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The Journey to 50,000 New Findings Over 5 Months

A Case Study of How Mercy Partnered with Aidoc to Turn Years of Investment Into Tangible Impact For Patients & Clinicians
What’s Being Accomplished Today
In medicine, timing can matter as much as the diagnosis itself. Some of the most consequential moments in a patient’s care come down to whether the right clinical insight reaches the right clinician at the right time. That insight might involve a condition already suspected, one that needs to be triaged and acted on urgently. Or it might be an “incidental finding” (something a scan wasn’t ordered to look for but that shows up anyway, such as evidence of a brain bleed on a scan for something unrelated). These findings may be entirely outside the reason the patient was scanned that day, yet potentially no less significant.
For the patient, what matters isn’t just what was found, but that it was found in time; a condition caught months or years before it would have surfaced on its own could mean the course of a treatment, or a life, changed for the better.
Moments like these happened 50,749 times in just five months at Mercy – each one an incidental finding caught before it could slip through, each one a patient whose path forward looked different because of it. From January through May of 2026, Aidoc, an AI clinical decision support platform designed to prioritize acute findings on medical imaging, worked alongside Mercy’s clinicians, flagging these findings without requiring a single new radiologist.1 That staggering volume is the result of the right technology being layered on top of the right platform, at scale. That scale means the same advanced technology reaches every Mercy patient, everywhere, every time – whether someone is scanned at a flagship hospital or in one of Mercy’s large rural communities.
But in order to understand how Mercy and Aidoc got here, it helps to understand the pursuit of better outcomes that made this kind of investment necessary, the years of deliberate groundwork Mercy laid that made it possible, and what that impact looks like in practice today.
Solving the Clinician Crisis
Healthcare faces a structural crisis: a projected national shortage of 141,000 physicians by 2038.2 In radiology specifically, one 2024 industry estimate placed the ratio at roughly three open positions for every one available radiologist.3 This shortfall drives severe burnout, with over half of clinicians reporting debilitating stress from relentless administrative demands.4 This toll doesn’t just affect staff; it follows them into the exam room, directly impacting the quality and safety of patient care.5
Patients are acutely aware of this shift. Today, 85% of consumers prioritize safety and trust when choosing where to seek care.6 Simply put, health systems are being asked to do more for more people with fewer clinicians7 – and patients notice the difference.
Health systems cannot simply hire their way out of this workforce shortage, though they have tried. Instead, leading health systems are steadily turning towards Artificial Intelligence to bridge the gap between patient needs, clinical capacity, and improved outcomes.8,9
How Mercy approached the crisis
Mercy was experiencing that pressure firsthand. Imaging volumes were growing 12% to 15% annually, while the number of radiologists available to read those studies could not keep pace at the same rate. Radiologists across healthcare are being asked to review more images, identify more conditions, and communicate more urgent findings, often within the same working day and with little additional capacity.
The consequences extend beyond workload. When thousands of scans move through a health system each day, reading them all presents one challenge; ensuring that the most consequential findings reach the right clinician in time – including potentially overlooked incidental findings that were not the original reason for the scan – presents an even more pressing challenge. A routine outpatient imaging study may contain a pulmonary embolism, aneurysm, fracture, or another serious condition that requires attention long before that study would ordinarily rise to the top of the reading list if completed in the usual FIFO (first in/first out) order.
Operationally, that pressure creates a cascade of consequences. Longer reading backlogs can delay diagnoses, slow treatment decisions, and prolong emergency department and hospital stays. At the same time, health systems may rely more heavily on costly external physician coverage, overtime, or additional recruiting just to keep pace. The result is a perfect storm of clinical, operational, and financial concerns: rising demand places greater strain on clinicians while making timely, efficient care increasingly difficult to sustain for patients.
AI is not here to replace clinicians. Rather, it augments their work by serving as a second set of “eyes” and “hands.”8,9,10 By absorbing routine, burdensome tasks – from scheduling11 to multi-step operational workflows12,13 – AI gives clinicians precious time back to focus on patients.14 Crucially, the human clinician always retains the final say over every care decision.
While most health systems are racing to adopt these tools, deployment alone isn’t enough.11 True progress requires a strong foundation of secure data, seamless integration, and rigorous governance. The true distinguisher today is no longer just having AI – it is proving that it safely, ethically, and reliably works for both the clinician and the patient.11
That last point is where Mercy and Aidoc’s joint story begins. Scaling AI safely, ethically, and reliably, in a way patients and clinicians can trust, is not something a health system can switch on overnight; it has to be built over time. That ability rested on two differentiators that took years to build and are hard to copy: a deliberately built infrastructure backbone, and the disciplined way Mercy chooses, governs, and scales AI. The first of those differentiators is where the story has to start.
