The Impact of Transportation: Care Access and Adherence

No matter where a patient falls on this simplified care continuum, it’s vital to ensure that they are adhering to the care plan laid out by their care provider. Care adherence can decline for many reasons, and non-medical reasons can exacerbate this.

For patients to receive much-needed care, it’s vital that they have access to and from said care– especially the most vulnerable Medicaid and Medicare Advantage populations.

Through the rise of technology adoption and forced dynamics such as the Covid-19 pandemic requiring people to stay home, virtual care solutions and telehealth options have grown significantly. Virtual care options have helped narrow the access gap to care, but there is still a critical need to provide in-person care options across the care continuum to help proactively identify health complications before they expand, intervene and revise active care plans that are not working, and triage complications along the patient journey.

No matter where a patient falls on this simplified care continuum, it’s vital to ensure that they are adhering to the care plan laid out by their care provider. Care adherence can decline for many reasons, and non-medical reasons can exacerbate this decline. These non-medical reasons are most commonly known as social determinants of health (SDoH). One of the best ways to improve care access and adherence is transportation – a fundamental SDoH factor.

Care Access

How can a patient receive health care if they can’t physically get there in the first place? The variety of care each patient needs is often a curated collection of appointments, meetings, tests, procedures, medications, and more. Whether due to the transportation distance, cost, or access, it can’t be overlooked that care access is not a guarantee, especially for the most vulnerable patient populations across the country.

According to a study of North Carolina Medicare and Medicaid residents with six or more outpatient appointments in the past year, one in three respondents experienced transportation-related issues and barriers. From this group, individuals with disabilities and those without a household vehicle were even more likely to face barriers to transportation. While a lack of driver/vehicle access and transportation costs were the most prevalent issues reported, every individual has nuanced social living circumstances that may only further complicate their ability to access care.

Example: Debra is a dual-eligible Medicaid and Medicare individual living with her daughter who is a single parent of two. Debra has an elevated risk of heart attack and stroke, and should be prescribed statins to reduce her cholesterol and overall risk. However, due to her daughter not being able to take time off work and get her mother to the doctor, ultimately, Debra suffers from a heart attack and now has an expensive hospital stay while in an already-difficult financial position. Had Debra been able to receive transportation to and from the doctor earlier to receive intervention and the right care, her physical and financial health would have had a better outcome.

Elevating Care Adherence

Not only is having access to care important, but sticking and adhering to a care program (and related medications) is equally critical. When transportation falls through at any point along the care journey, there are severe financial and physical ramifications.

Prescription Medication

Medications are a true lifeline for individuals treating an array of conditions, both chronic and acute. However, adherence to vital chronic condition medication is not nearly where it is – in fact, the adherence rate hovers around 50%. With the rise in chronic conditions diagnosed across the United States, getting individuals to and from the pharmacy to get their prescriptions (as well as to the doctors that prescribe them) is an essential part of the care plan.

Medication adherence is even more challenging within the most vulnerable Medicaid and Medicare Advantage populations. In a recent American Hospital Association guide, it was noted that restrictions on Medicaid payments for transportation result in decreased prescription refills. It goes without saying that transportation makes a significant difference in earlier intervention and staying on track with a care plan and medication adherence.

Missed Appointments

Meeting with doctors is crucial throughout the care journey, whether for an appointment, test, or procedure. However, appointment no-shows result in a $150 billion weight that bogs down the healthcare industry. By missing or avoiding these appointments, risks increase for costly downstream costs such as hospital (re)admittance.  These missed appointments are a losing game as doctors have less time to see other patients, insurance providers face higher claims, key quality measures are missed – and patients ultimately face worse health outcomes. With transportation to and from appointments, these cascading healthcare costs can be minimized.

No matter where on the care continuum someone may be, transportation makes a difference. Transportation access allows for greater opportunities to proactively catch a problem before it snowballs as well as intervene when needed. Every individual’s care plan is unique and the transportation-related challenges individuals face to access their care are equally unique.

At SafeRide Health, we put the patient (and member) at the center of our technology-powered non-emergency medical transportation offerings. We’re dedicated to closing gaps to care for Medicaid and Medicare Advantage members. Whether it’s for a basic checkup, more complex chronic care treatment, or for a medication refill, getting access to care helps maintain care adherence, elevate the patient/member experience, cut costs, and drive better health outcomes.

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