Removing Transportation as a Barrier to Care
Episode 588

Mark Switaj, Founder and CEO at Roundtrip

Removing Transportation as a Barrier to Care

Does transportation improve healthcare outcomes? In this episode, Mark Switaj, Founder and CEO of Roundtrip, discusses how his company helps improve health outcomes through better transportation. He talks about some variables that affect the no-show rate, working together with health plans, serving the entire population, streamlining efforts, coordinating with EHRs, and improving the perception of high-quality care. Mark is a wonderful entrepreneur and a great conversationalist with a lot of insights to share. If you’re looking for something new and creative to boost your entrepreneurial spirit, this podcast could be the one you’re looking for!

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Removing Transportation as a Barrier to Care

Episode 588

About Mark Switaj

Mark is the CEO and founder of Roundtrip. Since starting the company in 2016, Mark has led Roundtrip to become the leading digital transportation marketplace for better health outcomes. The no-show rate for patients with transportation arranged by Roundtrip performs five times better than the national average.

Mark holds his MBA from Georgetown University and BS in Management from Boston College’s Carroll School of Management. He’s also a fellow of the American College of Health Care executives and an avid skier and runner.

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Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket, Sal Marquez is here and today I have the privilege of hosting Mark Switaj. Mark is the CEO and founder of Roundtrip. Since starting the company in 2016, Mark has led Roundtrip to become the leading digital transportation marketplace for better health outcomes. The No-Show rate for patients with transportation arranged by Roundtrip performs five times better than the national average. Mark holds his MBA from Georgetown University and BS in Management from Boston College’s Carroll School of Management. He’s also a fellow of the American College of Health Care executives and an avid skier and runner. Such a privilege to have you here on the podcast today, Mark, and really looking forward to to our conversation.

Mark Switaj:
Hey Saul. Pleasure to be here.

Saul Marquez:
So, Mark, we’re going to talk about the great things that you guys are doing with round trip and improving outcomes of transportation. And so before we dive into that fun stuff, I’d love to hear more about what inspires your work in health care.

Mark Switaj:
The impact, right. It all boils down to the impact for me and really for the organization that we’ve blossomed. I come from the patient transportation space. It’s my love. Actually, when we were starting and preparing for this conversation, I mentioned that I was a Boy Scout and that’s where it began. When I was a Boy Scout, I found out that I could volunteer on my local town’s ambulance, and I did at the age of 16 or 17.

Saul Marquez:
Nice.

Mark Switaj:
And volunteered for a bit and eventually navigated my way through various levels of patient transportation. And I followed my love’s really how the intersection of transportation and outcomes had really been separated. And we’ll get into that. And from there, like I said, blossomed Roundtrip.

Saul Marquez:
That’s cool. That’s really cool. And, you know, it’s awesome the experiences that you could have as a kid and that really kind of bleed into your adult life. You shared some really great ones. And it’s great to see that that the Boy Scouts had that type of impact on you. I’ve got a three year old and I always think about the things that I could do for him to to develop his mind. And so I appreciate that inspiration and what they did for you.

Mark Switaj:
Yeah, it really was impactful. And it set the values right. that even as when we formed our organization, we spent a lot of time focusing on what is it that we’re doing, why we’re doing it, who is ultimately benefiting. At the end of the day we view patient transportation as that step to better health outcomes. And that’s what drives our team, drives the people that we hire, drives the clients that we serve and the conversations that we have.

Saul Marquez:
I love it. So let’s talk about it, Mark. To talk to us about how you and the Round trip team are adding value to the health care ecosystem.

Mark Switaj:
Yeah. So what is this round trip right? Coming from this patient transportation story I worked on a vehicle for from direct patient care, both emergency and non-emergency on an ambulance. And really what I saw was patients are giving up on their health care not because of the care they were going to receive, but because the ride was so burdensome. And what I saw was a lot of it was social. So we’ll talk about social determinants of health as it’s now been branded. But really, it was a lack of engagement. So there were plenty of rides that I did with dialysis patients, folks going for chemo, radiation treatment, even rehab where did the lack of engagement, coordination, communication for that individual, coupled, of course, with the larger social conversation, made it difficult for them to want to continue with their care. So we’re talking about vulnerable populations right.. So generally the elderly generally lower socioeconomic disadvantaged and the conversation black lives matter. We definitely saw different populations that were more vulnerable than others. And, you know, when we started Roundtrip in 2015, you know, taking that American leap, I have been sketching out this idea for quite some time and I knew there had to be a better way to improve outcomes with better transportation. And so really starting in twenty fifteen, we took an entire year before we even launched with our first client and followed a design thinking methodology which was so cool, iterating with hospitals, patients, transportation companies, nurses, social workers, doctors, all clinicians, everybody in between to say if we were to rewrite the process of ordering, coordinating, receiving rides that view to improving health outcomes, what would it look like? And that didn’t end in 2015, right.. So our product certainly goes through that process. Every sprint, every design, every release that we create is the product of working in tandem with our partners to say how do we make it better for tomorrow?