The Long-Standing Foundation Delivers 13 to 50 in 4
Thirteen AI solutions deployed at over 50 hospitals in four months. The Mercy-Aidoc deployment stands as both the fastest complex technology deployment in Mercy’s history and the largest enterprise partnership Aidoc had ever undertaken – a record on both sides, achieved together.15,16
This was possible because Mercy did not react to the AI moment; it prepared for it. The plan traces back to Strategy 2025, written in 2019, before the recent AI boom.15 It set a clear path: run one shared Epic system across the enterprise, bring data back in-house onto a platform Mercy owns, and build data partnerships with peers like Mayo Clinic.15,17 As one Mercy leader put it, the strategy laid down years ago was “all about getting ready for AI. We saw it coming.”15
The result is a foundation that few systems can match. Mercy runs one of the largest single Epic instances in the country, feeding an owned data platform with years of patient records.15,17 Because patient data spans a wide mix of people across Missouri, Oklahoma, Arkansas, Kansas, Illinois, and the broader Midwest – it helps AI tools work well for different patients and lowers the risk of bias.17 This readiness was built patiently over two decades, not rushed to keep up with the market.
This groundwork enabled Mercy’s partnership with Aidoc – a clinical AI partner whose software plugs into radiology workflows to analyze medical images, flag findings, and help radiologists prioritize route cases.
When deploying Aidoc, the enterprise did not need to build a new foundation but rather connect with the strong platform already in use. Each layer unlocked something specific:
- One shared Epic system: Every Mercy site runs the same system, so an Aidoc finding appears in the same patient record everywhere. That let Aidoc reach every patient at every site right away, at no extra cost, instead of going live one location at a time.17
- Connected imaging systems: Mercy’s imaging systems were already linked, so Aidoc could send findings straight into the tools radiologists already use, with one click to open a case. The AI sits inside the radiologist’s normal workflow, not in a separate program beside it.17
- An owned data platform: Because Mercy owns and runs its own data platform, Aidoc had clean, well-organized patient data to read from and write back to across the whole system.15,17
Aidoc is a key chapter within the Mercy AI story. A story that is about building a foundation that can support any AI tool, including ambient and generative features built into their instance of Epic that reduce the documentation burden on clinicians.17 This type of foundation, though, is only as valuable as the operational discipline applied on top of it.
The Operational Differentiators
Mercy’s second differentiator may be even harder to build than its infrastructure: the disciplined way it chooses, governs, and scales AI.
First, rapid and safe decisions are a core competency.
Ethics is not just added as policy after the fact; it helps decide which uses of AI are worth pursuing in the first place. Every AI project must meet seven key guiding principles (among them: people, not software, making the final call on care; patient information is never sold to nor used to train the models of external AI companies, and tools stay safe, transparent, and monitored over time).17 Each project passes a required review with named owners across teams and is logged in a central AI registry.17
Second, invest in platforms over point solutions.
Careful vetting is built-in, keeping each department from chasing its own new tools based on “market noise” and piling on cost and complexity – and allowing Mercy to focus AI investment on where it matters most for patients and clinicians.
Third, move from pilots to practice – quickly.
Mercy’s intention was to rapidly scale their AI solutions. As an operational principle, it was important to not let Aidoc’s solutions stall in pilots. Mercy’s leaders share a simple belief: if something will help patients, not only do they have an obligation to adopt it – it should reach all patients, not just a few.
Fourth, partner for impact, trust, and scale.
