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    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Research in Progress (RIP)</title>
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      <title>Transportation Barriers to Vision Care for the Visually Impaired</title>
      <link>https://rip.trb.org/View/2342038</link>
      <description><![CDATA[Concerns about or problems with transportation acutely affect the large and growing population of people in the US living with visual impairments, who have been shown in previous studies to lack adequate transportation which keeps them from receiving low vision rehabilitation and other specialized care. This research will take a multi-fold approach to understanding safety concerns that pose transportation barriers to health care among Nebraska residents with visual impairments, focusing on those living in rural areas. For one research thrust, the project team will conduct in-depth, semi-structured interviews with patients seeking care at the University of Nebraska Medical Center’s (UNMC's) Weigel Williamson Center for Visual Rehabilitation, which operates a main clinic in Omaha and satellite clinics in Lincoln and Hastings—the latter intended to serve people living in rural and small urban areas in central and western Nebraska. Interview data will shed light on transportation safety and access concerns facing patients as well as on the prevalence and nature of transport barriers to low vision care. For another research thrust, the project team, working with University of Nebraska, Lincoln (UNL) and UNMC partners, will explore potential strategies for addressing transportation barriers, such as deploying innovative, integrated non-emergency medical transportation services; coordinating patient transportation; providing travel training or information on alternative transportation services at points of care; and offering telerehabilitation. This cross-cutting research, with implications for policymaking and practice in transportation and medicine, will advance understanding of transportation barriers facing rural residents with visual impairments and assess strategies to address these barriers.]]></description>
      <pubDate>Mon, 19 Feb 2024 18:28:51 GMT</pubDate>
      <guid>https://rip.trb.org/View/2342038</guid>
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      <title>Traffic Congestion and Asthma-related Hospital Visits in Central TX</title>
      <link>https://rip.trb.org/View/2264252</link>
      <description><![CDATA[As one of the most common health diseases that are susceptible to environmental changes in urban neighborhoods, asthma is a major health concern among the disadvantaged populations living in urban neighborhoods with a higher proportion of poverty and racial/ethnic minorities (Corburn et al. 2006). The Centers for Disease Control and Prevention (CDC) estimated that 5.1 million U.S. children had asthma in 2019. 

Notably, air pollution has been a growing concern in environmental health, being considered to trigger new asthma symptoms and exacerbate existing asthma symptoms, and plenty of studies provide evidence for the association between air pollution and respiratory diseases (English et al. 1999; Janssen et al. 2003; McConnell et al. 2006; McCreanor et al. 2007; Guarnieri and Balmes 2014). Traffic congestion increases vehicle emissions and degrades ambient air quality (Zhang and Batterman 2013). However, the understanding of the association between traffic congestion and asthma is very limited. Thus, the research question is whether traffic congestion is a determinant of asthma-related hospital visits.
]]></description>
      <pubDate>Fri, 06 Oct 2023 19:13:59 GMT</pubDate>
      <guid>https://rip.trb.org/View/2264252</guid>
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      <title>Expanding Rural Access to Non-Emergency Medical Transportation</title>
      <link>https://rip.trb.org/View/2071596</link>
      <description><![CDATA[River Cities Public Transit will receive funding to expand a program that provides transportation for oncology patients to a large hospital in central South Dakota to all types of patients within a 60-mile radius. The project will feature an integrated single payment system and allow Avera St. Mary's Hospital to hire a full-time transportation coordinator to advocate the service.]]></description>
      <pubDate>Mon, 28 Nov 2022 14:20:21 GMT</pubDate>
      <guid>https://rip.trb.org/View/2071596</guid>
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    <item>
      <title>Bay Area Transportation Authority's (BATA's) Project/Comprehensive Healthcare Access with Rural Transit Solutions (CHARTS)</title>
      <link>https://rip.trb.org/View/2071590</link>
      <description><![CDATA[The Michigan Department of Transportation will receive funding on behalf of three regional agencies in northwest Michigan to develop a mobility-on-demand service to meet the non-emergency medical transportation needs of rural residents. The grant will support technology that consolidates dispatch scheduling, asset condition reports and security systems across the agencies.]]></description>
      <pubDate>Mon, 28 Nov 2022 14:20:17 GMT</pubDate>
      <guid>https://rip.trb.org/View/2071590</guid>
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      <title>Impacts of Medicaid Transformation on North Carolina Public Transit Systems: Lessons Learned and Best Practices</title>
      <link>https://rip.trb.org/View/2003216</link>
      <description><![CDATA[On July 1, 2021, North Carolina began the transition of Medicaid health care delivery from fee-for-service to managed care. Prior to the transition, in 2019, community transit systems in North Carolina provided 1.3 million rides through the Medicaid Non-Emergency Medical Transport (NEMT) benefit amounting to 23% of all trips and 21% of revenues. The NEMT rides were blended into the coordinated transportation system, meaning at any time, a public transit vehicle could be carrying trips sponsored by NEMT, senior centers, employment programs, and/or other programs. Under managed care, private transport brokers make NEMT decisions which may bypass public sector transport providers completely or include service standards that make it difficult to coordinate NEMT with other transportation needs. The scale of this change in health care delivery will alter community transportation systems' finances and operations and transit riders' level of service for all trip purposes.

