Travel time is the hidden cost in mobile practice

Run the numbers on your own diary before you read any further. Take last week, count the minutes each practitioner spent driving between visits, and multiply by what an hour of their time costs you. For a practitioner doing six or seven home visits a day across a spread-out patch, twelve hours a week of driving is not unusual. At a fully loaded cost somewhere north of sixty dollars an hour, that is a four-figure monthly line item that appears nowhere in your accounts, because it is not a cost you pay — it is revenue you never earned.

Clinic practices do not have this problem, which is why most practice-management software does not solve it. Their software models a room and a diary. Yours has to model a car.

The first job is to make the travel visible

You cannot manage a number that is not recorded anywhere. In most practices, travel exists as a gap between appointments — a booking ends at 10:00, the next starts at 10:45, and the 45 minutes in between is doing double duty as driving, notes, lunch and slack. Nobody can tell you afterwards which it was.

In AspireOS travel is a field on the appointment, not a gap. Every booking carries kilometres and minutes for the outbound leg, and separately for the return leg where you have one — because the trip home from the last visit of the day in Frankston is a real cost, and it is a different question from whether a funder will reimburse it. When you book a visit in the calendar, the estimate is offered from the practitioner's base suburb to the patient's address: the Distance Matrix service gives a real driving figure when a Google Maps key is configured, and there is an offline suburb-centroid estimate underneath it so the field is never blank while you wait for an API. Move the appointment and you can re-estimate from the new practitioner or the new address without retyping it.

Once it is a field, it aggregates. The day's route on the practitioner phone app shows total minutes on the road and the travel leg into each stop. /analytics carries an average travel distance per completed visit. That single number is worth putting in front of yourself monthly — it moves when your patient mix moves, and it moves before your profit does.

Some funders pay for travel. Not all of them, and not the same way.

This is where mobile practices lose money quietly, because the rules differ by scheme and the differences are not intuitive.

• NDIS allows provider travel to be claimed within limits, both for the time and, separately, for vehicle running costs.
• WorkCover and TAC will often reimburse travel to a home or workplace visit — but only where the insurer has approved it as part of the treatment approval. Travel you did before that approval was confirmed is travel you funded.
• Support at Home does not pay travel separately; the rate is set on the basis that it is already accounted for.
• Medicare chronic disease management, DVA and private patients generally do not carry a separate travel line at all, so travel to those visits is pure overhead and needs to be priced into your fee or your geography.

AspireOS models this as a per-funding fee schedule (Settings → Billing & finance): each stream has its own base fee, per-kilometre rate and provider-travel rate, entered per hour and applied per minute, plus optional caps on both the base line and the travel line so a claim cannot exceed a funder's ceiling. The defaults it ships with reflect the shape above — Support at Home starts at zero travel, private and Medicare start at zero — but they are your rates to set, and you should check them against the current price arrangements rather than trusting a default someone else chose. What the invoice then has to say about that travel is covered in what plan managers actually need on an invoice.

The WorkCover and TAC case is worth calling out because it is the one that catches people out. In AspireOS those two streams are approval-gated: the patient's funding card carries an explicit "treatment and travel approval confirmed" flag, and the intake checklist treats a missing approval as an incomplete file before the booking happens. That is deliberate. Chasing an insurer for approval after you have driven ninety minutes each way is a conversation with only one outcome.

The route is a scheduling problem, and it is worth ten minutes a day

The single biggest lever on travel is not the funder's travel rate. It is the order of the day. A day that goes Ringwood → Frankston → Ringwood → Dandenong has bought you an entire wasted leg for no clinical reason, and it usually happened because someone booked the Frankston patient into the first free slot without looking at the map.

AspireOS flags this rather than leaving you to notice it. The logistics lens looks at each practitioner's day and reports when the route doubles back — visiting a suburb, going elsewhere, and returning — with the actual sequence and the day's total travel minutes so you can see what the reorder is worth. It also flags a day carrying more than two and a half hours of booked travel, which is usually a day that should have been two days or a different practitioner.

On the practitioner side, the phone app builds the day as an ordered route with the travel leg into each stop, and one deep link that opens the whole day in Google Maps with the intermediate visits as waypoints. That sounds like a convenience feature. It is really a compliance one: a practitioner who does not have to sit in the car re-typing an address into their phone between visits is a practitioner who arrives on time and writes the note while it is fresh.

Four decisions that move the number

1. Give every practitioner a service area, and enforce it. Each practitioner in AspireOS carries the suburbs they will travel to, and the enquiry matcher ranks new referrals against them. The temptation to take the patient forty minutes outside the patch is strongest when the diary is soft — which is exactly when the extra travel is least affordable.
2. Cluster by geography before you cluster by time. A patient who can only do Tuesday mornings is a real constraint. A patient who says "any time that suits" and gets booked into whatever is free is a self-inflicted one.
3. Price the travel you cannot bill. If half your private patients are twenty-five minutes away, your private fee has to carry that. Look at your average travel distance per visit by funding stream before you set next year's fees.
4. Decide what counts against a case allocation. A patient case in AspireOS can be set to include or exclude provider travel when drawing down its allocated hours, sessions or funds. Get that decision right at the start of the episode rather than arguing about it when the allocation runs out early.

None of this makes the drive shorter. What it does is stop the drive being invisible — so that when you look at a practitioner's day and it does not work financially, you can see why, and you can see which of the four decisions above is the one to change. Mobile practice has a genuinely good margin when the route is tight. It has almost none when it is not, and the difference between the two is about twenty minutes a day of someone thinking about the map.