Mercy’s focus on a single platform enables them to double down on partnerships. That same discipline gives Mercy a rare agility and speed to scale. Leaders share a simple belief: if something will help patients, not only do they have an obligation to enact it – it should reach all of them, not just a few. Promising tools do not languish in one-off pilots but move toward full scale. When Mercy decides to act, its senior leaders are personally involved, from a CEO who meets regularly with partners to a C-suite that backs the investment and grants its teams clear authority to move. That keeps decisions high-level and fast, and it means they hold once made. That confidence also shapes the kind of partners Mercy pursues having moved deliberately away from a fragmented mix of point vendors, Mercy had the clarity and conviction to commit to Aidoc as a strategic partner and enterprise-wide platform – one that clinicians, operational leaders, and the C-suite aligned on together, and one built to scale alongside Mercy’s ambitions rather than cap them.16
This seniority does not mean decisions are dictated or bogged down in approval cycles. These decisions are made in conjunction with teams, not just handed down from the top: a clinical AI committee of lead physicians ensures that the same people who use these tools helped choose them.15 In the case of Aidoc, that meant Aidoc’s clinical team engaged directly with physician leaders across the ministry – in Missouri, Oklahoma, Arkansas, and beyond – before any agreement was reached.15 This not only helps ensure that each tool holds up in real clinical practice – that it fits the workflow, surfaces the right information, and earns the trust of the people using it – but also means that acceptance and adoption grow on their own, rather than being mandated.15
Aidoc’s leadership observed these same strengths from the outside: Mercy is quick to decide and scale, strong at measuring what a tool delivers, and structured in a way that causes staff to adopt it.15 This mixture of fast, well-aligned decisions and clean measurement drives Mercy’s speed to scale: it can roll out AI in measurable steps, check the results, and quickly move to the next area where it can help most. That is how Mercy and Aidoc working together put thirteen AI solutions across over 50 hospitals, reviewing about 2.5 million cases a year.15,16 Breadth and scale are proof that Mercy’s approach and structure are built to put AI where it matters most, rather than letting it stall.
The next question is whether that approach is delivering where it counts most: at the point of care.
The Positive Impact on Patients & Clinicians
The backstory of Mercy’s foundation and operational discipline is only noteworthy if it causes a positive change in the patient and clinician experience.
Aidoc’s role is designed to prioritize acute findings for Mercy’s clinicians – and the results bear that out. With AI deployment, it is estimated that 41.3% of incidental pulmonary embolism cases annually were discordant, meaning the AI algorithm identified a positive finding where the unaided radiologist’s initial interpretation was negative. Following deployment, between January and May 2026, the AI algorithm flagged 50,749 incidental findings, bringing these cases to clinical attention as part of the routine workflow – representing real patients whose conditions were flagged before they had the chance to slip through.1
Aidoc surfacing these findings outside the original scope of a scan means the cases most in need of a radiologist’s attention are flagged for immediate review, rather than waiting their turn in an unordered queue. When a finding is caught at the moment of scan rather than days or weeks later, it can make the difference between a condition being treated early enough and that condition being discovered after a patient’s options and outcomes have been narrowed.
Dr. Daniel Choe, a Mercy radiologist and physician champion of the deployment, describes what this looks like in practice: “We’ve been able to reduce the turnaround time for someone who needs to be on blood thinners, or someone with a hemorrhage who needs to get to the emergency department. Cases that might have sat on the list for several hours, if not a day, can now be triaged within minutes.”15
Beyond incidental findings, in a field where radiologists review hundreds of cases a day, even the most experienced clinician can benefit from a triage safety net checking every scan independently. Before AI deployment, retrospective assessments indicated AI-positive/radiologist-negative discordance rates of 27% for brain aneurysm cases, 3.5% for brain bleed cases, an estimated 20% for breast cancer cases, 18.8% for vertebral fractures, 15.2% for rib fractures, and 13% for pulmonary embolism.1 Post-deployment, in each of these cases, the AI flags and brings forward the relevant finding; the diagnosis and care decision belong to the Mercy physician.17 And the benefits don’t end there: finding potentially life-threatening pulmonary emboli can drive timely care activation and an increase in appropriate patient admissions.
For clinicians using these AI tools daily, technology has earned its place in the workflow. Thirteen solutions are currently live at Mercy and are absorbing real demand growth, with Mercy’s imaging volume rising 12%-15% year over year and the same teams able to meet that case load.1
This not only helps patients get their results faster but gives clinicians time back to focus on other high-priority tasks. For the most time-sensitive cases (specifically the top roughly 10% of highest-turnaround-time cases flagged for acute findings), the time from scan to result narrowed from about 19.8 hours to 1.3 hours – surfacing the cases that need a radiologist’s eyes first rather than leaving them to sit in a chronological queue.1 So far in 2026, Mercy’s Aidoc deployment has improved prioritization and facilitated care for 5,642 patients, reclaiming an estimated 9,039 hours of radiologist reading time – hours spent on the work that actually requires a physician’s judgment rather than on clearing routine cases.1
The Impact of AI In Practice
A Day In The Life
Consider a recent, real case at Mercy, with the patient’s details removed: a 55-year-old woman had a CT scan of her abdomen ordered by her GI specialist to investigate the cause of unexplained weight loss.1 On that scan was a small blood clot in her lung, a pulmonary embolism, resting at the very top edge of the image in the thin sliver of lung that appears when the abdomen is scanned – the exact sort of detail that can slip past even an experienced eye deep into a day of hundreds of scans.15 This incidental finding, and what followed, altered the course of her case, and possibly her life, entirely.
