senior women getting in the car
By IHPL - May 15, 2025

Maria, a 72-year-old woman living in a rural town, has diabetes and heart disease but struggles to make it to her monthly doctor’s appointments. With no public transit and no family nearby to drive her, she often misses her check-ups, leading to worsening symptoms and frequent emergency room visits. Her story highlights how transportation barriers in rural communities directly impact health.1

Missed medical appointments can result in worsened health issues in patients especially for those who have chronic diseases. Missed appointments not only impact the overall health of the patient, but can also have a significant financial burden on healthcare providers, costing an estimated $150 billion annually.2

One major factor contributing to missed appointments is transportation barriers. According to the American Hospital Association, 3.6 million people in the U.S. delay or do not seek needed medical treatment due to lack of transportation.3 This issue is even more significant in rural areas, where about 1 in 5 Americans reside.4 Rural populations tend to be older, experience more health issues, and travel twice the distance for medical care compared to their urban counterparts.5 The situation is further exacerbated by hospital closures, forcing residents to travel even longer distances to access essential healthcare services.6

In rural areas of California, Non-Emergency Medical Transportation (NEMT) plays a critical role in ensuring access to healthcare for residents who face long travel distances and limited public transportation options. Because many rural communities lack reliable transit services, NEMT coverage under Medi-Cal helps patients who cannot drive due to medical conditions, disabilities, or a lack of resources. By providing essential transportation, this service helps to reduce missed medical appointments for vulnerable populations in rural settings.

As policymakers and healthcare leaders navigate cost-cutting decisions, it is important to recognize that eliminating essential services like transportation may lead to greater long-term costs—both in financial terms and in patient health outcomes. The lack of transportation services would result in an increase in missed appointments, worsening health outcomes and further straining emergency care systems.

Author Bio:

 

Huma Shah, DrPH, MPH, FACHE

Dr. Shah is the Program Director of the Master's in Healthcare Administration Program and Associate Professor at the School of Public Health. Her research interests include organizational strategy/culture, health policy, leadership, clinical outcomes, and spirituality in the workplace

References:

  1. OpenAI. (2025). ChatGPT (February 27, 2025; version 4.0) [Large language model]. https://chat.openai.com
  2. Morse, S. (2016). Missed appointments cost providers $150 billion annually, report says. Healthcare Finance News. Retrieved February 27, 2025, from https://www.healthcarefinancenews.com/news/missed-appointments-cost-providers-150-billion-annually-report-says
  3. American Hospital Association. (2017). Transportation and the role of hospitals. Health Research & Educational Trust. Retrieved February 27, 2025, from https://www.aha.org/system/files/hpoe/Reports-HPOE/2017/sdoh-transportation-role-of-hospitals.pdf
  4. Centers for Disease Control and Prevention. (n.d.). Rural health. U.S. Department of Health & Human Services. Retrieved February 14, 2025, from https://www.cdc.gov/rural-health/php/about/index.html
  5. Rural Health Information Hub. (n.d.). Transportation to support rural healthcare. Rural Health Information Hub. Retrieved February 22, 2025, from https://www.ruralhealthinfo.org/topics/transportation#travel-burdens
  6. U.S. Government Accountability Office. (2020). Medicaid transportation: CMS actions needed to ensure state programs comply with federal requirements (GAO-21-93). Retrieved February 27, 2025, from https://www.gao.gov/assets/gao-21-93.pdf