One of the most difficult aspects of delivery is the transportation piece. Wisconsin Family Care IRIS 2.0 beneficiaries tend to need frequent trips to varied medical providers to manage the symptoms of chronic disease processes. Individuals with cognitive deficits - memory loss will require another (door to door transport) to accompany them with these trips from home.
Wisconsin is a rural geographical area with no access to taxi cab service in much of the road ways.
Serving a State wide population is expected to create additional transportation difficulties.
Initially the State through a Federal Waiver will guide the Department of Health Services to assign transportation to the Integrated Health Agencies. Through contract the Integrated Health Agency will mandate the provider to perform all necessary transportation. The provider contract will list the inclusion of medical transportation.
The transportation expectation is unfortunately viewed by providers as an unfunded mandate. Specifically the assessment process which determines the time and task the provider can submit a claim and be reimbursed will not capture the transportation cost. This is the disconnect.
Committed providers who adjust their practice to insure longevity will not have the resources to perform the transportation piece at the rate of reimbursement. This will not be immediately understood by all involved with this State wide heath care transition.
Expect beneficiaries and family, Integrated Health Agency staff, employee's of the third party claims, and care givers of contracted providers to begin to blame each other for the difficulty created with this system deficiency.
This predicted system wide deficit will look like:
- State includes transportation in Federal Waiver request
- DHS explains transportation will be managed by Integrated Health Agencies
- Integrated Health Agencies include transportation in standard provider contract
- Participating providers question precisely how transportation is reimbursed
Home Care Path encourages readers to watch as the State rolls out the new Family Care IRIS 2.0 insurance model.
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