Immediately after her scan finished, Aidoc examined the image. Before Aidoc was in place, scans at Mercy – as at most other hospitals and health systems, were read roughly in the order they arrived, and a routine outpatient case like hers could wait a day or longer before it reached a radiologist.15 Now every scan gets a quiet first look the instant it lands, and nothing sits in line unseen.
The AI discovered the clot and automatically flagged her case in the reading list. Before Aidoc, there was no dependable way to tell which routine cases that contained an AI finding needed attention first; all routine cases looked alike on the list.15 Now, cases like this – the ones that cannot wait – stand out from the ones that can.
Within minutes, the radiologist had her case open, studying the images himself and weighing the flag against his own reading to make the call.1,15 A day later, a dedicated scan confirmed the clot, and she was routed to the emergency department for treatment – a pulmonary embolism caught and addressed in time to change the trajectory of her care for the better.1
What AI did not do matters every bit as much as what it did. At no point did it do any of the following:
- It did not diagnose her of its own accord
- It did not choose her treatment plan
- It did not view / look into her patient records as a whole
Instead, it simply noticed a pattern in an image and raised a hand,15 leaving the clinician with the final say. As Dr. Chris Connor, a neuroradiologist puts it, this is the kind of dynamic where the clinician and the AI tool are “better together.”15
For a patient, that is the heart of it: AI supports clinicians quietly in the background to make care faster and safer15 while those clinicians still make every decision.
For the staff who carry the work, this AI tool is a relief system, not a rivalry; it takes on the manual burden of watching every case so carefully that nothing slips through, and returning actual clinical judgment to the professionals trained to make it.15 Clear roles and visible limits are what allows this kind of tool to be one the workforce can keep trusting to support them.
What’s Next
While the outcomes of this story are impressive on their own, they also offer a glimpse into the future. The achievements captured represent only a fraction of the potential; as this AI deployment matures, Mercy and Aidoc expect it to ease broader operational pressure points as well, helping to counter the ongoing radiology workforce shortage while gradually shortening patient lengths of stay and reducing delays in care. Clinically, Mercy and Aidoc are also actively co-developing new capabilities together, including tools designed to identify heart disease risk in patients before it becomes a crisis.15 This relationship reflects how Mercy approaches all of its partnerships: not as a collection of separate tools, but a platform to build on through partnerships.15
On a separate front, Mercy is also developing a new Digital Experience Engine, designed to ease patients’ access to care by helping them find the right appointment, understand their costs upfront, and stay connected to their care plan.17
Beyond technology development itself, Mercy’s governance discipline is what’s driving its next milestone: working toward becoming one of the first health systems in the country to achieve Joint Commission certification for responsible AI, based on the strength of governance practices already in place.15
Further out, the goal is to advance AI from supporting individual care decisions toward something with wider reach: predicting health risks, catching problems earlier, and personalizing care at a population scale. With more than three million individuals already in Mercy’s predictive care model and over 300 AI solutions running daily, this is not at all a distant ambition – the groundwork is already happening.17
As AI tools multiply and take on more of the administrative / coordination work that wears clinicians down, Mercy’s platform is purpose-built to absorb them without starting from scratch each time, thanks to the foundation described earlier in this story.
The owned data platform, the single Epic system, the governance structure, the leadership that moves fast and stands behind its decisions – those same conditions made the Aidoc deployment possible, and are what makes the next steps described above possible too.
For clinicians, this means a system genuinely investing in making their day-to-day work more sustainable. For patients, it means that what Mercy has delivered here is not a one-time achievement, but part of an ongoing commitment to care. What Mercy and Aidoc have achieved together – the speed, the impact, the scale of adoption – is not only a clear signal of where Mercy intends to go from here, but tangible proof of what enterprise AI deployment can look like when done right. And it is only the beginning.

Citations & Sources
- Mercy Health and Aidoc. “Mercy–Aidoc Deployment Performance Data.” Unpublished proprietary internal data, 2026. Aidoc-provided figures confirmed by Mercy.
- HRSA Bureau of Health Workforce. “Health Workforce Projections.” U.S. Health Resources and Services Administration, December 2025. https://bhw.hrsa.gov/data-research/projecting-health-workforce-supply-demand.
- Fornell, Dave. “Radiology at Tipping Point with Limitations of RVUs and the Growing Shortage of Radiologists.” Radiology Business, March 2024. https://radiologybusiness.com/topics/healthcare-management/healthcare-economics/radiology-tipping-point-limitations-rvus-and-growing-shortage-radiologists.
