About this episode
Sam Farmer, CEO of Roundtrip, a technology broker that puts hospital care coordinators on one screen to order any level of transport, says most inpatient discharges reach providers with about three hours of lead time. Providers who insist on 24 hours notice get shut out of that volume, and traditional Medicare covers no non-ambulance NEMT, leaving facility pay, patient pay, and Medicaid rates Farmer calls almost prohibitively low. In states with an ambulance certificate of necessity, which he compares to a taxi medallion, consolidation thins the ambulance field and stretcher vans move the same patients at multiples cheaper out of pocket.
Key takeaways
- The million-dollar question Farmer poses: if you fill the schedule with routine Medicaid rides reimbursed at low rates, you are blocking on-demand discharges that pay more.
- Ambulance operators already game the clock, front-loading routine dialysis work into the morning because hospital discharges back up in the afternoon, then get hammered anyway.
- Hospitals over-order by muscle memory, defaulting everyone to a BLS ambulance. Roundtrip coaches them on medical necessity: a sedan for ambulatory patients, a stretcher van for bed-bound patients who need no monitoring.
- Roundtrip lets transportation partners name their own rates within reason and shares blinded demand data on payer mix and time of day for operators weighing a new market or more vehicles.
- Dispatcher mistrust is slowing AI scheduling as much as missing features. Farmer hears 'I know the system, I am the expert here' and says he is not sure how to build that trust.
Chapters
- 0:00 Introduction
- 0:57 Sam's journey to CEO of Roundtrip
- 2:57 How Roundtrip does NEMT brokerage
- 5:22 The Importance of Hospital Discharges in NEMT
- 8:43 Challenges in on-demand trip scheduling
- 11:39 AI Solution for scheduling on-demand trips
- 13:38 Navigating the Financial Landscape of NEMT
- 18:36 NEMT doing more hospital discharges
- 19:17 Market-Specific Strategies for NEMT Success
- 21:02 NEMT success stories with healthcare facilities
- 24:04 Working with Roundtrip
- 25:31 RUN BAMBI RUN!!
