August 22, 2013

Loss of drivers cited for MaineCare ride troubles

A new contractor says it's recovering after many drivers quit over lower reimbursement rates.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

KENNEBUNK — MaineCare's nonemergency transportation program has experienced problems since new contractors started coordinating rides Aug. 1 largely because volunteer drivers walked out to protest new driver reimbursement rates, officials with one of the companies said Wednesday.

click image to enlarge

Robert Harrison, who supervises operations at LogistiCare’s new call center in Kennebunk, said ride services for MaineCare recipients have improved since the beginning of August.

John Patriquin/Staff Photographer

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A van at the LogistiCare office in Kennebunk is among eight the contractor says it bought to provide rides because it lost so many volunteer drivers over reimbursement rates.

John Patriquin/Staff Photographer

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Officials with Atlanta-based LogistiCare spoke with the Portland Press Herald on Wednesday and provided a tour of their new call center in Kennebunk.

"So many volunteer drivers walked," said Robert Harrison, LogistiCare's senior vice president for operations.

More than 2,000 MaineCare recipients have complained that they have missed rides to doctor's appointments and other medical services since LogistiCare won the state contract to serve the York County region and Coordinated Transportation Solutions of Connecticut won the contract to coordinate rides in most of the state, says the Maine Department of Health and Human Services.

The program depends on hundreds of volunteer drivers, especially in rural regions. Many of them got upset when Medicaid changed reimbursement rates so that drivers would no longer be paid for miles they drove when a patient wasn't in the car.

Drivers told the Press Herald that they were losing money, especially on rural routes when they had to drive many unreimbursed miles to get to a patient's house.

Harrison said that at the York County Community Action Agency -- the largest provider of drivers for LogistiCare -- the number dipped from about 110 to 60 as LogistiCare went through the typical growing pains of a startup operation.

Drivers became so scarce, he said, that LogistiCare took the unusual step of buying eight vans and hiring eight drivers, although it doesn't expect to have the drivers and vans long-term.

Harrison said LogistiCare's service has improved dramatically since the first week. But he and Steven Linowes, an executive vice president for LogistiCare, would not provide official complaint numbers that they filed with Maine, saying that's the duty of state officials.

The state has not yet released official numbers to the public, except for providing the 2,000 estimate.

Complaint calls have eased up over the past week, said Pam Lee of Kennebunkport, who has given out her phone number to disgruntled MaineCare patients since LogistiCare started coordinating rides. But she suspects many people have given up requesting rides.

"I'm still getting calls, but they're not as frequent," she said. "It was like a gold rush at the beginning."

The Press Herald has also received fewer complaints about LogistiCare this week.

Mary Mayhew, Maine's health and human services commissioner, said last week that the state was investigating discrepancies in complaint numbers and holding off on releasing figures until it could be sure they were accurate.

State officials did not return calls and emails Wednesday asking when the numbers would be released.

Over the past week, agencies that provide drivers in the York County and Augusta regions have restored the previous reimbursement system, with the goal of retaining drivers and luring back those who quit because they were losing money.

Drivers in both regions now are reimbursed 41 cents per mile, even without patients in the car.

The agencies have worked with the contractors to devise ways to comply with Medicaid rules but still reimburse drivers for all of the miles they drive.

The state overhauled its ride system and hired the contractors in response to Medicaid rules requiring greater transparency and accountability. The system separates the entities that coordinate the rides from those that provide them, with the aim of avoiding conflicts of interest.

LogistiCare won a $5.1 million one-year contract with the state to arrange rides in the York County area, while Coordinated Transportation Solutions won a $28.3 million contract for most of the rest of the state.

Many states have adopted similar systems, Harrison said, and LogistiCare is operating in 43 states.

"This is our core business," said Linowes. "We have a high degree of satisfaction in many states."

LogistiCare's call center in Kennebunk occupies a former dentist's office, where 12 employees take calls and plan routes for patients. They sit in cubicles answering calls in an otherwise quiet room.

A screen displaying call wait times showed all zeros Wednesday, which meant that callers were getting through without delay. If there's a rush of calls, they can be routed to call centers in other states, Harrison said.

LogistiCare and Coordinated Transportation Solutions hired Maine workers for their call centers. The local nonprofit agencies that previously dispatched and provided the rides had to lay off employees.

Those agencies ran the program with few problems, patients have told the Press Herald.

Harrison said every complaint is important to his company.

"You need data to evaluate effectively," he said. "We want to know about complaints, because that's the way we correct the problems."

Harrison and Linowes dismissed criticism over the past week about brokers like LogistiCare having a motive to limit service to earn higher profits.

The contractors receive flat fees based on the number of patients they serve. Critics say the fewer rides the contractors provide, the more money they make, so they have an incentive to turn down patients.

But Harrison said there's a "moral imperative" and a federal requirement to provide rides to people in need. The state contracts also contain numerous performance standards.

Harrison said some people don't really need the rides, and it's part of LogistiCare's job to weed out those people so that the government is not unnecessarily providing the service.

Harrison said he's heard stories in other states where people were getting free Medicaid-provided rides to beaches and casinos.

"That's one way we save states money," Harrison said. "We get rid of trips that shouldn't be run."

Maine has not predicted that the contractors will save the state money.

"You have to be good stewards of the taxpayer money and provide high-quality levels of service," Linowes said. "That's the balance that we hit every day."

But Lee, in Kennebunkport, said she's uncomfortable with call center employees from a private company making life-altering decisions for patients.

"Who at LogistiCare is qualified to make those decisions?" she said. 

Joe Lawlor can be contacted at 791-6376 or at:

jlawlor@pressherald.com

Twitter: @joelawlorph

 

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