Saul Marquez:
That’s neat. And so what would you say makes Roundtrip different or better than what’s available in the market?

Mark Switaj:
Yeah, so I think as we started the conversation you shared, we’re leading the space when it comes to improving health outcomes. So what we found is really some key differentiators, right.. So throwing transportation at a population doesn’t necessarily improve health outcomes. And there was a pretty interesting study that came out of the University of Pennsylvania two or three years ago that for a disadvantaged population, transportation was offered to them and it didn’t change anything. So what we learned is just by throwing an option at somebody or group doesn’t improve. Well, what does improve, though? You have to understand the mindset of the individuals, the populations, and certainly how transportation works. So when we began the company, it is still very much still true today, what we learned is a couple of key things. One, transportation is a huge problem. You can go on the stats for all day. One in five people give up on their health care with transportation being one of the main reasons. That’s generally evidenced by no show rates, transportation or major reason driving no-show rates, particularly in the outpatient space, in the inpatient space, significant delays right now. We’re talking about in an efficiency conversation, patients are occupying inpatient beds as they wait for that ride to show up. The patient is generally disengaged. So are the care teams when that ride is going to be getting there and then payment for these rides is incredibly complex. Sometimes an insurance will pay for them, sometimes they won’t. Sometimes the patient has to pay for copay or deductible and it goes on and on.

Mark Switaj:
Medicaid has benefits. Medicare sometimes has benefits, but it depends on the type and the location and the product and your plan.

Saul Marquez:
So many very variables.

Mark Switaj:
So what we do is we clean all that up. So our value proposition pretty clear. We work together with provider organizations, meaning hospitals, health systems, outpatient groups, care teams, care coordination groups. We work together with health plans, large conversation on the Medicare Advantage space because it’s an evolving dialogue, a lot of regulatory changes that have been going into effect that allow for Medicare Advantage plans to start crafting transportation benefits to help improve those health outcomes. That’s pretty new and that’s pretty exciting for us. And so what do we do that makes us different for better? One, we serve an entire population. So whether you can walk like me or you can’t, whether you have behavioral health consideration, whether you are COVID diagnosed, we can move you through those transportation partners on our platform. Number two, the value of data is so crucial. Everybody knows, like I said, transportation is a problem, but we need to know how transportation correlates to outcomes. So by giving populations transportation benefits, how do we begin to craft them so that it’s important and it improves their outcomes? So give you an example, giving rides to, let’s say, a heterogeneous group, for lack of a better word, a group that is made up of different folks in a particular health plan, product, very different transport benefit than, say, somebody that is on that has renal failure or end stage renal disease that needs transportation to and from dialysis three times a week.

Mark Switaj:
And so what we have found is that by tapping into the connection of ride data and health care data, we can say for these populations, here’s how we can refine transportation to improve outcomes. And the third is get a lot of health insurance companies pay for medical transportation. It’s part of the benefits offering. And so what we’ve been able to do is allow for our partners ordering rides for their patients to navigate that space so they can see what Right. benefits may cover, the transportation that is needed for those individuals to and from their health care experience. They’re going to say very quickly, serving a full population, the value of the data is through the integration. So we’re first to market across different health care platforms, epic Cerner and many others, and then finally tying it all back to the ability to tap into patients insurance that’ll cover those rides. That’s cool. So you guys are integrating with all of these EMR? That’s right. Yeah. So we’ve done mostly moderations. Yeah. Yeah. So it’s pretty neat. So what we found is that coordination also correlates to the ability of the care team to seamlessly access rides for those patients Right.. So we can’t add labor to the process. We want to streamline, take waste out of the system. So by integrating into epic Cerner and others, what it allows for the care team to do is seamlessly navigate Right. within their current workflow, the ability to access rides.

That’s pretty good. Yeah, and that absolutely slashes the ordering time. It improves the overall experience and most importantly, very, very robust data and that data flows downstream. Right. maximizes engagement with the patient, is receiving content. It’s maximizing information to the transportation company who’s doing the actual ride to make sure they’re sending the right, right, right vehicle at the right time.

