HealthTran

Summary

Need: To provide transportation to patients in South Central Missouri who otherwise have non-existent, limited, or expensive transportation options to and from healthcare appointments.
Intervention: A non-emergency transportation service that offers rides for patients demonstrating a transportation need for timely primary and preventive care access.
Results: HealthTran has helped to improve healthcare access and long-term health outcomes, as well as reduced preventable hospitalizations and unnecessary emergency department visits.

Description

For more than 20 years, transportation has continually surfaced as a key barrier to healthcare access in rural Missouri. Approximately 25% of missed appointments are transportation-related, causing an average loss of $544,500 in revenue for a provider that sees an average of 22 patients per day. Rural areas in South Central Missouri lack full-time healthcare providers, putting the burden on the patient to find the means and a mode of transportation in order to receive medical help. For many, this can be an expensive and encumbering option.

In 2013, a panel discussion was held at the Missouri Public Transit Association's strategic planning session regarding this problem. Several organizations collaborated and devised a plan that would provide transportation coordination and ride subsidies for patients, with the goal to improve their long-term health outcome.

The concept, now known as HealthTran, was presented to the Missouri Foundation of Health as a project of the Missouri Rural Health Association (MRHA) and was selected for a 3-year grant starting in 2013. Funding was also provided by the Missouri Department of Transportation, and the National Center for Mobility Management to service a total of 10 Missouri counties.

HealthTran passenger and staff — HealthTran's first passenger pictured here with coordinators and medical staff.

HealthTran provides the missing link between transportation and healthcare. HealthTran rides are made to be affordable, averaging $3 for a local trip, to $81-150 round-trip for specialty services. All costs are dependent upon the trip's distance. Those who benefit from the service are mainly elderly, disabled and/or Medicare/Medicaid dually eligible patients who are referred to HealthTran by a medical provider.

Chart showing the health issues of Health Tran riders

Transit partners include:

Participating health partners include:

Services offered

How HealthTran works:

Organizations or communities interested in offering HealthTran services sign up to become members.
A community launch event kicks off the program.
HealthTran Coordinators (HTCs) are trained to use a schedule platform and assure transportation needs are being met.
Patients ask a member health provider for a HealthTran referral when they make their appointment.
The health provider will send a transportation request electronically to an HTC.
The HTC calls the patient to complete an assessment and schedule the trip.
After the ride, the HTC calls the patient to compete a post-assessment.

HealthTran's model for creating sustainable transportation coordination:

120 days of assistance, set-up, and partial reimbursement for trips scheduled within the first 90 days of the launch.
Transportation coordination training for HTCs
Transportation coordination for patients through provider referral
Coordination between local healthcare and transportation providers
Healthcare provider training and education regarding HealthTran's purpose, value and implementation process
Civic presentations on the importance of removing transportation barriers to healthcare access

Results

Over time, HealthTran found that their transportation services actually reduced the cost of healthcare and improved health outcomes for most patients. Gross charge collections for healthcare partners have increased substantially as a result of patients making and keeping primary and specialty care appointments. Data has shown a clear correlation between the increased revenue and provision of transportation.

Overall, HealthTran has helped to improve healthcare access and long-term health outcomes and reduced preventable hospitalizations and inappropriate emergency department use. HealthTran has brought together organizations to work together to address the barriers to healthcare access.

Below are specific results of their program:

As of October 31, 2015, HealthTran has received approximately 2,235 unduplicated provider referrals, of which 1,795 (80%) were completed trips.
Since HealthTran began receiving Section 5310 funds from the Missouri Department of Transportation (July-September 2015), they have coordinated 686 trips for 221 unduplicated riders at an average cost per trip of $45.92. Of the individuals served during that time period, 29% were elderly, 60% were disabled and 11% were low-income.
Using a 10-point scale, HealthTran received the highest rankings through a survey distributed to HealthTran passengers.
As of September 2015, one provider experienced a 20.2% reduction in missed appointments as a result of patient referrals to HealthTran.

Challenges

Below are some challenges HealthTran has faced during its launch and its continuation:

Securing technology that reduces coordination time and displays multiple transit providers for the most cost-effective rides
Securing funding resources for the cost of the trips
Communication between healthcare and transportation providers
Flexibility in changing business practices
Identifying riders and pockets of need
Legalities and patient privacy
Lack of healthcare and transportation providers
Cost and distance of travel
Schedules and systems that are hard to navigate
The need to increase public awareness
Constant changes in medical costs insurance policies and/or coverage
Systems that are incapable of reciprocal operation

Replication

Below are some principles for anyone wanting to duplicate a program like HealthTran:

Find a community champion who can develop unique solutions
Rally community support
Provide in-home services
Make a point to reach out to local veterans and those with special needs
Partner with local businesses
Leverage as many resources as possible and support enhanced funding for public transportation

Northwest Health Services and Health Care Collaborative of Rural Missouri will be launching HealthTran in 2018. HealthTran continues to gather data to support advocating for increased public transportation funding and identify resources to support medical facilities in addressing transportation access issues.

Fifteen months after the launch of HealthTran, the Federal Transit Administration (FTA) launched a nation-wide transportation program called Rides to Wellness. HealthTran collaborators have adopted several ideas within the realm of technology and business operations. HealthTran also recommends Rides to Wellness for those who wish to replicate a transportation program. The annual Missouri Rural Health Conference now offers HealthTran training.

Contact Information

Mary Gordon, HealthTran Manager
Missouri Rural Health Association
HealthTran
573.632.2700
mgordon@cabllc.com

Topics
Access
Primary care
Transportation

States served
Missouri

Date added
November 12, 2015

Date updated or reviewed
February 6, 2018

Suggested citation: Rural Health Information Hub, 2018. HealthTran [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/859 [Accessed 31 May 2023]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.