1. WWW.PROJECTACTION.ORG 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

2. 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 transportation 2

3. 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 3 Disability and Aging Demographics Potential Need for Ride

4. 4 Greater the number of Chronic Conditions the greater the cost ArthritisHeart DiseaseCancerDepressionHigh Blood PressureHigh Cholesterol Diabetes….growing significantly Stroke Cost

5. 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 5

6. 6 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

7. WWW.PROJECTACTION.ORG Trends and key concepts for building bridges with healthcare systems 7

8. Centers for Medicare and Medicaid Innovation Healthcare Transformation AIMS Improve access to care Improve patient outcomes Reduce value based costs 8

9. Centers for Disease Control Framework 9

10. WWW.PROJECTACTION.ORG Examples of Business Case – Approaches to Quantifying Need and Benefit for Access to Transportation Options

11. 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% 11

12. 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 12

13. 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 13

14. 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 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/ 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.pdfhttp://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 http://assets.aarp.org/rgcenter/health/beyond_50_hcr_conditions.pdf State and County Health Rankings: http://www.countyhealthrankings.org/http://www.countyhealthrankings.org/ 14