And all of that has incredible impact to the running of the love that I mean, how many times I’ve walked into Target and just picked up something from the eye. All that I like bubblegum. Yeah, I need that. Just when it’s Right.. There in your workflow, you’re more likely to do it and the accuracy is there to Right. because they’re literally in the patient’s screen.

Exactly right. If you’ve nailed the visual. That’s right. So it’s within the workflow, so to speak. You click a button and information pulls forward. That’s right.

That’s awesome. When did you guys come up with that? Because that seems like and also when you did, how did that impact the uptake of your service?

What did we do? Gosh, my my integration seemed to be on me. If I didn’t have this, I’m going to say about 18 months ago is when we did our first launch.

And that was with an epic instance. And what it has proven is it’s made us incredibly sticky and it’s from a real technical side effects are parents from the care teams that are using us. We’re watching, obviously, how long it takes to book rides. It’s just the time that it takes to be a lot more work is involved up front to make sure that we get the integration right. A lot is relative. It’s actually not that bad, but it does on the on the client setup, make sure that we’re positioned with the I.T. team of the hospital to do that integration. But once all that’s done, the word spreads fairly quickly within the organization on how they can monitor rides. And then obviously our utilization goes right up, especially when it works.

Right. like, OK, great, we’ve got this new thing. Let’s try it out now. Mr. Smith is showing up to all of his appointments and then the numbers overall are impacted in the positive direction. Then I’m sure it just takes off.

That’s right. So everything you just said is the outpatient conversation. And we also do the inpatient side. And what we’ve found is, you know, there’s this this kind of saying that’s been around for a long time to the transportation space. And I heard another client of ours say to me last week, which tells me it’s still active, which is, if you think about it, transportation is oftentimes the first or the last touchpoint a patient has with their health care experience right now. And so typically, the way the mind works is those last experiences are top of mind. When I say completing an experience for. Yeah. And so we want to make sure that that that experience that that patient receives is top quality so that their overall perception of care delivery is a good one. And we can keep going down this conversation. And those that have a high perception of high quality care are likely to get healthier sooner or have better health outcomes. So all of this just makes so much sense to me, makes so much sense.

And I thank you for taking this side road. Just more of a curiosity for me, but and I’m sure everybody else is wondering. So I appreciate you indulging us here on a huge difference maker when you’re able to integrate into the workflow at both inpatient and outpatient is critical for those the scores and also the overall outcomes. What would you say is an example of how you guys have improved outcomes or even improved business and health care?

So my my family and probably my partner would would laugh at me making this comment. I get a little I get a little teary eyed over some of the stories that some of our partners share. So last week I was on the phone with one of our first clients, Right.. And so now we’ve been with them a couple of years. And our champion was on the phone and she said, Mark, I want to tell you that it is so different here than the way it was.

And this is a this is our champion, Andy Anderson Cancer Institute at Cooper. And she said before round trip I’d walk into my lobby seven o’clock at night. She’s a workhorse. She works a lot. And I said, I’ll get up and walk in the lobby at seven o’clock at night and there’d be patients, people, guests waiting, sitting for a ride to show up, having no clue if when if there is something she said to me, she’s like, I would actually pull money out of my own pocket trying to find cabs to get folks home. Yeah. And she goes, Mark, I don’t have that.

Now I look in my lobby and that’s not the story anymore. And that to me, it still gives me chills. Like that’s my test for improving health outcomes. Right. Folks are not worried about the ride. They’re focused on their health.

Love it. That’s so great. And to have somebody tell you that and just overall Right. somebody that’s really passionate, not just anyone Right. and that’s a testament. And so when you think about the journey, Mark, you guys have have entrepreneurship and health care is a meandering road. So what would you say is one of the biggest setbacks you’ve experienced? And what was the key learning that you guys were able to pull out of it to make you guys even better?

Yeah, I think we’ve learned a lot of things. So what’s been really cool about the setbacks we’ve had several was that people understand that we’re mission driven organization. We entered this space to improve it.

And along the way, it’s going to be a little bit bumpy for a couple of parties. Right, because we’re trying to test site. Offices see what doesn’t work, and so I’ll give you a couple of examples on the more advanced Right. options in our technology. What does that mean, like non-emergency ambulance ordering? So for folks that are in a bed that need to move between hospital locations or from one location, let’s say to another, discharged from hospital to prosecute, we found out that a lot of provider organizations have preferred transportation companies.

