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Health and Transportation – Partners in Wellness & Affordable Healthcare

Mary Leary, Vice President, Easter Seals Transportation Group

National Center on Mobility Management Webinar

3-27-2014

Outline • Statistics underscoring growing needs for human

services populations to get healthcare rides

• Chronic conditions driving increased levels of disability

and cost

• How Accessible Communities Can Help

• Trends and key concepts for building bridges with

healthcare systems

• Value proposition for the intersection of health and

transportation2

37,326,100 of in US reported one or more disabilities (12.1%)

14% of people with

disabilities have

conditions that affect

mobility (5M)

70M Older Adults 50+ have one or more chronic

condition

51.5% of Older Adults over 75 have

disabilities (28M people

are 70 or older)

11M Older Adults have

over 5 chronic conditions

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Disability and Aging Demographics

PotentialNeed for

Ride

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Greater the number of Chronic Conditions the greater the cost

Arthritis

Heart Disease

Cancer

Depression

High Blood Pressure

High Cholesterol

Diabetes….growing significantly

Stroke

Cos

t

Major Formal and Informal Transportation Options for Community Health Needs

Department of Health and Human Services estimates range from $ 3B - $ 4B in human services transportation primarily associated with

Medicaid Transportation Estimates

Federal Transit Administration Overall Approximately $ 10B with 5310 grants over $ 257M 2013

Families (caregiver transportation), taxis and volunteer driver programs

Veterans Administration $ 824M Medical Transportation Benefits 2011 according to AARP 2013 report

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Provides access to preventive

care

Helps people convalesce at

home

Reduces unnecessary

hospital readmission

Helps people self-manage their chronic conditions

For those who are mobile, safe and

accessible streets and

transit increase and

maintain fitness

Less cars reduce harmful

emissions

Livable Communities with Accessible Transportation Options Can Mitigate Chronic Conditions

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Trends and key concepts for building bridges with healthcare

systems

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Centers for Medicare and Medicaid Innovation Healthcare Transformation AIMS

Improve access to care

Improve patient

outcomes

Reduce value based costs 8

Centers for Disease Control Framework

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Examples of Business Case – Approaches to Quantifying

Need and Benefit for Access to Transportation Options

Personal Health Mobility (PHM) Measure

Quantify estimates for individuals’ health access needs - # of appointments they require

per year

• How many can they get to today• How many do they really need• Example, need 4/month today only have 2 or

50% PHM, add one more we increase PHM by 25%

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Reduce Unnecessary Hospital Readmission

First suggested in 2008 by Florida State University• 1% of trips help

clients avoid a hospital stay saving on average $ 7,900/stay

Partner with local hospital systems to quantify costs • to find their re-

admissions rates and average cost per re-admission

• apply recent research suggesting that 11% of these are preventable

• apply an agreed upon average for what % of these were related to lack of transportation

Example: Local Hospital has 11% unnecessary re-

admissions associated with approximately

2000 patients (220 patients) costing them an average of $ 5,000 per re-admission or

$ 1.1M

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Summary – Mobility Managers Can Be Key in Improving Health and Wellness for their

communities• Learn about the health/wellness needs and stakeholders in your community

– Connect with people with disabilities and older adults to understand their preferences and concerns regarding healthcare access

– Build relationships with public health, mental health, long term services/supports, medical care and other healthcare services providers to identify issues and cost pressures

– Apply your expertise and teach them about multi-modal resources, help them connect into your coordinated transportation work

• Much more information is available on healthy behaviors and health indicators at the county

level

• For more assistance or help with quantifying need, just call the NCMM - 866-846-6400

• Also, check out the Easter Seals Project ACTION Brochure on planning for

transportation after a medical procedures are:

http://www.projectaction.org/Initiatives/HealthTransportation.aspx

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Resources/Sources• Singh, Mahender. 2008. “Chronic Care Driving a Fundamental Shift in Health Care Supply Chains.” MIT

Center for Transportation & Logistics. Retrieved 10-31-2013 from URL: http://

esd.mit.edu/staging/research/vignette/wp_singh_chronic_care.pdf

• MIT Technology Review. 2013. “Where do the Healthcare Dollars Go?.” Retrieved 10-31-2013 from URL:

http://www.technologyreview.com/news/519981/infographic-most-expensive-health-care-technology/

• Lynott, J. Fox-Grange, W. Guzman, S. 2013. “Weaving It Together, A Tapestry of Transportation Funding

for Older Adults”. AARP Public Policy Institute. April 2013. P. 15

• Tinetti, Mary E., Fried, Terri R., Boyd, Cynthia M. 2012. “Designing Health Care for the Most Common

Chronic Condition – Multimorbidity.” JAMA, June 20,2012-Vol. 307, No. 23 p. 2493. Article referenced

these statistics from another researcher noted in references as Anderson, G. Chronic care: Making the

Case for Ongoing Care. Princeton, NJ: Robert Wood Johnson Foundation, 2010.

• Farber, N. Rall, J. 2010. “Human Services State Transportation Coordination Profile: Florida”. National

Conference of State Legislatures. September 2010.

• CMS. 2012. “Chronic Conditions among Medicare Beneficiaries Chartbook 2012 Edition. P. 22. Retrieved

10-31-2013 from URL:

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/Downloads/2012Chartbook.pdf

• “Chronic Conditions among older Americans.” P. 12. Retrieved 10-31-2013 from URL: http://

assets.aarp.org/rgcenter/health/beyond_50_hcr_conditions.pdf 

• State and County Health Rankings: http://www.countyhealthrankings.org/

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