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 The trends in health care are evolving. In the early part of the 20 th Century, the doctor had the mobility role making house calls  In the last half.

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Presentation on theme: " The trends in health care are evolving. In the early part of the 20 th Century, the doctor had the mobility role making house calls  In the last half."— Presentation transcript:

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2  The trends in health care are evolving. In the early part of the 20 th Century, the doctor had the mobility role making house calls  In the last half of the 20 th century, the patient and the doctor met at the hospital and long hospital stays became common.

3  Today, the patient is the mobile one › Outpatient surgery › Outpatient treatment › Outpatient rehabilitation

4  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

5  Addiction and the need for treatment is increasing  Dialysis treatment is growing  Mental health treatment is more acceptable and therefore increasing

6  Our troops are coming home with critical mental and physical health issues › Traumatic Brain Injury › Loss of limbs › Stress related disorders

7  Aging is requiring increased medical care  Aging is requiring increased assistance in transportation

8  Increased difficulty in travel to seek medical treatment  Increased difficulty in travel to employment in the medical industry

9  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

10  The emerging transportation need of the twenty first century

11  Volunteers in Medicine Institute

12  Older adults  Veterans  Persons with disabilities  Children  Healthcare employees  persons who are “fuel challenged”

13  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.

14  Rising fuel costs have resulted in “fuel challenged” riders  Persons who have never thought of using public and community transportation are new customers

15  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.

16  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

17  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

18  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

19 How will people be able to get to the health care they need?

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22  Medical transportation has worked its way to the forefront of public and community transportation  Historically, private transportation has provided medical transportation

23  Brokerages manage non-emergency Medicaid transportation  Ambulance handles emergency transportation a emergencies and Medicare

24  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

25  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

26  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

27  Work with state chapters of national medical associations  Work with veterans’ associations to identify their needs  Plan overlapping conferences and share common training

28  Help them to help you

29  Educate your transit community about CMS  Follow proposed rule changes  Be educated---Be vocal

30  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

31  Medical transportation is the new focus › Keep good data on numbers of medical trips, miles, mode of travel

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33  Transportation is the difference between life and living

34  Community Transportation Association of America  Medical Transportation Specialist   


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