The National Academies Press

Currently Skimming:

Pages 121-176

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.

From page 121... ... 121 Introduction This chapter presents 16 examples that describe a wide range of collaborative efforts that improve transportation access to health care, with examples from across the country. See Exhibit 6-1. Read the entire page →
From page 122... ... 122 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services This exhibit groups the practices into nine categories, ranging from Innovative Funding and Reimbursement to Mobility Management to Brokerage Technology. Collaborative Practices The 16 collaborative practices described in this chapter include relatively straightforward examples such as the hospital in Campbellsville, Kentucky, with a free van service for patients in its surrounding counties. Read the entire page →
From page 123... ... Collaborative Practices 123 Together, the Delta Rides network provides transportation services to 21 counties in the Mississippi Delta region. Community members seeking to travel between counties can contact a Delta Rides mobility manager, who will coordinate between agencies to schedule their ride. Read the entire page →
From page 124... ... 124 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services In addition, AEH receives federal funding from the U.S. Department of Transportation (USDOT) Read the entire page →
From page 125... ... Collaborative Practices 125 Health Care Insurer Offers Free NEMT Transportation: CareMore Health System Description of Practice CareMore Health is a physician-founded, physician-led integrated health insurer and care delivery system. CareMore's focus is on chronically ill patients and developing holistic solutions. Read the entire page →
From page 126... ... 126 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services CareMore had provided patients with wheelchair vans and other specialized transport for years, but after receiving numerous complaints from patients that the services were inadequate, CareMore sought out a solution to improve the transportation program. The pilot was so successful that after just a few months CareMore expanded the program systemwide. Read the entire page →
From page 127... ... Collaborative Practices 127 This is one more example of the for-profit private sector understanding the necessity of transportation and how important it is to appropriate health care. Lessons Learned Transportation access is crucial to health. Read the entire page →
From page 128... ... 128 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services NEMT Provided by a Health Care Consortium in Columbia County, New York: Children and Adults Rural Transportation Service (CARTS) Description of Practice The Children and Adults Rural Transportation Service (CARTS) Read the entire page →
From page 129... ... Collaborative Practices 129 including dialysis or chemotherapy/radiation. Many older clients lack a social support system or family who can help provide transportation to health care or feel hesitant about driving in larger cities. Read the entire page →
From page 130... ... 130 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services • CARTS uses the county garage for repairs and parks their vehicles in the City of Hudsonowned lot. • The Columbia County Board of Supervisors includes a small amount of funding for CARTS in the county budget each year. Read the entire page →
From page 131... ... Collaborative Practices 131 County Demand Response Program Partners with Local Hospitals for Funding Support in Baltimore County, Maryland: CountyRide Description of Practice Baltimore County, Maryland, provides a demand response public transit system known as CountyRide (Exhibit 6-4) Read the entire page →
From page 132... ... 132 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Needs Transportation access to hospitals and medical facilities in the Baltimore region is difficult for many seniors and people with disabilities without access to private transportation. Baltimore County saw rising demand for trips into Baltimore City for medical appointments but limited funding to expand service. Read the entire page →
From page 133... ... Collaborative Practices 133 Funding/Sustainability CountyRide's partnerships with medical facilities are informal and the amounts provided by individual hospitals and health-care organizations may vary year to year. Nevertheless, the funds are an important contribution supporting CountyRide's operations. Read the entire page →
From page 134... ... 134 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services rabbittransit serves as the coordinator of transportation service for the pilot. In addition to providing trips within its own service area, rabbittransit coordinates with neighboring public transit providers to deliver/perform trips within their respective service areas. Read the entire page →
From page 135... ... Collaborative Practices 135 Logistics Platform Connecting Transportation and Health Care: Kaizen Health Description of Practice Kaizen Health offers a platform that aggregates diverse types of transportation in one place. Kaizen Health aims to accommodate the needs of everyone, including people with limited mobility and children. Read the entire page →
From page 136... ... 136 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services and language of choice to receive updates about the ride. Passengers receive communication with the details about their upcoming rides. Read the entire page →
From page 137... ... Collaborative Practices 137 transportation barriers include lack of access to personal cars, limited public transit options, and lack of technology to arrange their own transportation. How Did the Collaboration Start? Read the entire page →
From page 138... ... 138 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Health Care Transportation and Ride Hailing: Lyft Description of Practice Lyft is a ride-hailing company that offers health-care providers and payers access to NEMT through its network of over one million drivers. Coordinators can either schedule rides directly on the Lyft Concierge platform or integrate Lyft's Application Programming Interface (API) Read the entire page →
From page 139... ... Collaborative Practices 139 The Centers for Medicare and Medicaid Services (CMS) has provided more opportunity for Lyft and other TNCs to provide health-care transportation with a 2019 ruling allowing for greater use of supplemental benefits in Medicare Advantage plans, which include transportation. Read the entire page →
From page 140... ... 140 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services towns, and six pueblos. In 2013, NCRTD was a low ridership service with difficult-to-follow routes and schedules. Read the entire page →
From page 141... ... Collaborative Practices 141 Funding/Sustainability The service changes that resulted in the increased ridership were implemented at no additional costs. Funding and sustainability, however, is no longer an issue for NCRTD as it has taken advantage of a New Mexico law that allows for the forming of a district with a dedicated sales tax (Gross Receipts Tax) Read the entire page →
From page 142... ... 142 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Ridership increased over 400% as the fixed route generated a highly successful service for a city of its size. Management believed that coordinated transportation provides better public transportation. Read the entire page →