- The Physicians Foundation. “The State of America’s Physicians: 2025 Wellbeing Survey.” September 17, 2025. https://physiciansfoundation.org/research/the-state-of-americas-physicians-2025-wellbeing-survey/.
- JAMA Health Forum. “Burnout, Professionalism, and the Quality of US Health Care.” March 24, 2023. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802872.
- Press Ganey. “Healthcare Consumer Experience 2025.” November 27, 2025. https://www.pressganey.com/resources/e-books/healthcare-consumer-experience-2025/.
- Deloitte Center for Health Solutions. “2025 Global Health Care Outlook.” January 29, 2025. https://www.deloitte.com/us/en/insights/industry/health-care/life-sciences-and-health-care-industry-outlooks/2025-global-health-care-executive-outlook.html.
- Yonsei Medical Journal. “How Does Medical Artificial Intelligence Revolutionize Physician Productivity?” December 8, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12748275/.
- JAMA Health Forum. “How AI Will Help Solve Medicine’s Productivity Challenges.” December 11, 2025. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2842893.
- IBM Think. “What Is Agentic AI?” Accessed 2026. https://www.ibm.com/think/topics/agentic-ai.
- ONC Assistant Secretary for Technology Policy (ASTP). “Hospital Trends in the Use, Evaluation, and Governance of Predictive AI, 2023–2024.” September 2025. https://healthit.gov/data/data-briefs/hospital-trends-use-evaluation-and-governance-predictive-ai-2023-2024/.
- NPJ Digital Medicine. “The Role of Agentic Artificial Intelligence in Healthcare: A Scoping Review.” March 14, 2026. https://www.nature.com/articles/s41746-026-02517-5.
- Deloitte Center for Health Solutions. “Health Care Leans into Agentic AI.” February 11, 2026. https://www.deloitte.com/us/en/insights/industry/health-care/agentic-ai-health-care-operating-model-change.html.
- Federal Reserve Bank of St. Louis. “The Use of AI in the Health Care Workplace: The U.S. Experience.” July 15, 2025. https://www.stlouisfed.org/on-the-economy/2025/jul/use-ai-health-care-workplace-us-experience.
- AVIA. “Mercy Health and Aidoc Stakeholder Interviews.” Unpublished proprietary interviews, 2026. Conducted for the Mercy AI Story engagement.
- Aidoc. “Mercy-Aidoc Partnership Value Narrative.” Unpublished proprietary internal report, 2026. Prepared by Aidoc for the Mercy AI Story engagement.
- Mercy Health. “Strategy, Governance, and AI Program Documentation.” Unpublished proprietary internal materials, 2019–2026. Includes Strategy 2030 Overview, AI Community of Practice Charter, Generative AI in Epic Overview, and Mercy-Aidoc deployment and press materials.
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Medical Transportation: The Hidden Cost Center

How health systems can quantify and recapture the margin lost to transportation inefficiency
Co-authored by AVIA and DocGo | March 2026
The beds your organization cannot turn are not waiting for a doctor’s order. They’re waiting on a ride.
Every health system CFO can tell you what they spend on contract labor, drug costs, or IT infrastructure. Very few can tell you what transportation inefficiency is actually costing their organization. Not the line item for rides, but the full downstream cost: the beds occupied by patients who are medically ready to leave, the nursing hours consumed by phone-tag with transport vendors, the denied claims from incomplete medical necessity documentation, and the admissions deferred because discharge throughput has stalled.
In AVIA’s work with more than 80 U.S. health systems, the dominant theme in every executive conversation this year is the same: cost reduction with a clear, near-term line of sight to margin improvement. Initiatives that cannot demonstrate hard ROI within twelve months are being deprioritized. CFOs and COOs are now directly involved in technology and operations decisions that once lived in departmental budgets. Against that backdrop, transportation represents an unusual opportunity. A workflow where the cost exposure is significant, the levers are operational and technology-enabled, and measurable results can materialize in months rather than years.
A Multi-Stakeholder Challenge
Whether you are approaching this from finance, operations, or clinical quality, transportation inefficiency shows up differently in your data, but traces back to the same root cause. For CFOs, it is avoidable days and denied claims. For COOs and operations leaders, it is bed turns stalled and ED boarding compounded. For nursing and quality leaders, it is clinical time consumed by administrative tasks and patient experience implications that directly affect HCAHPS scores and readmission rates. This article addresses all three, because any operational solution has to.
