Social Care Services Evidence Summary: Transportation Services 

This evidence summary includes a broad range of research/resources on transportation services and is primarily focused on health 

care impact. It is not intended to be an exhaustive compilation of research/resources on this topic. The information presented in this 

summary can inform the value proposition of partnering with a community-based organization (CBO) or a network of CBOs to offer 

these services and supports as part of a strategy to address social determinants of health (SDOH). 

Transportation services are services that support individuals to travel to meetings, appointments, and errands. Transportation 

services may include direct transport services, rideshare services, or supporting individuals in accessing public transportation. While 

states vary in their approach to providing transportation through Medicaid waivers, all states are required to make nonemergency 

medical transportation (NEMT) available to Medicaid beneficiaries (Bentler et al., 2016). Expanding access to NEMT in nongovernmental health plans would likely decrease unmet need among the older adults and individuals with disabilities population. 

Individuals with access to a health plan that includes NEMT are less likely to report an unmet need for transportation (Bentler et al., 

2016). This is an important consideration, for while NEMT needs may not constitute emergency situations, NEMT is far from 

nonessential. Both rural and urban Medicaid participants report using NEMT services for life-saving dialysis more frequently than for 

any other medical concern (Smith et al., 2017). 

Rideshare services have become more widely available for individuals looking for transportation without having to rely on their own 

vehicles or public transportation. Ridesharing is an option utilized by many individuals participating in Medicaid waivers for both 

NEMT and other kinds of transportation. Thrifty-five percent of Medicaid participants reported using a rideshare service at least 

once. However, there are barriers associated with using rideshares, such as late and failed pickups for individuals requesting rides 

(Eisenberg et al., 2020). 

For specific, further detailed information on this evidence, please review the resources listed below. 

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Transportation Services Research and Evidence 

Study Population Studied Objective of Study Type of Analysis Findings / Results 

Bentler et al. Members whose To understand and Observational For those in IHAWPWP with an unmet 

(2016) health plan included 

an NEMT benefit 

[Medicaid State 

Plan (MSP)-Family 

Medical Assistance 

Program (FMAP)] 

and those in health 

plans that were not 

obligated (through a 

governmental 

waiver) to provide 

an NEMT benefit 

(10,180 from each 

program) from 

October 28, 2015 – 

January 15, 2016 

evaluate issues relat ed to 

NEMT for Iowa Healt h 

and Wellness Plan 

(IHAWP) members. 

survey, statistical 

analysis 

(multivariable logistic 

regression models) 

need for routine care, 23% were not able 

to get transportation. 16% of MSP-FMAP 

members and 13% of IHAWP-WP 

members reported an unmet need for 

transportation to health care visits and 

this difference was statistically significant. 

Eisenberg et 1101 Medicaid To assess whether more Observational More than 35% of respondents received 

al. (2020) enrollees in a 

northwestern US 

state 

rideshare transportation 

to health care was 

associated with improved 

self-reported ride 

experiences and fewer 

late/failed passenger 

pickups for Medicaid 

enrollees. 

survey, statistical 

analysis (bivariate 

tests and 

multivariable logistic 

regressions) 

NEMT from rideshare services at least 

once. Perceptions of the ride experience, 

driver, and vehicle did not differ based on 

the proportion of rideshare trips received. 

Having more rideshare trips was 

associated with reporting late and failed 

pickups. The statistical significance held 

for failed pickups. 

Jang et at. 

(2018) 

14 Transportationdisadvantaged older 

adults in 

To determine whether a 

community-based 

“buddy” program that 

Qualitative 

interviews 

It was determined that there is a need to 

improve the mobility and independence 

of older adults in Hillsborough County 

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Study Population Studied Objective of Study Type of Analysis Findings / Results 

Hillsborough pairs college-age students through the provision of information on 

County, Florida with transportationdisadvantaged older 

adults could improve 

quality of life for seniors 

in Hillsborough County, 

Florida. 

existing transportation and health 

resources. Participants were receptive to 

the Healthy Buddy concept and felt it 

could improve their transportation access 

and quality of life. 

Miller et al. 21 participants all To explore the promise, Observational, Although sharing economy services have 

(2018) aged 85 and older use, and perceptions of 

sharing economy services 

among older adults in the 

United States and to 

understand the 

opportunities and 

challenges that exist in 

this space for gerontology 

educators, students, 

consumers, businesses, 

and senior care providers. 

mixed-methods 

study involving a 

questionnaire and 

three focus groups; 

researchers used 

descriptive statistics 

to determine the 

likelihood of a 

participant knowing 

about the availability 

of a service in their 

community and focus 

groups that 

discussed barriers to 

utilization. 

potential to support aging in place, to do 

so successfully will require reconstructing 

how older adults, family caregivers, aging 

service professionals, gerontology 

educators, and gerontology students 

conceptualize and deliver care to an aging 

population. 

