Health and Transportation

Opioid Use Disorder: Challenges and Opportunities in Rural Communities (Pew Charitable Trust 2019). A report that looks at access issues to opioid addiction treatment in rural areas, including physician and clinic shortages, and references the impact on transportation providers.

Essential Hospitals and States: Confronting Transportation Barriers to Health (America's Essential Hospitals, 2019). Essential hospitals care for underserved patients and communities—those most affected by transportation barriers. Recognizing the impact of transportation on health and health care costs, some essential hospitals have taken steps to reduce transportation barriers for their patients and communities. This issue brief summaries within this brief represent a sampling of such efforts.

Transportation and Health Access: Rides to Wellness Community Scan Project (Health Outreach Partners, 2017).  Describes the scope of the problem of transportation barriers and its financial impact due to missed appointments, reporting results from a national survey of health centers.

"Rides to Wellness" Listening Session Implementation Guide (National Center for Mobility Management, 2017). A guide to help states, regions, and local communities implement Rides to Wellness events and facilitate connections between mobility and healthcare professionals. We would love your feedback and examples of your local rides to wellness activities.

Transportation to Healthcare Destinations: How A Lifeline for Patients Impacts the Bottom Line for Healthcare Providers (National Center for Mobility Management, 2016). This document provides transportation providers with an understanding of the many ways in which the healthcare industry is affected when patients lack transportation to appointments. The companion document, Resource Guide for Conversations Between Transportation Professionals and Healthcare Professionals, assists transportation professionals in starting those conversations.

Go Buffalo Moms: Improving Transportation Access for Pregnant Women (National Center for Mobility Management, 2016). Describes program in Buffalo, New York, to use mobility management strategies to connect pregnant women with pre-natal services to reduce the incidence of pre-term birtsh.

Expanding Capacity to Provide Transportation to Ongoing Dialysis Appointments (National Center for Mobility Management, 2016). Explores issues related to transporation to dialysis appointments.

Preventing Patient Re-Hospitalizations: Successful Transportation is Part of the Solution (National Center for Mobility Management, 2016). Discusses the potential for transportation in reducing hospital readmissions, by ensuring patients can get to post-discharge appointments.

The Importance of Consistency and Predictability in Transportation Services for Behavioral Health Patients (National Center for Mobility Management, 2016). Explores transportation issues related to patients ability to successfully connect with behavioral health services.

Forging Partnerships Between Heath Care Facilities and the Transportation Agencies that Serve Their Patients (National Center for Mobility Management, 2016). Highlights the experience of transportation and health care professionals as they collaborate in improving patient health outcomes.

Community Connections: Ideas & Innovations for Hospital Leaders (American Hospital Association, 2015).  This report highlights ten innovative human service programs that address specific challenges faced by rural communities, including transportation access.

The Health Transportation Shortage Index: The Development and Validation of a New Tool to Identify Underserved Communities (Children’s Health Fund, 2012). Presents a health planning tool to help communities improve transportation access to health care services.

Transportation and Health Toolkit (Convergence Partnership, 2011). Designed to help health advocates better understand transportation issues and their related health connections, and help inform transportation advocates on the importance of health in their work.[/expand]

The Hidden Risk of Cutting Medicaid NEMT: An Examination of Transportation Service Interdependency at the Community Level (Medical Transportation Access Coalition and Community Transportation Assn. of America, 2020). Discusses how non-emergency medical transportation (NEMT) is interwoven into the services provided by local transportation agencies, which often serve as key NEMT ride providers. The authors further note that curtailing Medicaid NEMT would have significant negative consequences on local transportation services beyond Medicaid. Please be sure to also read the Health Affairs blog on the report.

Handbook for Examining the Effects of NEMT Brokerages on Transportation Coordination (TCRP, 2018). TRB's Transit Cooperative Research Program (TCRP) has released the Handbook for Examining the Effects of NEMT Brokerages on Transportation Coordination.  Because the Medicaid program is administered by states, which are able to set their own rules within federal regulations and guidelines set by the Centers for Medicare and Medicaid Services (CMS), coordination of NEMT with public transit and human services transportation is highly dependent on each state Medicaid agency’s policies and priorities. This report provides background information about NEMT and describes the different models available to states for providing NEMT for Medicaid beneficiaries. The handbook also discusses why human services transportation and public transportation providers encourage coordination of NEMT with other transportation services.  The report is accompanied by a companion document that explores the state-by-state profiles for examining the effects of NEMT brokerages on transportation coordination.

Improving Care for High-Need, High-Cost Medicare Patients (Bipartisan Policy Center, 2017). Describes data relating to the costs of providing four illustrative non-Medicare-covered supports, including in-home meal delivery, minor home modifications, non-emergent medical transportation, and targeted case management, and the potential impact on patient health outcomes.

Safe Harbor Regulation and NEMT (webinar, National Center for Mobility Management, 2017). Discusses rules from the U.S. Department of Health and Human Services, Office of the Inspector General, updated December 2016, affecting non-emergency medical transportation (NEMT). The rules provide opportunities for healthcare providers and institutions to support patient transportation. Read the new ruling and the Community Transportation Association of America's review of the rule. Read transcript of the webinar.