What Transport Delays Actually Cost
When a patient is medically ready for discharge but waits hours for a ride, the hospital absorbs an unreimbursed day of room, board, nursing, ancillary services, and overhead. According to the AHA’s 2025 Cost of Caring report, total hospital expenses grew 7.5% in 2025, more than double the rate of growth in hospital prices 1, and the average U.S. inpatient day now costs between $2,800 and $3,300 depending on facility type and geography 2. In high-cost states, that figure exceeds $4,000.
The scale of the avoidable-day problem is well documented. Advisory Board analysis of CMS claims data found that approximately 19% of total inpatient days are avoidable, driven by non-clinical factors including transportation coordination failures 3. The AHA has reported that length-of-stay for patients discharged to post-acute care settings has increased sharply, with Medicare Advantage patients experiencing double the average pre-discharge length-of-stay compared to Traditional Medicare beneficiaries between 2019 and 2024 4.
These costs do not appear as a transportation line item. They show up as extended length of stay, slower bed turnover, increased ED boarding, and deferred admissions. A 2025 peer-reviewed synthesis of 20 studies published in PMC found that centralized discharge coordination oversight, which includes transportation, reduces length of stay by 0.5 to 1.0 days on average 5. At $3,000 per inpatient day across a system doing 25,000 discharges annually, even a half-day improvement translates to meaningful margin recovery.
The workforce cost is equally concrete and rarely measured. Case managers and nurses spend an average of 15 to 30 minutes per transport event on phone calls, status checks, and rebooking coordination. At a 250-bed community hospital handling 50 discharges per day with 30 percent requiring arranged transport, that is approximately 15 transport events daily. With an estimated 20 minutes per event, clinical staff absorb five hours of low-value administrative work every day for a loaded nursing cost of $85 per hour. That translates to approximately $155,000 annually in clinical time consumed by a task that is ripe for automation, before accounting for the morale and retention implications of asking highly trained staff to spend their shifts on hold with transport vendors.
Why Transportation Stays Invisible
Transportation is typically managed within case management, siloed from finance and IT. The data (which often might not exist) lives in phone logs and spreadsheets, not in the EHR or enterprise analytics. AVIA’s work on patient throughput and command center strategy consistently finds that transportation is one of the last major discharge components to be digitized, even in systems with mature Epic implementations and sophisticated capacity tools. The result: no systematic way to measure discharge-to-departure intervals, attribute avoidable days to transport causes, or benchmark vendor performance. Health systems have treated this as a vendor management problem when it is a workflow and data problem.
Beyond the Balance Sheet: Patient Experience and Health Equity
Transportation delays are not only a financial problem. They are a patient experience problem and, increasingly, a health equity issue that health systems cannot afford to ignore.
Discharge delays rank among the most common sources of patient dissatisfaction captured in HCAHPS surveys, contributing to lower scores that affect value-based reimbursement and public reputation. When patients wait hours in a hospital bed for a ride they were told was coming, the experience of an otherwise successful clinical encounter ends on a note of frustration and uncertainty.
The equity dimension is equally significant. Transportation gaps disproportionately affect Medicaid beneficiaries, elderly patients, and individuals in underserved communities. These populations who are less likely to have personal vehicle access and more likely to depend on arranged transport for every care encounter. When coordination fails for these patients, the consequences extend well beyond an inconvenient delay: missed follow-up appointments, disrupted transitions to post-acute care, and preventable 30-day ED readmissions. For health systems working toward health equity commitments and managing readmission rate penalties, transportation is not a peripheral operational concern. It is a social determinant of health with direct financial and quality implications.
The Broader Stakes: Why This Matters Now
The U.S. Non-Emergency Medical Transportation (NEMT) market alone is valued at approximately $6.6 billion and projected to more than double by 2031 67. But the financial exposure for health systems extends well beyond direct transportation spend. From AVIA’s conversations with members, we know that transportation intersects with nearly every operational priority on the executive agenda.
Patient throughput. Systems investing in command centers and real-time capacity tools need transportation to function as a predictable, integrated discharge component not an unpredictable bottleneck. When a bed cannot turn because a ride is late, the cost cascades upstream through the ED and surgical schedule.
Workforce efficiency. Nurses and case managers spending 15–30 minutes per transport event on phone calls, status checks, and rebooking compounds across an organization. Eliminating low-value administrative work from clinical workflows is one of the most direct levers available.
Revenue protection. Transportation gaps contribute to patient leakage. When post-discharge follow-up is delayed or a patient cannot reliably reach their next care setting, the downstream revenue and quality implications are real, especially as they compound across populations.