With this project, the research team will document how Medicaid Transformation is impacting community transportation's ability to provide North Carolinians with access to critical destinations. The team will consider operational and financial impacts on transit systems and travel impacts on riders. The team anticipates significant variation across the state with some systems able to maintain or increase service delivery while others reduce service. The team will exploit these differences to identify the factors such as service area characteristics, population characteristics, NEMT agreements with private transport brokers, and service policies that allow systems to provide access to health care, employment, and other destinations while maintaining operational efficiency and financial health.

This issue is of critical importance to the North Carolina Department of Transportation (NCDOT) because the organization provides tens of millions of dollars in state and federal funding for community transportation systems and any impact to the service delivery model will change the levels of mobility and access that these funds support. This issue is also important to rural areas in North Carolina and other transportation disadvantaged communities because community transportation provides essential mobility options that allow people to age in place, supporting individual freedoms and rural economies. Identifying and sharing lessons learned and best practices for managing Medicaid Transformation with community transportation systems and NCDOT will maintain essential mobility for North Carolinians, assist agencies negotiating with private transport brokers and improve access to health care and other opportunities. The investigation will also provide NCDOT with information needed to work effectively with the North Carolina Department of Health and Human Services (NCDHHS) to coordinate community transportation for medical access.]]></description>
      <pubDate>Thu, 04 Aug 2022 14:33:43 GMT</pubDate>
      <guid>https://rip.trb.org/View/2003216</guid>
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    <item>
      <title>Benefit Analysis of Private Health Sector Investments in Non-Emergency Medical Transportation</title>
      <link>https://rip.trb.org/View/1957095</link>
      <description><![CDATA[State departments of transportation (DOTs) are responsible for providing mobility services to the transit-dependent public while maximizing investments of state and federal dollars in public transportation. Available funds often leave needed projects partially or wholly unfunded. Mobility managers, frequently housed within DOTs, are responsible for coordinating transportation resources for individuals with unique access needs and are sometimes challenged to find suitable transportation options for the individuals they serve. 

People who are unable to transport themselves and require recurring medical trips for chronic conditions not served through telehealth, such as diabetes or cancer, face challenges when seeking access to care. Public or healthcare transportation may help individuals without a support network, however, transit service limitations, prohibitive costs, or the lack of access to public transportation may cause restricted healthcare access. Additionally, those with access to public transportation may experience service delays, interruptions, or closures. 

Healthcare transportation, known as Non-Emergency Medical Transportation (NEMT), is provided by some health insurance plans, but the uninsured, underinsured, or those who have insurance without this transportation benefit struggle to gain access to healthcare services. Private healthcare organizations that do not contribute financially to NEMT need information about the potential benefits, costs, and advantages, which may include greater service delivery. NEMT affects healthcare providers and patients and is necessary for healthcare customers. Research is needed to provide actionable solutions with multifaceted benefits of providing improved NEMT services for patients resulting from the healthcare industry’s increased investment. 

OBJECTIVE: The objective of this research is to develop a guide and tool kit for a diverse set of stakeholders, aimed at determining and communicating the costs and benefits of healthcare providers and hospitals providing healthcare customer transportation. ]]></description>
      <pubDate>Tue, 24 May 2022 19:31:00 GMT</pubDate>
      <guid>https://rip.trb.org/View/1957095</guid>
    </item>
    <item>
      <title>Transportation to Dialysis Centers: Health/Transportation Policy Intersection</title>
      <link>https://rip.trb.org/View/1378193</link>
      <description><![CDATA[In 2010, more than 20 million Americans had chronic kidney disease (CKD). As documented by the United States Renal Data System (RDS), the incidence of CKD has increased from 12.3% of the general population in 1994 to 14.0% in 2010. CKD can lead to kidney failure or end-stage renal disease (ESRD). The only treatment options for ESRD are dialysis or transplant. According to the National Institute for Diabetes and Digestive and Kidney Diseases, from 1980 through 2009 the prevalence rate for ESRD increased nearly 600%. The cost of clinical dialysis for Medicare patients alone was $23.6 billion in 2010. However, the national financial impact and the need and availability of transportation to dialysis treatments have not been quantified.

Dialysis services are provided primarily by large, for-profit corporations. These corporations do not provide the transportation services that many of their clients require; rather they rely on publicly subsidized transportation. While some people choose to drive to and from their dialysis sessions, doing so presents a number of health and safety risks. A recent report by Ride Connection emphasized the challenge faced by our nation when it stated, “The growth in incidence of end-stage renal disease and the decreased mortality rates in this population creates increased burden on a transportation system that was not designed to accommodate life sustaining treatment trips.” Some transportation providers have been forced to deny transportation requests to dialysis while other providers have denied other transportation requests in order to accommodate increased demand for transportation for dialysis. These problems are further compounded in rural communities because there are few dialysis treatment facilities.

The objectives of this research are to quantify the current and projected demand and associated costs of transportation for kidney dialysis in the United States and identify current effective practices and new strategies for funding and providing transportation for dialysis. The research should address a number of important areas and answer the critical questions presented in the Request for Proposal. This research should consider and address differences that affect transportation for kidney dialysis in urban and rural areas.]]></description>
      <pubDate>Sun, 27 Dec 2015 13:01:54 GMT</pubDate>
      <guid>https://rip.trb.org/View/1378193</guid>
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