Boston Children’s Hospital: Launching Innovative Approaches to Care

Nearly 3.6 million Americans miss or delay medical care due to the lack of transportation resulting in poorer management of chronic illness ultimately leading to more repeat visits to the emergency room (ER). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668763/, n.d.) This leaves healthcare providers, and managed care organizations to carry the burden of addressing and managing the flow of patients throughout the healthcare facility.  

Boston Children’s Hospital (BCH) confronted those challenges head-on.

In alignment with Boston Children’s longstanding mission, to enhance the health and well-being of the children and families in its community, Boston Children’s Hospital (BCH), the Boston Children’s Physicians Organization (PO), and the Pediatric Physicians Organization at Children’s (PPOC) joined together to form the Boston Children’s Accountable Care Organization (BCH ACO), responsible for the cost, quality, and health outcomes for over 100,000 pediatric Medicaid patients across the Commonwealth of Massachusetts. Together, the BCH ACO, and Circulation, a technology leader in the non-emergency medical transportation (NEMT) industry, piloted a program in their largest urban pediatric primary care clinic in Boston to help improve patients’ connection to their medical home, and clinic flow by addressing patients’ transportation barriers.


While triaging same-day urgent care calls into the clinic, the nurses at the Children’s Hospital Primary Care Center (CHPCC) started asking if transportation was a barrier to visiting the clinic versus going to the ER. If a family indicated a barrier, the pilot provided roundtrip transportation to the patients and their families, so they could be seen in primary care for a same day sick visit. By doing so, patients not only sought care at the appropriate setting, and stayed better connected to their medical home, but unnecessary ER utilization decreased among this population by 28%, as families knew they could get a ride and be seen by their primary care provider the same day.

By utilizing Circulation’s on-demand transportation platform, staff and patients alike gained access to the mobility they needed resulting in pilot population same-day urgent care no-show rates dropping from 14% to 0%. Hospital staff were able to book rides quickly and efficiently with no paperwork required while ensuring the safety of the patient and family members. This real-time solution allows hospitals, ACOs, and MCOs the ability to provide medical transportation solutions to an ever-changing and diverse set of patient care scenarios.

 

“Using Circulation is ~50% more efficient and easier to use then cab vouchers and other transportation systems.” – Nurses, Social Workers, Patient Navigators at Boston Children’s Hospital Primary Care Center (CHPCC)

 

Lastly, BCH identified that over 20% of the patients in the pilot were part of primary care’s complex care program, those with complex chronic comorbidities, usually a population driving higher utilization, costs, and resources. By instituting this pilot, BCH can assist families in easing the stress by providing a safe and reliable way of getting the care they need.

As the program grows, we’re excited to continue to push the boundaries of innovative approaches to care alongside Boston Children’s Hospital.

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Written by Sara Gyllstrom, Marketing Manager at LogistiCare | Circulation, and Michelle Sasso, Director of Clinical Programs and Technology at Boston Children’s Hospital

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