Platform consolidation. AVIA’s members are rationalizing their technology portfolios and strongly favor solutions that integrate into existing EHR workflows. Any transportation approach that requires a standalone portal or parallel data entry is a non-starter in most environments. The organizations getting this right are deploying solutions that embed directly into the clinical record, allowing staff to order, track, and document transport without leaving their existing workflow.
What Technology-Enabled Transportation Management Looks Like
Solving the cost problem requires moving from fragmented manual coordination to a unified platform that treats transportation as an instrumented, measurable part of the discharge workflow. The capabilities that matter most address the root causes of cost leakage. Order entry integrated into the clinical record so requests auto-populate patient data and eliminate phone delays; live vehicle tracking that gives staff real-time visibility instead of repeated status calls; automated medical necessity documentation at the point of order to improve the insurance-paid versus hospital-paid transport ratio; a single interface that brings all transport vendors like ambulances, wheelchair vans, sedans, rideshare, into one coordinated network with standardized performance data; and analytics that surface bottlenecks, vendor on-time rates, and reimbursement capture metrics that previously did not exist.
When these capabilities work together, transportation shifts from an untracked cost center to a measurable, improvable workflow embedded in how the clinical team already works. The organizations getting this right do not add a new portal or require parallel data entry. They integrate transportation directly into the clinical record so that ordering, tracking, and documenting a transport happens without staff leaving their existing workflow.
DocGo’s Dara platform represents one mature implementation of this model currently deployed across multi-hospital health system networks, including a large, nonprofit system (operating five hospitals and more than 150 outpatient sites) that relies on the platform to support enterprise discharge and interfacility transportation workflows. In that deployment, Dara’s EHR-integrated ordering replaced phone-based coordination, giving care teams real-time visibility into transportation availability while automating insurance population, medical necessity documentation, and downstream billing processes. The platform helped reduce average transport response times by 25%, cut idle time between transports by more than 30%, and saved nearly ten minutes of staff time per transport request, all of which directly improved patient throughput and bed management efficiency. The platform’s recent incorporation of agentic AI for automated outreach and pre-billing extends these gains, signaling a broader industry shift toward intelligent automation not only within clinical documentation, but across the operational workflows that surround and often constrain care delivery.
Red Flags in Your Current Transportation Process
If any of the following are true for your organization, your cost exposure is likely larger than you realize:
– Your case management team cannot tell you the average time from discharge-ready to patient departure for transport-dependent patients
– Your finance team cannot separate transport-related avoidable days from other avoidable-day drivers in your LOS data
– More than 40% of arranged transports are paid by the hospital rather than a payer
– Staff contact multiple transport vendors primarily by phone for bookings and status updates
– Transportation is not visible in your throughput dashboard or command center reporting
Estimating Your Transportation Cost Exposure
The most common barrier to action is the inability to size the problem. The framework below is a step-by-step diagnostic that health system leaders can apply to their own operations — before any technology decision is made.
# Metric How to Calculate Typical Range 1 Daily discharges Pull from ADT data Avg U.S. community hospital: ~40–60/day 2 % requiring arranged transport Estimate from case management records Typical: 25–40% of discharges 3 Avg transport delay Time from transport order placed to actual departure. Note: this figure has two components to consider: (1) the gap from discharge-ready to transport order placed, and (2) the gap from transport order placed to actual departure. Both can add hours and together determine whether you cross into a full inpatient day. If unmeasured, assume 2–4 hours 5 % of delays adding a full inpatient day Delays exceeding the half-day billing threshold Typical: 10–25% of arranged transports 6 Your cost per inpatient day Use your facility’s cost-per-day figure National avg: $2,800–$3,300/day 12 7 Annual avoidable days Step 1 × Step 2 × Step 4 × 365 This is your baseline exposure 8 Annualized cost exposure Step 6 × Step 5 The number your CFO needs 9 Insurance vs. hospital-paid ratio % of transports reimbursed by payer Below 60% signals documentation gaps How Does This Look At the Average 250-Bed Community Hospital?
50 discharges/day × 30% requiring arranged transport × 15% experiencing a full-day delay = 2.25 avoidable days per day. At $3,000 per inpatient day, that is approximately $6,750 per day — or $2.5 million annually. A 30–40% reduction in transport-related delays would represent $750K–$1.0M in recaptured margin.
*These figures are illustrative. Actual exposure varies by facility size, payer mix, geography, and current process maturity. The purpose of this framework is to establish a starting point for internal analysis.