Non-Emergency Medical Transportation: A Vital Lifeline for a Healthy Community .(National Conference of State Legislatures, 2015). Provides an overview of the different ways states are dealing with increasing numbers of individuals, who because of age, income or persistent chronic conditions are in need of transportation to medical services.  The brief provides guidance for consideration by state lawmakers people who need transportation to medical services because of age, chronic conditions or income. It is intended to provide guidance for state lawmakers to consider regarding transportation's role in achieving positive health outcomes.

NEMT Coordinators in Minnesota: A Survey of How Minnesota Counties Use Coordinators to Deliver Non-Emergency Medical Transportation (Minnesota Council on Transportation Access, 2013). Report surveys and examines how select Minnesota counties utilize transportation coordinators in providing and administering NEMT under the state’s fee-for-service medical assistance program. Focuses on the role of coordinators in delivering the most common type of NEMT service in Minnesota, known as access transportation service.

Medicaid’s Medical Transportation Assurance: Origins, Evolution, Current Trends, and Implications for Health Reform (George Washington University, School of Public Health and Health Services, 2009). Reviews the origins and evolution of the assurance and presents the results of a survey of state Medicaid programs, with a focus on Medicaid’s unique capacity to not only finance medically necessary health care but also the services and supports that enable access to health care by low-income persons, such as non-emergency medical transportation.

Dialysis Transportation: Intersection of Transportation and Healthcare (Transportation Research Board, 2019). The report responds to major concerns of public transportation agencies about the rising demand and costs to provide kidney dialysis trips and about experiences showing these trips require service more specialized than public transportation is designed to provide.  It also documents the complicated relationship of two different industries—public transportation and healthcare, each with its own perspective and requirements—to highlight problems, identify strategies addressing concerns, and suggest options that may be more appropriate for dialysis transportation.

Transportation for Dialysis Patients (Ride Connection 2015).  A short, powerful video that speaks to the importance of having reliable transportation to dialysis. Message in the video is applicable to any community.

Improving Transportation for Patients Receiving Dialysis Treatments: A Report on Findings (Ride Connection, 2014).

Public Health and Transportation Webinar Series (National Center for Mobility Management):

• Part One - Collaborating Together for Community Health (October 10, 2019). Part one focused on how public health and transportation professionals can work together to support community health and well-being. This webinar provided an opportunity for mobility management and transportation practitioners to hear from public health professionals from the Centers for Disease Control and Prevention, the Association of State and Territorial Health Officials, and the State of Oregon Health Authority on potential areas for collaboration between the two sectors, and discuss ideas for developing, implementing, and evaluating initiatives to improve community health. View the slides and listen to the archived recording of the webinar.
• Part Two - On the Ground in Washington County, Minn. (November 6, 2019). Part two provided a deep dive into Washington County, Minn. Presenters representing public health, mobility management, and health care discussed how their community came together around health and transportation, and the outcomes of their cross-sector partnership. The presenters covered the roles of their Community Health Needs Assessment and Community Health Improvement Plan in propelling this work forward, and offer tips for identifying relevant stakeholders, participating in transportation and health priority setting, and building and sustaining similar partnerships in your community. View the slides.

The State of Transportation and Health Equity (Smart Growth America, 2019) The report identifies the biggest challenges to health equity facing our transportation system and the best tools to address the problem. Organized into 6 critical areas; each section outlines challenges, corresponding strategies, as well as success stories from around the country.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health (The National Academies of Sciences, Engineering, and Medicine, 2019). Health care systems are paying increased attention to social factors, such as access to stable housing, reliable transportation, and nutritious food. These upstream social conditions help shape people’s health because they affect both the delivery and the outcomes of health care. It is therefore critical to take them into account to improve both primary prevention and the treatment of acute and chronic illness.

A Guidebook for Communications between Transportation and Public Health Communities (AASHTO Committee on Environment and Sustainability, 2019). A user-friendly guidebook for state and local transportation professionals that identifies the challenges and best practices for successful communication and collaboration between transportation and public health professionals. The guidebook highlights the mission and processes of each community to enable a fundamental understanding between the professional communities.

Opportunities to Improve Community Mobility through Community Health Needs Assessments (National Center for Mobility Management, 2018). As a part of the Affordable Care Act, tax-exempt hospitals are required to perform community health needs assessments (CHNAs) every three years to identify the obstacles to improving community health, and then to create an action plan to address those obstacles. Many of these CHNAs have subsequently focused on mobility issues, which include access to transportation, safe biking and pedestrian facilities, and the ability to reach essential amenities, among other factors that inhibit or enable people to achieve better health outcomes.

This report explains CHNAs, what steps certain communities, guided by their CHNAs, have taken to address mobility challenges, and what, if any, impact such strategies have had. The report also identifies opportunities and strategies for mobility professionals to play a greater role in the CHNA process and engage local healthcare entities in community mobility issues.

Healthy Community Design Checklist Toolkit (Centers for Disease Control and Prevention, 2013). Provides links to health data, presentations and tools for incorporating health into transportation and land use decisions, and how to get a health profile of a specific area.

Recommendations for Improving Health Through Transportation Policy (Centers for Disease Control, 2010), with a companion toolkit. Discusses how transportation policies can have a profound, positive impact on health.