Innovative Mobility Access Program in Rural New Jersey Community Connecting Seniors with Preventative Medical Care

goHunterdon, a Transportation Management Association in Hunterdon County, NJ partners with a local healthcare provider to provide free Lyft and Uber rides to seniors. They make sure patients arrive at their appointments and safely return home.

With a density of about 300 people per square mile, Hunterdon County is one of the least densely populated counties in New Jersey. In the past decade, the number of residents age 65 and older has increased by about 14%. To get this rising population of seniors to preventative medical appointments, nonprofit transportation management association (TMA) goHunterdon established the Healthcare Access Transportation Program. Their team works directly with home medical care coordinators at Hunterdon Health, a regional healthcare provider, to identify patients 60 years or older who are at risk of missing non-emergency medical appointments due to a lack of transportation. In addition to scheduling Uber or Lyft rides, goHunterdon’s team calls patients the day before their ride, a half hour before their car is scheduled to arrive, and then again about 20 minutes after the patient returned home from their ride.

“We want participants, many of whom are well into their 80s and 90s, to feel that we’re there and that we’re going to get them to where they need to go safely….We take a personal approach and we treat every patient as though they’re our own parent or grandparent,” said Tara Shepherd, Executive Director of goHunterdon.

Innovative funding model

Data from the CDC’s National Health Interview Survey show that more than 5.8 million people in the United States delayed preventative medical care each year because of lack of transportation. Since 2016, the Hunterdon County Partnership for Health’s Community Health Improvement Plan has identified patient transportation as a barrier to accessing preventative care, particularly for residents age 65 and older.

In 2020, Horizon Foundation for New Jersey, the philanthropic arm of health insurance company Horizon Blue Cross Blue Shield, approached Hunterdon Health about piloting what became the Healthcare Access Transportation Program with goHunterdon. Funded in part by a $50,000 grant from the Horizon Foundation for New Jersey, goHunterdon launched the program by taking patients to a wound healing center for regular appointments. Patients who participated in the program kept their standing appointments, leading to continuity of care, preventing hospitalizations, and saving money.

As the goHunterdon team began facilitating regular transportation to wound care appointments, medical care coordinators found that the same patients had often been missing other prophylactic treatments. Patients were often years behind on routine preventative care like mammograms and dental check-ups. “By providing transportation to medical appointments, we have unlocked access to additional care in ways we didn’t fully anticipate,” said Shepherd.

The partnership with care coordinators at the Hunterdon Health clinics is critical to the success of the program.

Since the end of 2022, the Healthcare Access Transportation Program has transported 87 patients on over 1500 one-way trips. goHunterdon now works with 22 practices in the Hunterdon Health system. The team often receives requests from medical care coordinators for one patient to go to multiple appointments with each one way destination counted as a trip.  Each trip costs an average of $28 on Uber or Lyft, and saves as much as $6000 by preventing a hospitalization or a trip to an emergency department.

When launching the program, goHunterdon explored directly hiring drivers, but quickly identified that it wouldn’t be cost effective. Between a nationwide driver shortage and the hassle and expense of procuring and insuring vehicles, they decided to instead outsource the rides to transportation network companies (TNCs) like Uber and Lyft. By doing this, they have also created a market for TNCs to serve their rural community.

While the goHunterdon team often has to wait 20-25 minutes for a driver to respond to a request for the ride, the only times they were unable to find a driver was during the height of the COVID-19 Pandemic in 2020.

The Healthcare Access Transportation Program is being funded through a second $50,000 grant from the Horizon Foundation for New Jersey. The program is also supported by other sources that are part of goHunterdon’s other mobility programs.

Program limitations

Unfortunately, Uber and Lyft drivers do not have wheelchair accessible vehicles in Hunterdon County. Patients in wheelchairs are referred to the Hunterdon County Paratransit Service for transportation to preventative medical appointments.

goHunterdon does not accept ride requests directly from patients. By working directly with care coordinators at medical practices, the goHunterdon team is able to ensure that the patient has the cognitive and physical ability to take a ride, and track the health outcomes for the patients participating in the program.

As goHunterdon explores growing the program, they would like to start providing more rides, and expand to serve patients beyond the Hunterdon Health network.

Recommendations for implementation in your community

1. Have strong partners. The Healthcare Access Transportation Program has largely been successful because of the interdependent, collaborative relationship between the TMA, a local regional healthcare provider, and a foundation affiliated with a large healthcare insurer. Proactive care improves patient care and makes sense from a business standpoint.

2. Human connection is critical. The goHunterdon staff ensure that patients feel comfortable and safe by calling the on the phone before the ride, ensuring they arrive at the appointment, and calling them again when they arrive home. The team often find that older patients know that an organization is giving them a ride to the doctor, but don’t understand that Uber or Lyft drivers are freelancers. Instead, they rely on their relationship with the goHunterdon staff to feel safe.

3. Keep it simple. While goHunterdon is eager to scale this successful program, they’re careful to only work with medical partners that have the capacity to support their work. They also want to ensure that their own staff have the capacity to manage the logistics supervising multiple simultaneous rides.