Having access to dependable transportation is an important social factor that affects a person’s daily life, including health. Being unable to get to your medical appointments or to your pharmacy for filling up your prescription can have a significant impact on health outcomes. It is critical for those with chronic conditions. There has been a growing movement to develop community-based solutions to support patients’ transportation needs.
SOCIAL FACTORS AND HEALTH ARE INTERTWINED
When Kaiser Permanente interviewed people across the nation in 2019, it shone a spotlight on non-medical social needs that influence health:
- stable housing
- sufficient food
- reliable transportation
What may not come as a surprise to many, food and rent took priority over health for 21% of survey respondents. Other key study findings included:
- 80% of respondents said reliable transportation is very or extremely important
- 97% would like their doctor to ask about social needs
- Respondents with an unmet social need were 2.5-times more likely to report their health as poor or fair
Meeting these social needs will need a three-way partnership among health care systems, social service agencies, and the transportation industry. The challenge is to find a common ground and mission for each of these sectors.
ISOLATION AND HEALTH
Older adults may be particularly vulnerable to isolation and loneliness due to lack of adequate transportation, which in turn can affect their overall health. Younger adults with disabilities also face similar challenges if they are unable to drive themselves to places and lack access to public transport, as do people living in rural neighborhoods. This is food for thought for professionals working in the transportation industry.
NON-EMERGENCY MEDICAL TRANSPORTATION: WHAT ARE MY OPTIONS?
Currently, Medicaid and some Medicare Advantage plans cover non-emergency medical transportation (NEMT). This includes rides to and from:
- A doctor’s appointment
- Hospital
- Any other medical office for plan-approved care
Medicaid enrollees who do not have a car or a driver’s license, or cannot drive due to a disability, can get covered rides, but may need pre-approval from the state Medicaid agency.
Private insurance companies are also paying attention to NMET and other social factors and their influence on their enrollees’ health and wellbeing. The Blue Cross Blue Shield Institute has partnered with Lyft (ride share company), CVS Health, and Walgreens to improve access to medical appointments and medications in neighborhoods that are not well connected or lack a brick-and-mortar pharmacy store. Lyft has also partnered with Humana’s Medicare Advantage plans to offer rides to and from medical appointments, pharmacies, and fitness centers.
DO HOSPITALS SCREEN PATIENTS FOR SOCIAL NEEDS, INCLUDING TRANSPORTATION?
Yes and no. While hospitals and health systems are paying attention to social factors and their influence on patient health, there is significant variability in the actual programs being developed. A 2017 survey of >300 hospitals and health systems found that:
- 80% of were establishing processes to integrate social needs into clinical care
- 88% were screening patients for social needs, although the process was not very consistent or systematic
- Screening is not community-wide; hospitals are focused on inpatients and high-utilizers
A different study looked at more than 2000 physician practices and more than 700 hospitals between 2017-2018. They found that only 24% of hospitals and 16% of clinics screened patients for social issues including transportation needs. Screening was more common among practices and hospitals that served low-income neighborhoods.
The American Hospital Association has created a guide for hospitals on addressing transportation barriers among the populations they serve. Recommended solutions include:
- Mobile Health Centers
- Partnering with ride-share companies such as Lyft
- Volunteer driver programs
TRANSPORTATION TIPS AND RESOURCES
If you or a family member need health-related transportation services, Patients Rising can help!
One article provides tips on finding non-emergency medical transportation, including a how-to guide on using our PR Concierge service. Another article provides in-depth guidance on all your medical transportation options, including a list of websites that provide these services.
Surabhi Dangi-Garimella, Ph.D. is a biologist with academic research experience, who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.