And so and again, that’s the space I come from. So I knew this. But what I didn’t appreciate was how to approach hospitals and their partner transportation companies on the value proposition. I had to learn this a little bit of time. And again, we followed design thinking a lot of transportation companies. And so when we started our our business model was very basic. You order ride. It goes to a transport company. The Right. is completed.

But what provider organizations have said to us was they actually preferred transport companies, whether they owned a fleet of vehicles, of wheelchair vans or stretcher vehicles or like every every provider organization has a contract with the ambulance company or wheelchair company. They wanted to make sure that they maintain those relationships and actually maximize them, which I think is wonderful. And so we actually didn’t have that as part of our technology and that as we developed as an organization, we worked with a lot of organizations to say, how do we streamline rides to your preferred companies so that you can control that quality so that preferred partner company benefits greatly and the value proposition is clear. So we reduce phone calls. Obviously the data is much stronger than before. And so we had to do that. It’s a different conversation than, let’s say, ordering a ride share through our model. We’re seeing API connection to one of the Ritcher companies like Lyft. And what it does is it allows for that organization to have that full spectrum of Right. ordering staff. Our technology at the same time maintain and actually maximize the relationships that they develop with their partner transport companies. That’s been really cool to see.

That’s really neat. And it becomes sort of a standardization tool for them as well.

That’s exactly right. And because we don’t own or operate any fleet, it’s I’m agnostic to at the end of the day, it’s all about moving the patient and maximizing the quality Right.. So to work together with the partner organizations to develop this, that was that was a really cool experience because it was like, how can we do this? I love that approach.

And you guys just help them put the tools together. They obviously pick these partners for a reason because they believe they would improve outcomes and at a cost effective way. You guys are just helping drive the usage and standardization to help those rides and and then affect those outcomes. Yeah, exactly. That’s really neat. That’s really neat. So you guys got the the paratransit group involved and now it’s flowing smoothly. What would you say is something you guys are most excited about today?

So we’ve all heard this phrase before in health care, but we’re starting to see it in the transportation space as well. Health care, transportation space, which is patient centered, health care, patient centered models. We have a really interesting partner in California called Contra Costa Health System of Contra Costa County of Contra Costa, just in the Bay Area where they’ve got relationships with both the plan, the providers space outpatient space and even the paratransit program. And so what we’re seeing is this model where I chuckle a little bit because it should always have been this way, where we’ve got the patient at the center of our model. So within our system, we’re able to then see for a particular patient their transport needs. Will the paratransit program fund the ride to go to the grocery store for food to address social determinants of health? For that same patient? They need to go to a dentist appointment where their particular health plan benefit will cover the cost that Right.? Or are they part of an ACO or are they part of some type of waiver program that’s going to fund that ride? What we’re able to bring together all these different disparate transportation programs or benefits into the system to help that provider organization, a care team, begin to see and navigate where our Right. benefits for this individual so that we can maximize that individual, stay healthy and active in the community, as opposed to getting sicker and winding up in the E.R. at exponential costs. And obviously, the difference, that person’s health jackassery really excited.

Number two, I love that. So the approach is and I know you got a second part to that, so forgive me for this, but I did want to park there for just a quick second. The idea is get out of the sick care loop and get into the wellness and health care area for overall health, for those social determinants, like you mentioned, get get the food, go get them to those things that make a difference. I love that. I love that. Mark.

It’s exactly it’s moving from the reactive to the proactive state, which is one of the core values of our organization, is staying proactive. That’s how we think about health care moving earlier up the value chain to say, hey, look, it’s cheaper to provide ride and rides and access to this population for the social reason than to let that person get sick or turn into an E.R. visit. So that is really Mark.

I agree. And so you have a national footprint. So in the grand scheme of things, we look at what we’re able to do. Both plans, the state, the federal government, depending on the plan that you’re on, the appetite for these types of programs, I feel like California has been ahead of the game. How do we fund it and how do we get creative? Are you seeing more people do that? Can you comment on that?

