Slide 1: Point32Health
December IC Presentation: One Care Transportation
Note: the following footnote is shown on this slide and all slides going forward – “Confidential. Please do not distribute.”
Slide 2: Agenda
•	Types of transportation
•	Role of Care Coordinators
•	Transportation Process Summary
•	Transportation Challenges and Best Practices
•	Questions
Slide 3: Types of Transportation in One Care
Non-Emergency Medical Transportation
•	Planned trips to and from medical appointments. 
•	No prior authorization or limitation on medical transportation trips within a 50-mile radius. Trips outside a 50-mile radius require authorization.
•	Approvals for trips outside of a 50-mile radius are either based on a member’s care plan or to ensure access to certain providers.

Non-Medical Transportation 
•	Planned trips to and from non-medical locations (e.g. a church, a community event, a peer support/recovery meeting, etc.). 
•	Prior authorization is required for non-medical trips and is approved based on whether the trip/purpose of the trip is part of the member’s care plan. There is no set limit on the number of trips that are allowed once approved.
•	Members are encouraged to reach out to care coordinators 48 hours in advance to confirm a ride has been authorized and set. 
Slide 4: Role of Care Coordinators and Transportation Process
Care Planning and Transportation
•	Cityblock care coordinators work with members at the time of assessment, reassessment and through ongoing care management discussions to ensure that members have the transportation authorized that they need to fulfill care plan goals.
•	Nonmedical transportation is approved if it links back to a member’s care plan. 
•	Additional rides/trips can be authorized as new needs arise. 
Care Coordinator Assistance with Transportation
•	Tufts Health One Care member services, Cityblock, and members and their caregivers are able to schedule rides by calling our transportation vendor or using their online portal. 
•	Care coordinators will also set up rides for members. 
•	Care coordinators can also assist members in a three-way call with our vendor on the day of a ride if there is an issue. 
•	Care coordinators and our transportation vendor have developed door-through-door policies to ensure members are assisted to their drop off location as needed.
Slide 5: Transportation Process Summary
•	Once authorized, there is no specific limit on one-way rides per month for medical or non-medical transportation. 
•	Rides can be arranged by member services, Cityblock care coordinators, and over the phone and via online portal of our transportation vendor.
•	Medical rides are those that take a member to and from a location where they may receive covered services whereas non-medical rides are to any other location.
o	Non-medical rides are still an integral part of achieving care plan goals and promoting health and are approved if they tie back to the care plan. 
Slide 6: Transportation Challenges
•	Challenges in planning around transportation vendor 15-minute pick-up and drop-off windows.
o	Our transportation vendor informs members that there may be a 15-minute window before and after a scheduled pick up and drop off time. If members do not know this ahead of time or have not planned for this, it can lead to frustrating experiences where a member is very early or late for a medical or non-medical ride. 
o	Care coordinators can also educate members on the 15-minute window and assist with incorporating it into planning. 
•	Historical issues with members not being supported to get inside their destination and issues with return rides.
o	Care coordinators can assist with ensuring a trip is completed if these issues arise, work to ensure a full round-trip is scheduled and members can request door “through” door support.
o	Tufts Health One Care also monitors appeals and grievances as part of the core measures our vendor is accountable for. 
Slide 7: Transportation Best Practices

•	Utilizing care coordinators to schedule, authorize and troubleshoot transportation issues. 
o	Tufts Health One Care has found that having Cityblock care coordinators closely involved at all stages of the transportation process 
•	Successful implementation of door-through-door policies.
o	Historic problems regarding door-through-door issues have been addressed with policies, training and ongoing monitoring.
•	Close collaboration of care management and utilization management (UM) to authorize rides. 
o	The collaboration between Tufts Health One Care’s UM staff and Cityblock ensures that transportation needs are readily identified and authorized and allows issues to be resolved quickly if there is a process breakdown.