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Access2Care Payment System Slammed at Health Share Advisory Council

A project to integrate maternity care and addiction treatment is also underway
August 12, 2015

Drivers and small business owners complained to the Health Share Advisory Council that Access2Care’s payment and other practices are forcing them out of business.

Health Share and FamilyCare Inc. together contract with Access2Care to provide non-emergency transportation for their members to get them to and from dialysis, chemotherapy and other appointments.

Kirk Foster of Wapato Shores Transportation repeated concerns he raised before the council in March about cumbersome Access2Care systems that provide too little information to drivers about patient addresses, particular needs for wheelchairs and such or correct phone numbers. Sometimes, drivers say, Access2Care refuses to pay them at all.

Foster asked if “Health Share and FamilyCare could throw its weight around” to correct problems that he says are unique to the Tri-County area where Access2Care serves the Medicaid population through its contract with the two coordinated care organizations.

“We don’t see this issue anywhere else,” said Foster, adding that Wapato Shores is moving wheelchair vans and other vehicles to The Dalles and other areas where they can still provide transportation to Medicaid patients without the hassles they encounter with Access2Care.

Foster says Access2Care’s parent company AMR -- which describes itself as “the nation’s leading medical transportation company” with more than 18,000 employees and 4,200 vehicles providing more than 3 million transports in 2014 in 2,100 communities in 40 states -- brings in its own vehicles “as we take our vehicles off the road.”

Ron Cunningham, director of communications for Envision Health, said out of 700,000 trips, AMR performed 240 wheelchair trips “as a fallback to shore up when they have a short turnaround.”

The drivers said the Access2Care contract gave them an 11-27 percent pay cut when Access2Care took over the CCO contract along with what they see as an unfair audit process.

“What we tell the vendors is submit a clean provider claim,” said Cunningham.

Foster, who started his business 13 years ago, said the drivers have few options. “People’s lives depend on what we do. We can’t do a work stoppage. But most of us can’t stay in business at a loss. Most of us have invested in these small businesses.”

Jemal Abci agreed, saying he’s worked as a driver for five years and now has eight cars. “I mortgaged my house to run my business.” In tears, Abci told the council “I came to this country to make American dream but they are crushing my dream.”

Health Share provided this written response to The Lund Report’s request. “We appreciate the public comment from Access 2 Care’s providers and we are confident that Access 2 Care has appropriate systems in place as it relates to their contractual obligations to their network of providers. Our primary concern is ensuring our members get the services they need.”

The council also heard a recap of Health Share programs over the first three years of its existence, starting with foundational work such as standardizing rates and contracts for mental health services, then improving member outreach and onboarding to improve access to care, and now engaging in what Health Share’s Sandra Clark described as the CCO’s team showing “skill at facilitating complex conversations.”

For example, Project Nurture gets drug addicted pregnant women prenatal care and family care after the baby is born at a methadone clinic run by CODA, Inc. in partnership with Oregon Health & Science University -- and substance abuse treatment at a midwifery clinic through a partnership between Legacy Health System and Lifeworks NW.

“Quick anonymous surveys” showed 28 percent of the pregnant women on Medicaid and 14 percent of women with commercial insurance used drugs when they were pregnant, said Dr. Helen Bellanca, associate medical director for Health Share. “We were really surprised. That’s a huge number.”

One reason women with substance abuse problems don’t get prenatal care is fear of losing the child, Bellanca said. Health Share also worked with Oregon DHS Child Welfare for the 30-40 women in the pilot to “create a plan to be a safe and healthy parent.”

Going forward, Bellanca said Project Nurture ideally would expand to two additional sites dispersed around its three counties and add mental health, housing and food support, child care and a sustainable payment model.

Jan can be reached at [email protected].

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