Setting Realistic Expectations
AVIA’s members consistently tell us they value honest assessment over optimistic projections. Health systems have been burned too often by vendor claims that do not survive contact with operational reality. In that spirit:
Within 3 months of deploying a digital transportation platform, organizations should expect to eliminate phone-based ordering for the majority of discharges, gain baseline data on delay intervals, vendor performance, and reimbursement mix that previously did not exist, and see early improvements in discharge-to-departure time for straightforward transport cases.
Within 12 months, realistic outcomes include a 20–40% reduction in transport-related avoidable days (depending on baseline maturity), an improved insurance-paid versus hospital-paid ratio through better documentation, and integration of transport analytics into throughput dashboards.
What is not realistic: Complete elimination of delays: vendor availability, weather, and patient-side variables will always exist. Immediate ROI without change management: staff adoption and workflow redesign take time. A standalone fix for the broader throughput challenge: transportation is one component of a complex discharge ecosystem.
*Suggested timelines vary based on the size of the health system and enterprise wide implementation/adoption
From Cost Center to Strategic Lever
Medical transportation will not appear on a strategic plan alongside AI governance or enterprise EHR optimization. However, the most actionable cost-reduction opportunities are often the ones hiding in operational workflows that have not been meaningfully updated in decades.
Transportation sits at the intersection of throughput, workforce efficiency, revenue capture, care quality, and health equity, all priorities that are already commanding executive attention. Bringing visibility to this workflow is not just a cost reduction exercise. It is the prerequisite for meaningful improvement across all of them.
The first step is not a technology purchase. It is a set of honest questions for your case management and finance teams: How long does it take from discharge order to patient departure for transport-dependent patients? What percentage of arranged transports are reimbursed by payers versus absorbed by the hospital? Do we have that data? If not, why not?
If you cannot answer those questions today, you have already identified the problem, and for most health systems, that gap in visibility is where the real opportunity lives. The data exists somewhere in your organization but it is rarely assembled or analyzed as a unified cost story, and almost never connected back to the financial reports where it would command attention. The best way to pressure-test this analysis is a conversation with a peer who has already worked through it. DocGo can connect interested health system leaders with operational counterparts at deployed sites; case management directors, COOs, and throughput leads who have run the diagnostic and can speak to what the data actually showed. If that kind of peer conversation would be useful, reach out through DocGo’s AVIA Marketplace profile.
About the Authors
AVIA is a digital health strategy consultancy partnering with over 80 U.S. health systems to navigate technology decisions, evaluate vendors, and accelerate digital transformation across patient throughput, AI governance, workforce efficiency, and connected care strategy.
DocGo (Nasdaq: DCGO) is a technology-enabled mobile healthcare and medical transportation company. Its Dara platform provides EHR-integrated transportation management across 31 U.S. states, and its clinical services span mobile health, care gap closure, remote patient monitoring, and virtual care.
Sources
- American Hospital Association, “2025 Cost of Caring Report,” March 2026. https://www.aha.org/guides-and-reports/2026-03-09-2025-cost-caring-report
- Becker’s Hospital Review, “Hospital Expenses per Inpatient Day Across 50 States,” 2025. https://www.beckershospitalreview.com/finance/hospital-expenses-per-inpatient-day-across-50-states.html
- Advisory Board / CMS, avoidable inpatient days analysis, FFS claims data. https://www.advisory.com/content/dam/advisory/en/public/shared/Research/PACC/Resources/2019/Data-Primer-Avoidable-Hospital-Days.pdf
- American Hospital Association, “Patients and Providers Faced with Increasing Delays in Timely Discharges,” updated 2025. https://www.aha.org/issue-brief/2022-12-05-patients-and-providers-faced-increasing-delays-timely-discharges
- PMC/NIH, “Reducing Delays, Improving Flow: The Importance of a Dedicated Discharge Coordinator in Hospital Discharge Planning,” 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12166983/
- Mordor Intelligence, “Non-Emergency Medical Transportation Market Size Report,” 2025–2030. https://www.mordorintelligence.com/industry-reports/non-emergency-medical-transportation-market
- Business Market Insights, “US Non-Emergency Medical Transportation Market,” 2025. https://www.businessmarketinsights.com/reports/us-non-emergency-medical-transportation-market
- Becker’s Hospital Review, “Hospital Expenses Grew Twice as Fast as Prices in 2025: 4 AHA Findings,” March 2026. https://www.beckershospitalreview.com/finance/hospital-expenses-grew-twice-as-fast-as-prices-in-2025-4-aha-findings.html
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