The trends in health care are evolving. In the early part of the 20 th Century, the doctor had the...
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The trends in health care are evolving. In the early part of the 20th Century, the doctor had the mobility role making house calls
In the last half of the 20th century, the patient and the doctor met at the hospital and long hospital stays became common.
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Today, the patient is the mobile one
› Outpatient surgery
› Outpatient treatment
› Outpatient rehabilitation
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Persons are living longer with more infirmities
The average hospital stay is much shorter
The population is aging
Obesity is becoming epidemic bringing with it many health related issues
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Addiction and the need for treatment is increasing
Dialysis treatment is growing
Mental health treatment is more acceptable and therefore increasing
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Our troops are coming home with critical mental and physical health issues› Traumatic Brain Injury
› Loss of limbs
› Stress related disorders
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Aging is requiring increased medical care
Aging is requiring increased assistance in transportation
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Increased difficulty in travel to seek medical treatment
Increased difficulty in travel to employment in the medical industry
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Of 29 rich nations, the United States has the highest rate of ‘amenable mortality’ before the age of 75
The U.S. is falling further behind
Nolte,McKee, London School of Hygiene and Tropical Medicine
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The emerging transportation need of the twenty first century
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Volunteers in Medicine Institute
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Older adults Veterans Persons with disabilities Children Healthcare employees persons who are “fuel
challenged”
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One in five persons over 65 does not drive
Compared with older drivers, older non-drivers in America make 15% fewer trips to the doctor
Men can expect to spend the last six years of their lives dependent on others for transportation. For women the time is 10 years.
Lack of transportation was named the No. 3 problem in the lives of seniors, ahead of both Medicare and Social Security issues.
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Rising fuel costs have resulted in “fuel challenged” riders
Persons who have never thought of using public and community transportation are new customers
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America has some of the best medical facilities with the best medical care in the world.
This is no better than a third world country if the person cannot access the health care.
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Total statewide benefit to Florida of more than a billion dollars (number of trips x.1x average cost of one day hospital stay
Florida Transportation Disadvantaged services: Return on Investment Study
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Many older adults are not comfortable driving in the metropolitan area
Income and or disability may dictate the need for transportation assistance
Medical community does not consider transportation in land use planning
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Across the US› Average distance for medical/dental
care was 10.2 miles› Rural trips average 17.5 miles vs. 8.3
miles for urban residents
Nationwide average medical trip took 22 minutes
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How will people be able to get to the health care they need?
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Medical transportation has worked its way to the forefront of public and community transportation
Historically, private transportation has provided medical transportation
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Brokerages manage non-emergency Medicaid transportation
Ambulance handles emergency transportation a emergencies and Medicare
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Medical transportation need is so great it will require a variety of modes and levels of transportation
Incorporating these modes into coordination plan will take effort
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Think outside of the box
Work with new people
Don’t discount volunteers, donated labor
Work with family members of riders to see what they can offer to your system
Create unusual partnerships
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Introduce your system to the medical community
Invite the medical community into the transit community
› Learn each others language
› Identify each others assets
› Identify each others needs
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Work with state chapters of national medical associations
Work with veterans’ associations to identify their needs
Plan overlapping conferences and share common training
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Help them to help you
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Educate your transit community about CMS
Follow proposed rule changes
Be educated---Be vocal
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When dealing with Medicaid
› Keep accurate records
› Be able to justify your cost from a third party vantage point
› Insure that Medicaid is not paying for any costs not pertaining to Medicaid service
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Medical transportation is the new focus› Keep good data on numbers of medical trips, miles, mode of travel
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Transportation is the difference between life and living
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Community Transportation Association of America
Medical Transportation Specialist [email protected] 202-294-2212
www.ctaa.org