Guidebook for Integrating Transportation and Health Care Providers

The Fixing America’s Surface Transportation (FAST) Act mandates that the federal interagency Coordinating Council on Access and Mobility (CCAM) improve services for making trips to medical facilities, stressing the importance of effective partnerships between transportation and health care providers. Building partnerships will require a robust dialogue, the development of a shared vision, and overcoming many challenges. The Federal Transit Administration (FTA) has initiated and supported several important efforts to improve access to healthcare and build coordination between transportation and healthcare providers. In 2015 FTA launched the Rides to Wellnessto find solutions that increase access to care, improve health outcomes, and reduce healthcare costs. initiative to increase partnerships between health and transportation providers and show the positive financial benefit of such partnerships. In 2016 FTA released over $5M in Rides to Wellness grants In June 2016 FTA sponsored a workshop that brought transportation planners, researchers, and service providers together with health care researchers and providers to explore critical issues. The workshop was conducted in collaboration with National Academies of Sciences, Engineering and Medicine. ( FTA is funding a community scan through Health Outreach Partners to answer important questions including: How does lack of transportation impact healthcare costs, including missed appointments? What percent of missed appointments are due to transportation issues? What are the direct costs associated with missed appointments? What are the indirect costs associated with missed appointments? The Affordable Care Act and other recent policies and programs are providing incentives to consider and implement strategies, such as cross-sector partnerships, to meet the social needs of patients. As one example, the Centers for Medicare & Medicaid Services launched in early 2016 the Accountable Health Communities initiative, which will evaluate health system approaches to meet the social needs (including transportation) of Medicare and Medicaid beneficiaries. One of the three tracks of the initiative aims to “encourage partner alignment to ensure that community services are available and responsive to the needs of the beneficiaries.” There is a need to review the findings of these projects, identify and address numerous challenges, and develop a guide for professionals in health and transportation to build effective partnerships and support each other’s missions. The health care sector is striving to ensure access to health care for all eligible people, help more people access free health screenings that could reduce the cost of care, and reduce missed appointments. The Transportation sector is striving to improve mobility and access for many trip purposes, including work, shopping, social, and importantly, health care. It needs additional investment and new service alternatives to improve access to all destinations and to support the goals of health care providers. Measuring the value of these activities is challenging since there is inadequate data to help both health care and transportation providers communicate, assess, and report on the value derived from partnerships. In addition, funding mechanisms create additional challenges: in the health area money often follows the person, so it is at an individual level; and in public transportation funding largely flows to a transit system–from Federal formula grants. These funding mechanisms present difficulties in cost-sharing, an area currently being explored by the Coordinated Council on Access and Mobility – the interagency council charged with finding ways to coordinate transportation across federal agencies. The complexity of transportation access to health care suggests the need for a research roadmap to identify next steps and future research priorities for advancing these efforts. There are many important research questions that must be answered such as: How can technology solutions integrate scheduling and dispatching for both health care appointments and needed transportation services? How does the flow of funding at both a person-level and transit-system-level help or hinder health and transportation coordination? How will fewer missed appointments impact health outcomes and health care costs? How can transportation be considered as part of health care payment reform efforts (to account for where funding comes from and where value is realized)? What institutional models have been tried and what lessons, both good and bad, can be learned about various institutional model? The objectives of this research are to prepare two important deliverables: A guidebook on effective practices to build health and transportation partnerships to help professionals effectively communicate, overcome barriers, and implement effective programs for improving access to medical services. A research roadmap that outlines specific research projects to address existing needs and gaps in the area of access to health care facilities. Research roadmaps are a very effective way of planning for the future in areas where attitudes, conditions, or technologies are developing rapidly.


  • English


  • Status: Proposed
  • Contract Numbers:

    Project H-55

  • Sponsor Organizations:

    Transit Cooperative Research Program

    Transportation Research Board
    500 Fifth Street, NW
    Washington, DC    20001

    Federal Transit Administration

    1200 New Jersey Avenue, SE
    Washington, DC  United States  20590
  • Project Managers:

    Schwager, Dianne

  • Start Date: 20170107
  • Expected Completion Date: 0
  • Actual Completion Date: 0
  • Source Data: RiP Project 41374

Subject/Index Terms

Filing Info

  • Accession Number: 01622198
  • Record Type: Research project
  • Source Agency: Transportation Research Board
  • Contract Numbers: Project H-55
  • Files: TRB, RiP
  • Created Date: Jan 7 2017 1:00AM