- 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.
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 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.
Transit partners include:
- Missouri Public Transit Association (MPTA)
- Southeast Missouri Transportation Service (SMTS)
- OATS, Inc.
- City of West Plains Transit System (WPTS)
- South Howell County Ambulance
- South Howell County Transit, West Plains
- Ozarks Co Ambulance District
- Licking Bridge Builders Senior Center
Participating health partners include:
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
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 HealthTran passengers.
- As of September 2015, one provider experienced a 20.2% reduction in missed appointments as a result of patient referrals to HealthTran.
Leo Haralson testifies how HealthTran was a life-saver, transporting him for a rural Missouri community to receive hyperbaric wound treatments:
Read more about the program:
- Why doctors should consider giving their patients a ride, POLITICO Magazine, 2017
- Medical Transportation Service is a Lifesaver for Rural Missourians, The Rural Monitor, 2016
- 'Get Link'd to HealthTran' Meeting Points to Shared Mission for Success, West Plains Daily Quill, 2015
- HealthTran in This Area is Awarded $203,469, West Plains Daily Quill, 2015
- HealthTran Expands Services & Takes on New Transit Partners, Missouri Public Transit Association, 2014
HealthTran is also featured in RHIhub's Access to Care for Rural People with Disabilities Toolkit Program Clearinghouse and the Rural Transportation Toolkit Program Clearinghouse.
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 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
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.
November 12, 2015
Date updated or reviewed
February 6, 2018
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.