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2 Transportation to Health-Related Destinations
Pages 5-20

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From page 5...
... Bruce Robinson, the acting associate administrator for program management at FTA, described the FTA Rides to Wellness initiative in more detail, and Oscar Gomez, the chief executive officer of Health Outreach Partners, discussed the Rides to Wellness Community Scan, a survey of the outcomes of missed appointments. Following the overview of FTA-supported efforts, Heidi Guenin, a senior associate at GridWorks, presented a synopsis of her findings from an environmental scan of health care and transportation partnerships around the nation, commissioned by the National Academies of Sciences, Engineering, and Medicine for this workshop.
From page 6...
... (Guenin) •  he challenges and barriers to creating health and transportation partnerships T include defining return on investment, funding, missing data, technology, ge ography, nonemergency medical transportation destination and service gaps, and cross-sector collaboration.
From page 7...
... is built, in part, on the premise that regular, affordable access to primary care can lower costs and improve health outcomes over an individual's lifetime. However, every year approximately 3.6 million Americans miss or delay nonemergency medical treatment despite having health care coverage because they lack transportation to care (Myers, 2015)
From page 8...
... As Flowers had explained, FTA launched the Rides to Wellness initiative to help address the important issue of transportation to health care. The initiative's goals are to leverage public transportation assets and services to improve access to health care, improve outcomes, and reduce health care costs, Robinson said.
From page 9...
... Rides to Wellness Community Scan by Health Outreach Partners The mission of Health Outreach Partners is to build strong, effective, and sustainable health outreach models by partnering with local community-based organizations in order to improve the quality of life of low-income, vulnerable, and underserved populations (e.g., homeless, low-income seniors, farmworkers, immigrants)
From page 10...
... That 3-year project identified and documented six successful case studies addressing transportation as a barrier to care; convened a National Policy Advisory Council, which produced a policy analysis and recommendations; launched a policy campaign to disseminate the findings; and incorporated lessons from the project into Health Outreach Partners' training and technical assistance activities.2 In 2016, Health Outreach Partners launched its transportation initiative, which consists of the Not Just a Ride project, funded by the Health Resources and Services Administration, and the Rides to Wellness Community Scan, funded by FTA.3 Gomez reiterated the point made by others that for many individuals, gaining health care coverage under the ACA does not necessarily translate to having access to care. Certainly, relationship- and trust-building and overcoming fear of the system are key issues for first-time health system users, Gomez said, but at the core of the access issue is transportation.
From page 11...
... Seniors are getting to their health care appointments and also meeting other personal and social needs that enhance health. ENVIRONMENTAL SCAN OF OTHER TRANSPORTATION EFFORTS As background for the discussions, the planning committee for this National Academies of Sciences, Engineering, and Medicine workshop, with support from FTA, commissioned a scan of the landscape of health care and transportation partnerships, including the data being collected and shared, and how return on investment or value is being measured.
From page 12...
... For physical health the main outcomes affected by transportation access to care included exercise capacity, mobility, mortality, pain, sensory ability, and low birth weight. Outcomes related to mental health included depression, anxiety, and suicide.
From page 13...
... . sures are used, such as primary care utilization, emergency department utilization, missed appointments, transportation trips provided, and other data reflecting the provision of transportation and care.
From page 14...
... ; same-sector information gaps (i.e., not just between the transportation and health care sectors, but within each sec tor across providers, payers, services, etc.) ; and the impact of the Health Insurance Portability and Accountability Act (HIPAA)
From page 15...
... TRANSPORTATION TO HEALTH-RELATED DESTINATIONS 15 partnerships, client-side barriers to accessing available technology (e.g., a lack of awareness or understanding, technological limita tions) , and the difficulty of tracking trips on public transit.
From page 16...
... Topics discussed included the lessons learned from recent mobility demonstration projects; transportation as a component of prevention; and the challenges of geography (e.g., the location of care, rural transit barriers) , data availability, and funding gaps.
From page 17...
... She mentioned a project funded by the HHS Administration for Community Living that is studying how to better engage people with disabilities and older adults in coordinated planning activities. Important elements of the demonstration projects included an educational component that helps patients navigate the transportation and transit services in the community; systemic data collection and evaluation processes built in during project design and development; multiple levels of data collection (e.g., individual/rider, organization/agency, and systems/community levels)
From page 18...
... Martin Ornelas of the Rural Economic Assistance League, Inc., stressed the importance of developing rural models based on rural realities and not simply applying urban models to rural areas and assuming they will work. In addition to health professional and health facility shortage areas, rural areas have transportation shortage areas.
From page 19...
... About 5 years ago, she said, GAO asked states about coordination among their transportation programs and heard a lot of negativity around the Medicaid brokerages that were in place in some states. More recent surveys, however, show that some states are feeling more positive about the Medicaid brokerages and are even finding ways to coordinate and collect data through those brokerages.


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