About 16 million people are expected to receive insurance coverage over the next year with the Affordable Care Act’s new health insurance exchanges and Medicaid. This number seems great until we stop to realize that many of these individuals do not have access to their doctors due to lack of available transportation.

Flora M. Castillo, APTA Immediate Past Chair, noted in a blog post (1) that about 3.6 million Americans skip or delay nonemergency medical care every year because of issues with transportation. Considering how prevention is crucial to a person’s health, this delay in care could mean worsening health conditions and higher medical bills. Castillo also mentions that “their limited mobility doesn’t just jeopardize their health — it also exacerbates America’s health cost crisis.”

In an article released by the Community Impact Newspaper (2), Mark Hernandez, chief medical officer of the Community Care Collaborative, said, “It is very clear that the ability to actually go to a health care venue will have a fairly direct impact on the outcomes of health in that population.”

The CIN article offers an interesting example of how transportation and healthcare entities could potentially work together: “If a patient with severe diabetes goes to the hospital once or twice a month, it could cost the health care system and the public about $500,000 per year.” The article goes on to explain that if the healthcare system allocated funds for transportation, costs for patient care would decrease. “By paying for transportation or by arranging for transportation, which allows the patient to receive primary care on a regular basis, hospitalizations could be avoided,” Hernandez said.

Castillo offers come examples in her blog of how healthcare and transportation are already working together in some areas of the country:
• Consider Cleveland’s HealthLine service, which delivers patients and riders to the Cleveland Clinic and University Hospitals, among other destinations, every five minutes during the morning and afternoon rush hours. Such a system provides patients with convenient, direct access to their health care providers, and increases the likelihood that they’ll make their appointments.

• North Carolina’s Department of Health and Human Services has adopted an integrated approach, calling on state policymakers to coordinate nonemergency medical transportation with local public transportation agencies already providing public transit in their communities.

• Since July 2009, New Jersey has contracted with a broker to provide nonemergency transportation to Medicaid beneficiaries. The broker receives an annual fee for each eligible patient. By working with county community transit systems and purchasing NJ Transit bus and rail tickets when appropriate, the broker has reduced costs per passenger trip. Over 15 percent of the 5.2 million Medicaid nonemergency trips in 2012 were provided by public or county community transit.
It is the responsibility of both the transportation industry and health care system to work together and find answers to these issues and improve on America’s Health.
(1) “Public Transportation Blog.” Public Transportation Blog. N.p., n.d. Web. 23 Oct. 2013. <http://blog.publictransportation.org/>.
(2) “Access to public transit could influence health care choices.” Community Impact Newspaper. N.p., n.d. Web. 23 Oct. 2013. http://impactnews.com/austin-metro/northwest-austin/access-to-public-transit-could-influence-health-care-choices/.