Health and Transportation

Transportation to Opioid Addiction Treatment

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.

Patient Transportation Access

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.

View Presentations from the 2018 CTAA EXPO Session "Redefining Access: The Role of Transportation in Access to Health Care".  As health care systems pay closer attention to the costs associated with caring for patients, they are turning to social factors that impact overall health. The lack of transportation can be a leading barrier to accessing care and can cause an overuse of emergency services. Stakeholders from across the health and transportation spectrum will discuss the role of transportation as a social determinant of health and provide local examples of how transportation can work with health care providers to support overall community health. View videos of the perspectives presented by

Leveraging Medicaid to Address Social Determinants and Improve Child and Population Health (Georgetown University Health Policy Institute, 2018). Provides background for health care advocates on social determinants of health (SDOH) basics and describe ways Medicaid, in partnership with the health plans and providers that deliver public coverage benefits, can improve the health of enrollees by addressing the SDOH.

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.

Creating a Value-Driven Healthcare Delivery System: Quality and Outcomes Do and Will Matter (2016). Remarks by Laura Gustin, Development Director, The Finger Lakes Performing Provider System, Rochester, NY at Community Transportation Association of America Health Care Transportation Summit.

2015 Rides to Wellness Summit. Summit of healthcare and transportation professionals to explore strategies to eliminate one of the largest barriers to healthcare access for millions of Americans: the lack of transportation. Implemented through the collaboration of member agencies of the federal Coordinated Council on Access and Mobility, including the Departments of Transportation, Health and Human Services, and Agriculture along with NCMM staff. Participating in this half-day summit were healthcare executives, transportation executives, as well as medical transportation experts and policymakers. The keynote speakers and small group discussions explored areas in which the health and transportation sectors could collaborate to improve transportation access to healthcare.

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.

Charting Medical Transportation (CT Digital Magazine, 2014). Includes articles, commentary, and podcasts on the impact of major health care provision changes and trends in transit systems of all sizes and in all types of communities. Trends include the increase in chronic health care conditions, including dialysis.

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.

Non-Emergency Medical Transportation

The Hidden Risk of Cutting Medicaid NEMT: An Examination of Transportation Service Interdependency at the Community Level (MTAC, CTAA) For the fourth time in three years, an NEMT-focused essay appeared on the Health Affairs Blog, the most prestigious forum for essays and short pieces on health policy topics. The most recent essay, published on January 14, was co-authored by Michael Adelberg of the Medical Transportation Access Coalition, Scott Bogren of the Community Transportation Association of America, and Alexandra King, also from CTAA. The authors argue that non-emergency medical transportation (NEMT) is interwoven into the services provided by our nation’s 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.

Medicaid Expansion and Premium Assistance: The Importance of Non-Emergency Medical Transportation (NEMT) To Coordinated Care for Chronically Ill Patient (MJS & Company, 2014). Examines the impact of changing health care trends on Medicaid-supported non-emergency medical transportation. Includes a forward by the Community Transportation Association of America.

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

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).

Study of Paratransit Services for Dialysis in Maryland (Maryland Transit Administration, by KFH Group, 2013). Looks at the demand for dialysis-related transportation in Maryland, asking 1) How many dialysis patients rely on public transit currently? 2) How many additional trips would be provided now, and in the future, if additional funding/resources were available? Researchers surveyed dialysis providers and public transportation providers. Resulting data may be used by other states as peer comparison and as an indication of trending in demand for dialysis transportation.

Transportation and Community Health

News: Rethinking transportation would greatly improve the health of Americans (11/8/18). Thousands of Americans suffer from largely preventable diseases every year, like heart disease and diabetes, that account for over 75 percent of national health care spending. Could our transportation network itself help prevent these diseases?

News: Two cities make strides toward car-less transit to trails (10/9/18). Access to the outdoors is a critical component of community health, and making it easier to reach is an important step for communities to make in their mobility plans.

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.

Successful Partnerships: Strategies for Multi-Field and Cross-Sector Collaborations (Convergence Partnership, 2010). This webinar explores how transportation, healthcare, and other sectors can work together to navigate the complexities of making communities healthier.

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.

National Nonprofit Organizations and Transportation

American Cancer Society's Road to Recovery program. A nationally coordinated, locally run network of volunteer transportation programs that provides rides to cancer patients.

Patient Travel Referral Program. A program of Mercy Medical Angels provides information about all forms of charitable, long-distance medically-related transportation and provides referrals to all appropriate sources of help available in the national charitable medical transportation network.

Shepherd Centers. A national network of centers dedicated to older adults. Activities are coordinated and run by volunteers, including volunteer transportation programs.