Yeah. So I have a pretty interesting take on this. So we started the conversation today by talking about rides by heterogenous population. And I don’t think that’s the solution, meaning giving rise to a fairly diverse group of individuals that are classified by one particular filter, like Medicaid population, where I see the future is in the disease state dialogue. So you’ll see that as I talk and as evidenced by our technology, we’re starting to see the value of rides is different by diagnosis. So, yeah, we would probably agree. Like I said before, somebody getting dialysis, radiation, chemo, covid transports or a different dialogue Right. and need and benefit then seeing somebody who has access to a vehicle that can drive themselves to the doctor’s office. So how do we understand the disease, even some social cues to begin to offer tailored or specialized Rin’s Right. benefits to that population and maybe even increasing them from where we are today is Right.. So rides are generally dowl for that population on an average. So maybe we begin to refine that conversation, offering more specialized or specialized types of benefits to this population as opposed to another proposition that’s versus going to the value. Ultimately, it’s going to boil down to the intersection of that health care data on that this data to show the outcomes. And I’ll just like one quick thing if you can. Yeah, please. I’m really excited about a grant we received from the National Institutes of Health. The National Institutes of Health came together with our organization, a wonderful, wonderful group.

And they said, look, there’s a crisis going on right now, actually, another crisis which people have been talking about for quite some time. And that’s the opioid epidemic. And we and they said we know that there’s in conversation relative to transportation. So it’s a lot of people are unable to comply with or get access to those treatments with transportation being a barrier. So we received a grant, the maximum allowable from the National Institutes of Health Naida, that allows for us to work together with a couple of key partners. Contra Costa, who I mentioned in California, left the University of Pennsylvania to conduct the study to say, let’s take a look at the intersection of transportation, the opioid epidemic, by offering these specialized Right. benefits to the population, are we able to move the needle, improving compliance? Are we able to improve the conversation relative to health outcomes? That gets you really excited. And again, we’ve got to to do the maximum allowable amount for phase one. Our team is stope and again, it ties right back to why we’re doing what we’re doing, which is this conversation of improving health outcomes. That gets me excited and it continues us down the dialogue of saying it’s going to be by disease or condition state to say how transportation’s impacting outcomes. Wow, that’s so great. Congratulations. Thank you. Super proud of the team. Shanno Triveni on our team. We spearheaded all of that. It’s been wonderful.

That’s so great. And a very good reason to start looking at transportation from a disease state and therapy state. It makes sense. Why not if if you’re going to be able to tailor the approach and increase the benefits. Thank you for sharing that. Yeah, well, certainly those that get involved in whatever specialty become the experts. And Marc and his team are certainly experts at health care, transportation and providing those benefits to patients plans and health systems. Mark, why don’t you take us home here with closing thought and then the best place for the listeners to continue the conversation with you?

Yeah, as you look at health care, it is complicated. It’s political, it is confusing. And there are a lot of folks that are caught in the middle. And, you know, I have to say, I have seen the colorful, vibrant can do side of health care. Yeah. And I’ve also seen it through the intersection of forming a startup that said we can do this. We’re tackling two really complicated worlds. We’re tackling health care and transportation, and we’re bringing the two of them together. And what we’ve been able to do is work together with partners to say, how can we improve this for you? So many others. That, to me, is meaning. That’s that is the benefit built, scaled grown transportation programs for this is now another story. We’re looking at it largely through the data lens. You know, what is that? That information, insight that’s garnered by offering rides and ride benefits to populations that improve their health outcomes. That’s what brought me here. Right. That’s why I’m doing what I’m doing. Where team wonderful group that I get to learn from and support every day is driving that that conversation and story that change. More information obviously can be found out about us at our website. Roundtrip, Health, Dotcom. I’m on LinkedIn. You know, all the different social outlets. Feel free and pleasure to connect with anybody to learn more.

Mark, thank you. And folks, if something today resonated with you, there’s an opportunity for you to engage with round trip Mark and his team. Be sure to take them up on that and that contact. And Mark, just want to say thank you for today. It’s been a really great conversation around transportation and health care. Can’t thank you enough. Thank you. And thank you for making this conversation happen.

Hey, rocket listeners, Saul Marquez here, I get what a phenomenal asset a podcast could be for your business and also how frustrating it is to navigate editing and production, monetization and achieving the ROIC you’re looking for. Technical busywork shouldn’t stop you from getting your genius into the world, though. You should be able to build your brand easily with the professional podcast that gets attention, a patched up podcast could ruin your business. Let us do the technical busy work behind the scenes while you share your genius on the mic and take the industry stage. Visit smooth podcasting dotcom to learn more that smooth podcasting, dotcom to learn more.

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Things You’ll Learn

  • How to start the entrepreneurial spirit early
  • How to begin a business
  • How Roundtrip streamlined its process
  • How to look at health care through the data lens

Resources:
https://www.roundtriphealth.com/