Since being awarded the state contract to coordinate transportation to adult day care services, dialysis, medical appointments and services for those on Medicaid, LogistiCare has seen a spike in riders, general manager of Rhode Island, George Sousa said in an interview Tuesday.
The company provides similar services in 43 states and started Rhode Island operations on the 1st of May, coordinating providers that include RIPTA, cab companies and medical transportation companies who were handling from 3,200 to 3,400 passengers a day. That number is now about 4,000 and sometimes exceeds that.
To meet the demand, there has been a corresponding increase in providers; from 19 to 27. RIPTA remains the largest provider. During May, when the system provided 85,000 rides, RIPTA provided 16,500 of the total.
Sousa didn’t have more current breakdowns, but said RIPTA continues to be the largest provider. Prior to the LogistiCare’s contract, RIde, a division of RIPTA and a call center operated by LogistiCare, handled the scheduling of rides. In addition to scheduling, LogistiCare, now as the broker, contracts with providers and pays for the rides. LogistiCare has a three-year contract with the Executive Office of Health and Human Services (EOHHS) that is renewable in one-year increments for an additional three years.
Sousa and LogistiCare senior vice president Robert Harrison both see an upward trend in rides (referred to as “members”). They attribute that to the Affordable Care Act. There may be other factors at play, although Sousa notes that ridership usually drops off during the summer. Wednesdays and Thursdays are the busiest days. Sousa speculates that could be attributable to physicians scheduling appointments to take advantage of a longer weekend.
“That’s a reasonable explanation,” Thomas Martin, implementation program director for EOHHS, said of the impact of the Affordable Care Act. He also pointed out that providers are getting the word out to beneficiaries.
From the perspective of some providers, LogistiCare got off to a bumpy start. Systems and routines that had been in place for many years were changed. People who were accustomed to having the same driver for daily and weekly appointments were abruptly faced with another provider unfamiliar with the routine. Providers were faced with new compliance procedures, including billing.
Bay Taxi of Warwick was among those companies still waiting in late June to be paid for rides in May. Bay had outstanding bills totaling almost $50,000. RIPTA was also on the unpaid list. Checks were issued by early July.
“I think things are getting a bit better,” Lillian Romano of Bay Taxi said yesterday.
The company has received two checks, although there remains a dispute over payments.
What she has noticed is that LogistiCare is providing many rides in ambulances, which carry public plates. This enables LogistiCare to contract for a flat rate for ambulances, whereas cabs with taxi plates are required to charge by the meter.
“They’re saving a lot of money,” said Romano.
What she has noticed is that Bay is getting many shorter runs.
Sousa said there were a number of “hurtles” to overcome when LogistiCare took over. He said the state did not have contracts with providers and payments were based on rides without consideration to mileage. Under the LogistiCare system, payments are based on three mile increments, which, he said, has resulted in some providers being paid less and others more.
“It was a weakened network when we came in.” he said.
While Sousa said providers have been given a 60-day grace period to adjust to the system, LogistiCare has the power to “liquidate” providers for money if they repeatedly fail to show up for scheduled rides. He’s pleased but not completely satisfied with the 99.3 percent rate of rides for May. The statistic indicates that less than 1 percent of scheduled rides failed to happen. Given the 85,000 rides in May, that would be about 500 missed rides.
That concerns Sousa, who said the company’s overall performance rate is 99.9 percent.
“We’re not delivering Home Depot lumber,” Sousa said of medical appointments and other rides.
Martin said the number of missed trips has dropped, which is a good sign. Looking ahead, he said, he sees the system expanding its capacity.
The system is costly. The LogistiCare contract is for $24 million this year.
“This is Medicaid money designed for those who have no other means of transportation,” said Sousa.