From page 143... ... Collaborative Practices 143 and support, there would be advertising and promotional benefits for the sponsors. The manager stated that she went to the United Way first, and they agreed to support the project. Read the entire page →
From page 144... ... 144 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Lessons Learned There were a number of lessons learned. Clearly, a change of service design from low productivity demand response to fixed route made a major difference in ridership and credibility. Read the entire page →
From page 145... ... Collaborative Practices 145 Needs Tarpon Springs, a part of the Tampa Bay region, is a city of 25,000. Tarpon Springs is a retirement community with 25% of the population age 65 and older. Read the entire page →
From page 146... ... 146 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services A Call Center Increasing Access to Health Care in Southern Illinois: Rides Plus Description of Practice Rides Plus is a call center funded by the Rides Mass Transit District, a federally funded public transportation system that serves 17 counties in southern Illinois. Rides Plus works with transportation agencies and health-care providers throughout the service area to help increase access to NEMT. Read the entire page →
From page 147... ... Collaborative Practices 147 health services. Rides Plus takes additional steps to accommodate the needs of some of these patients, such as ensuring that they do not have to share a vehicle with another passenger. Read the entire page →
From page 148... ... 148 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services bus systems, residents may associate public transit vans with services for older adults or people with disabilities. Rides Plus staff anticipate that direct outreach will help community members become more comfortable with taking public transportation. Read the entire page →
From page 149... ... Collaborative Practices 149 about their options. Depending on the patient's preferences or needs, the case coordinator can also offer vouchers for public transit or call Medicaid NEMT to arrange transportation. Read the entire page →
From page 150... ... 150 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services programs, including Medicare Advantage. The ACO wants to offer competitive benefits to potential members, and transportation assistance is a key factor for many patients. Read the entire page →
From page 151... ... Collaborative Practices 151 general public service (Exhibit 6-7) , as well as Medicaid NEMT, which is coordinated with the general public service. Read the entire page →
From page 152... ... 152 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services The greatest recurring medical need was and is kidney dialysis transportation. In addition, the bulk of the passengers are frail seniors. Read the entire page →
From page 153... ... Collaborative Practices 153 The second performance measure, cost per one-way trip, is directly related to productivity. Taking a service from one to five one-way trips per vehicle hour reduces the cost by a factor of five and frees up service for other needs. Read the entire page →
From page 154... ... 154 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Free Van Service Operated by a Hospital in Central Kentucky: Taylor Regional Hospital Description of Practice Taylor Regional Hospital in rural Campbellsville, Kentucky, provides a free private van service to residents of Taylor, Green, Marion, and Adair counties (9) Read the entire page →
From page 155... ... Collaborative Practices 155 patients cannot be enrolled in Medicaid and cannot have access to another means of transportation. Eligible patients must be ambulatory as the vans are not wheelchair accessible. Read the entire page →
From page 156... ... 156 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Health Care Transportation and Ride Hailing: Uber Health Description of Practice In March 2018, ride-hailing company Uber launched Uber Health, a dashboard that allows health-care providers to schedule rides for patients, and an Uber Health Application Programming Interface (API) , a tool that enables integration of Uber into existing health-care products and information technology systems. Read the entire page →
From page 157... ... Collaborative Practices 157 Lessons Learned Uber Health service is best suited for ambulatory patients who can complete curb-to-curb trips without additional assistance. Uber Health is also more effective for on-demand trips when patients are ready for their trips. Read the entire page →
From page 158... ... 158 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Needs For decades, the public transit agencies in Vermont integrated Medicaid NEMT into their overall operations. Meeting transportation needs for accessing health care has always been an important service of the agencies, particularly in the more rural parts of the state. Read the entire page →
From page 159... ... Collaborative Practices 159 Types of Practice Tables 6-1 through 6-9 group health-care and transportation collaborative practices according to the following nine types: • Communication and Education • Coordination of Service • Innovative Funding, Payment, and Reimbursement • Health-Care Organization as Operator • Mobility Management • Service Design and Productivity • Brokerage Technology • NEMT -- Broker or Provider • Collaborations Initiated Through Public Transit, TNCs, and Taxis The icons displayed in Exhibit 6-9 denote the service area for each provider in the tables. Service Area Metropolitan and large urbanized area (over 200,000 population) Read the entire page →
From page 160... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 162... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 164... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 166... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 167... ... Table 6-5. Mobility management. Read the entire page →
From page 168... ... 6 # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 169... ... 7 HeathTran has been described as "a mobility manager." HealthTran from Medicaid or veterans' services. 8 9 (continued on next page) Read the entire page →
From page 170... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 171... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 172... ... # Description Transportation Organization(s) Health-Care Organization(s) Read the entire page →
From page 173... ... 4 "Personal Choice Driver" is an option 5 rides) to doctors' of�ices, hospitals # Description Transportation Organization(s) Read the entire page →
From page 174... ... Table 6-9. Collaborations initiated through public transit, TNCs, and taxis. Read the entire page →
From page 175... ... 5 notice. Depending on the patient's 6 Children's Hospital, Health System's acute Nemours Children's Read the entire page →
From page 176... ... 176 Guidebook and Research Plan to Help Communities Improve Transportation to Health-Care Services Chapter Notes 1. "D.A.R.T.S" Aaron E Read the entire page →

From page 121...

... 121 Introduction This chapter presents 16 examples that describe a wide range of collaborative efforts that improve transportation access to health care, with examples from across the country. See Exhibit 6-1.