Smith et al. 39,194 NEMT users To differentiate the Observational review Transportation and health insurance, as 

(2017) of LogistiCarebrokered services in 

Delaware residing in 

rural and urban 

areas from 2011 – 

2016 

characteristics of 

Medicaid NEMT use, 

noting the differences 

between rural and urban 

trips. 

of administrative 

data, statistical 

analysis 

(multivariable logistic 

analyses) 

enabling factors, may reduce individual 

and healthcare characteristics differences 

previously observed between rural and 

urban individuals. However, older age and 

the need for accompaniment from 

personal care assistants were more 

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Study Population Studied Objective of Study Type of Analysis Findings / Results 

common among participants picked-up in 

rural areas. Alternatively, wheelchair 

services and NEMT for purposes other 

than dialysis were less common among 

individuals picked-up from rural locations. 

Understanding the differences in NEMT 

use by middle and older age and by 

rurality can assist in planning for mobility 

and healthcare delivery over the life 

course and by context. For example, 

reduced support for preventive care in 

rural areas can end up being costly longterm when accounting for the 

transportation and treatment of 

avoidable chronic conditions. 

Solomon et al. 8 studies of health To synthesize existing Retrospective, Five studies reported that transportation 

(2020) care sectorsponsored 

programs that 

provided individuals 

assistance with 

nonemergency 

transportation and 

directly assessed 

the impact of 

transportation 

assistance on health 

and health care 

utilization outcomes 

research on 

nonemergency medical 

transportation 

interventions. 

systematic review of 

studies describing 

interventions that 

changed the 

availability or cost of 

NEMT; the studies 

were based in or 

sponsored by a 

health care 

organization 

(including insurer or 

provider group); or 

were designed to 

differentiate the 

services improved health care utilization, 

but many were conducted with small 

samples or had other methodological 

constraints that limit confidence in 

results. Among the highest quality 

studies, one randomized trial found that 

transportation interventions did not affect 

appointment show sates and two other 

randomized controlled trials found that 

transportation interventions improved 

appointment show rates. 

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Study Population Studied Objective of Study Type of Analysis Findings / Results 

impacts of the 

transportationrelated intervention 

from other 

components of the 

intervention and 

included 

transportation 

access, health, or 

health care 

utilization-related 

outcomes. 

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Additional Resources 

Resource Author Description of Content Target Audience 

Birnie et al. (2019) Mobility management is a relatively new approach to 

coordinating community transportation services in both urban 

and rural areas. Rather than focusing on managing the provision 

of a specific service or mode of service such as rail, bus, or van 

service, the mobility manager focuses on the customer and 

solving his or her transportation challenges using a variety of 

providers, service modes, and strategies. This paper addresses 

who mobility managers are and what they do—and why they 

are important now and in the future. It highlights emerging 

innovations via five case studies. It also presents the results of a 

national survey and inventory of mobility managers, and it 

discusses how mobility management can lead a transformation 

in transportation. 

CBOs, states 

Friedman & Rizzolo (2016) To examine Medicaid Home and Community-Based Services 

(HCBS) 1915(c) waivers, the largest provider of long-term 

services and supports for people with intellectual or 

developmental disabilities (I/DD), to see how transportation is 

provided for people with I/DD, the authors conducted an 

environmental scan of states’ approved 1915(c) waivers. The 

authors found that the majority of waivers provided 

transportation for people with I/DD through these two means; 

however, this transportation was often limited to very specific 

purposes. It appears transportation services for people with 

I/DD in waivers need to be expanded to support community 

access and integration. 

States, federal government 

Wolfe & McDonald (2020) This resources identifies examples of ways in which new 

ridesourcing (also known as ridesharing) services, such as Uber 

and Lyft, are changing existing modes of access to medical care 

and providing new ways for individuals to reach health care 

CBOs, health care providers, 

ridesourcing companies, states 

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Resource Author Description of Content Target Audience 

facilities. The authors conducted an environmental scan of case 

examples of the utilization of ridesourcing technology pulled 

from news publications. Three core types of innovation or 

collaboration were identified. The first, and most common, type 

of innovation is when a health care provider leverages 

ridesourcing technology to book individual’s trips. The 

second type of innovation involves an insurer or health plan 

formally partnering with a ridesourcing company to 

expand transportation offerings to beneficiaries or offer these 

services for the first time. The third type of innovation 

is when a paratransit provider partners with a ridesourcing 

company. 

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