What Drives Healthy Outcomes?
by Madeleine Richter-Atkinson, Jamie Dudensing
Experts agree that as much as 80% of a person’s health is determined by factors outside of direct medical care, including where they are born, grow, live, and work. To encourage better outcomes, health plans are working in communities to help address social barriers to good health, including the need for access to reliable and affordable transportation.
Transportation is a surprisingly large driver of health outcomes. Approximately 3.6 million Medicaid beneficiaries miss or delay care each year because they do not have access to transportation. Missed appointments and failure to access care can be costly both in terms of money and overall quality of health. Without regular and preventative care, patients may end up in the emergency room or find treatment ineffective. Access to transportation also allows individuals access to other necessities such as food, education, and employment, which all support better health outcomes and lower costs.
Too often, transportation is unreliable, expensive, or inaccessible. Car ownership may not be financially possible or desirable. An older car may be cost-effective, but frequent breakdowns could render it unreliable. Additionally, not all individuals can or want to drive. Buses and other public transit may offer low costs, but timing may be inconvenient and bus stops may be too far away from home or necessary destinations — while recognition of public transit’s role in keeping people healthy is growing, good infrastructure is still lacking.
The federal government has addressed part of this problem through the recent infrastructure bill, which includes $39B for public transit. But Texas health insurance providers are also doing their part to make sure Texans are able to get to the care they need.
Meeting Transportation Needs
Several health insurance providers partner with non-emergency medical transportation companies and cover the cost of these services. Bright Health Plan, for example, gives qualifying members unlimited rides to approved locations (doctors, specialists, and pharmacies) and ensures availability of wheelchair accessible vehicles. Members getting a ride are also able to bring one companion with them to support them when getting care.
Additionally, Texas Medicaid plans provide assistance getting to and from medical appointments, including covering the costs of public transportation or ride-hailing, gas, and necessary out-of-state medical travel. These services also extend to Texans enrolled in Children with Special Health Care Needs and Transportation for Indigent Cancer Patients.
Check out some of TAHP’s Associate NEMT members.
Telehealth became widely acknowledged as a viable alternative to some in-person care over the past year, especially in rural areas, where the transportation barriers are greater than in urban areas. Both the Texas Legislature and the federal government passed legislation expanding telehealth and broadband across the state.
Texas health insurance providers recognize telehealth services as a means to access some preventive and mental health care and bypass the need for transportation. Most health insurance providers partner with services like Teladoc, digitally connecting patients with medical professionals. Some even prioritize telehealth services through new, often lower-premium, virtual first plan offerings. While some of these plans require primary care to start online, others provide flexible options so patients can decide if accessing care online will be easier and meet their needs better than travelling to the doctor’s office.
Check out some of TAHP’s Affiliate and Associate telehealth members.
Approximately 4 million Americans are homebound due to age, disability, or frailty. Many homebound Texans rely on family or friends to transport them to medical appointments. But some may not have others they can rely on, or still face other transportation barriers to getting the in-person care they need.
Texas Medicaid and Texas health insurance providers have in-home care options for these Texans. Medicaid and insurance providers partner with value-based care services, bringing health care providers to members’ doors to deliver safe and effective in-home care.
While there is no single solution for overcoming transportation issues, health insurance providers are working to address the issues on multiple levels and going the extra mile for clients.
This article is part of a series on several categories of social determinants of health. Learn more about SDOH and read our articles on other SDOH to learn more about how each category affects overall health.