

Express Medical Transporters, or EMT, is the nation's first non-emergency medical transportation provider. EMT provides professional, non-emergency transportation services for a wide variety of clients. Examples include transportation to and from doctor's appointments, hospitals, dialysis treatment, rehabilitation appointments, nursing homes or even schools. Students who have special needs, are not on a regular bus route or attend school outside of their district all use EMT. Furthermore, the marketplace for non-emergency transportation services is growing rapidly because America's senior population continues to grow.

At its headquarters in St. Louis, EMT operates more than 170 vehicles, employs more than 200 employees and does more than 500,000 transports each year. In 2009, revenue was $6.5 million.

Yet McGoff said he recognized that Metro East was an underserviced area and wanted to reach out to the community. In order to help generate business, McGoff and his assistant – who had previously been at EMT's headquarters for 11 years – have been calling and visiting local nursing homes, school districts and various other institutions to explain their services. "Everyone has been extremely welcoming," said McGoff. "I've noticed this is an underserved area, and I'm happy to have the opportunity to serve residents in such a profound way."

Several school districts throughout Missouri rely on EMT to adequately transport children to and from school, and McGoff is hoping to continue that in the Metro East area. In St. Louis, EMT currently transports over 500 students under the No Child Left Behind Act every day.

A trip can be scheduled by simply calling an EMT customer service representative or visiting its Web site. All drivers are equipped with mobile devices that allow dispatchers to locate their position on Trip Tracer – a Web-based, real-time tracking screen created by Datatrac Corporation. Integrated with Google Maps, the system provides position and safety data while allowing dispatchers to quickly adjust workloads in response to weather, traffic and other scheduling considerations.

With its efficient process and demand across several markets, McGoff sees his EMT business growing exponentially over the next few years. "I'm excited to continue to provide such a personal level of service to people in need," said McGoff.

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Rapidly Growing Medical Transportation Franchise Opens New Student Division

Author: High Level Studios

EMT USA opens new division dedicated to Student Transportation.

Clayton MO, based EMT USA has opened a new school division. This new, Student Transportation Division will be dedicated to providing all routed and individual transportation for more than 40 local school districts involved in the Homeless Student Transportation Program as well as Special Needs children and the VICC program.

With a state of the art phone system, computerized GPS dispatching software, GPS mapping capabilities and dedicated personnel, this new division will be exceeding expectations of all school districts, students and their families they transport for. Bernie Squitieri President of EMT USA says, "We are very pleased to offer this new service and see it as a new opportunity to grow our business and help children with special needs get to school." EMT transports over 375 children to over 40 local school districts in St Louis and other states each day.

EMT: "The Driving Force in Transportation" More than transportation. We're about helping people, and we're about building owner equity.

With over 10 years in operation, and many more years of experience in the transportation industry to back us up, our affiliate, Express Medical Transporters is one of the first non-emergency transporters in the country.

Soon after its inception, our affiliate became its state's largest for-profit non-emergency transportation company, with over 150 vehicles and thousands of trips per year. Now you have the opportunity to realize this potential in your own protected territory by purchasing a franchise from EMT. EMT is seeking qualified individuals who will join us as we expand across the country, providing professional, necessary transport services to people everywhere. Make an impact in your community, while growing your own business!

For more information please visit

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