The Case for Patient Transportation Coverage for Health Plans

Access to transportation is becoming an important social determinant of health, and experts are coming to realize that health plans can benefit significantly from offering coverage to beneficiaries.

There’s no argument that improved access to healthcare is a good thing. When patients reach their doctors, hospitals, specialized care facilities and clinics, their overall health is improved. This is especially true for rural residents without accessible transportation.

It’s a given that prevention, early diagnosis and treatment are beneficial. Regular appointments and health care visits reduce hospital admissions, a factor in overall health improvement. 

By including transportation coverage, health plans can help ensure that patients attend regular check-ups, receive follow-up care, and ultimately manage chronic conditions more effectively with less expense.

While health plans adding transportation benefits may consider the additional costs, long-term savings from reduced complications and hospital admissions can offset these expenses. Preventative care and early intervention are generally less costly than emergency treatments for advanced conditions.

Another advantage of a transportation benefit in a very general sense is that health disparities can be reduced. Like housing, nutrition, and education — transportation, or the lack thereof, can be an overall social determinant of health. 

Non-emergency medical transportation (NEMT) services are especially necessary for specific medical conditions, as well as for the elderly, who may be unable to drive or navigate public transportation. These include wheelchair-accessible vehicles, stretchers, and trained medical personnel to assist with transport. Some medical conditions require continuous monitoring or oxygen support during transit.

Another added benefit of medical transportation is the relief and aid it provides family caregivers who often struggle to balance work, personal responsibilities, and caregiving duties. Medical transportation eases their burden by ensuring patients reach their appointments without relying on others.

There are challenges however, as smaller health plans that serve lower-income populations may find the initial financial outlays for transportation services to be a barrier. Offering transportation is not a cure-all and health plans need to effectively coordinate partnerships with private providers, local transit authorities or ride sharing services to  ensure coverage and make it easier for members.

The necessity for and implementation of transportation coverage varies by state and market. Non-emergency medical transportation (NEMT) through Medicaid is already a mandated benefit in many states. Commercial insurers design their benefits differently.

Even though it’s not a requirement for all health plans to offer transportation coverage, significant improvements in patient access, health outcomes, and potentially lower overall costs in the healthcare system can be realized, depending on a target population’s needs, cost-benefit analyses, and regulatory frameworks.

Medical transportation coverage isn’t just an option; it’s a critical component of a more comprehensive, patient-centered approach to healthcare.

Photo: lvcandy, Getty Images

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