We know anecdotally that a lack of appropriate transportation to support access to health care can often be a barrier to improved patient outcomes. What we don’t know is the extent to which this is true. There is no systematic collection of data on the reasons why individual patients do not make it to primary care and specialist appointments, nor are data regularly gathered from patients being discharged after hospitalization on what barriers might prevent them from making follow-up appointments that will help keep them from being re-hospitalized.
There are initiatives to incorporate data on transportation, housing, and other social determinant of health information into electronic health records. In addition, efforts are underway to determine how to incorporate social determinants, which have a large impact on physical and mental health, into diagnostic coding systems. These systems include the Current Procedural Terminology (CPT), which lists codes used to report health care services to health insurance companies for reimbursement. Another system is the International Classification of Diseases (ICD-11), the international diagnostic classification standard for all clinical and research purposes. By identifying the need for housing or transportation into a patient’s clinical record, and seeking reimbursement for interventions that address those needs, the health care system can not only begin to address these important determinants of health, but also begin to collect data on their impact in a systematic way.
This NCMM video contains Interviews with professionals on collecting performance measures data on health care access and transportation interventions.
The Gravity Project seeks to identify coded data elements and associated value sets to represent social determinants of health data documented in EHRs across four clinical activities: screening, diagnosis, planning, and interventions. The project is focused on three specific social risk domains: food insecurity, housing instability and quality, and transportation access.
This resource from the Urban Institute covers promoting the use of data by grantees, championing community data resources and capacity, and investing directly in building community-wide capacity.
Needham Community Council – Needham, MA
In 2017, the Needham Community Council began supplementing its volunteer driver medical transportation program with trips provided through the ridehailing company, Lyft. Lyft rides were funded through the Needham Community Council operating budget and a donation from Beth Israel Deaconess Hospital – Needham.
Cape Cod Regional Transit Authority – Hyannis, MA
To promote access for Cape Cod residents to specialty medical appointments in Boston, the Cape Cod Regional Transit Authority (CCRTA) has run a Boston Hospital shuttle since 2001. The shuttle starts on the Outer Cape and picks passengers up at seven stops in different Cape towns, and then drives into Boston and drops passengers off at their appointments. In the early afternoon, the shuttle picks riders back up for the return trip to the Cape. Prior to the pandemic, service ran one daily round trip five days a week; since the pandemic, the shuttle runs Monday through Thursday. In order to serve as many residents as possible, the shuttle is open to the general public.
Explains how states can use untapped funding options under the Affordable Care Act to expand services for targeted low-income populations
This American Journal of Public Health article quantifies the number of people in the US who delay medical care annually
This guide focuses on how communities can provide transportation services to support access to rural healthcare, which may also benefit
This report unpacks the interdependency between the provision of Medicaid NEMT and local public transportation. It uses case studies of
The report identifies the biggest challenges to health equity facing our transportation system and the best tools to address the
This Research in Progress Webinar discusses several low-cost ways of improving transportation opportunities for low-income urban diabetic patients, including providing
Health care systems are paying increased attention to social factors, such as access to stable housing, reliable transportation, and nutritious food.
The report responds to major concerns of public transportation agencies about the rising demand and costs to provide kidney dialysis
Essential hospitals care for underserved patients and communities—those most affected by transportation barriers. Recognizing the impact of transportation on health
TRB’s Transit Cooperative Research Program (TCRP) has released the Handbook for Examining the Effects of NEMT Brokerages on Transportation Coordination.
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