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.
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.
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.
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
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
HealthTran's model for creating sustainable
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
Coordination between local healthcare and
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
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
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
As of September 2015, one provider experienced a
20.2% reduction in missed appointments as a result of
patient referrals to HealthTran.
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
Securing funding resources for the cost of the trips
Communication between healthcare and transportation
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
Systems that are incapable of reciprocal operation
Below are some principles for anyone wanting to duplicate
a program like HealthTran:
Find a community champion who can develop unique
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
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
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.