Transportation

Availability of transportation is a significant barrier to health in the FLPPS region. A recent survey of community-based service providers in the FLPPS region found that a lack of transportation was the most frequently cited barrier to care and support services.

Regional Description

The FLPPS region has a population of over 1.5 million people and covers over 8,500 square miles with 21,000 miles of highway.  Communities span from urban to the very rural, and each provides its own unique transportation challenges.  Monroe County has 3,527 miles of highway with a population density of 1,132 people per square mile, to Steuben County, with 3,161 miles of highway and 71 people per square mile.  Of the 3,161 miles of highway, only 427.5 miles or 13.5% is served by Public Transportation. In the rural regions, a trip to a primary care provider may be 30 miles with very limited access to public or commercial providers, or 120 miles for specialty care referrals or follow-up care.

Medicaid/Medicare Funded Transportation

Non-emergency and emergency transportation services are paid benefits in the Medicare and Medicaid programs.  However, Medicare only pays for emergency ambulance type services; whereas Medicaid funds both emergency and non-emergency transportation services to approved destinations for health care. The general rule of thumb is that transportation will be provided if the service provider rendering the medical care is also a Medicaid approved service and is reimbursed by Medicaid.  This excludes non-medical community services such as nutrition centers, support groups, grocery shopping, and prescription pick-up.

FLPPS has focused intently on this particular work stream to identify new and existing transportation gaps related to the DSRIP program initiatives. This work stream is guided by an advisory committee and works directly with other FLPPS committees (i.e. Workforce, Finance, IT and Clinical) to ensure proposed initiatives align with the selected DSRIP Projects and the specific recommendations made by each Committee.

To date, there is not a lot of quantitative data available to illustrate the current barriers to transportation. One of FLPPS’ goals is to evaluate the capacity and funding of each type of regional transportation service (ie, bus, taxi, private, ambulatory, etc.) and create alternative solutions to increase transportation access for non-clinical support services such as the grocery, pharmacy, and shopping centers.

If transportation barriers can be incorporated into the electronic patient record, we can begin to quantitatively track the impact of this limitation on individual health outcomes. Throughout all of this, FLPPS is not working to increase capacity by adding capital resources but evaluating current state and create more efficient integrated systems using mobility management.

Mobility Management

Mobility Management is a growing type of service both nationally and in the FLPPS region. 

Mobility management focuses on meeting individual customer needs through the variety of services offered by multiple providers. The range of services offered by public, not-for-profit, and private providers are inventoried and catalogued to create a clearinghouse of available transportation options. Mobility managers use the clearinghouse to match customers to the most appropriate service based on their requirements (e.g., ability to access the service, if the destination is served by the provider, etc.). This program creates greater efficiencies and improves cost-effectiveness as all transportation services are considered in a centralized manner.

FLPPS received a $25,000 Mobility management planning grant from National Center for Mobility Management to plan transportation solutions for a transformed and integrated delivery system.

Read more here about the Big Data and Transitions to Care Projects as they relate this grant:

Big Data

 

Transitions To Care