When patients lack reliable transportation, they may miss important medical appointments, and this can have a negative impact on their health outcomes.
To address this social determinant of health, SSM Health St. Mary's Hospital — Jefferson City in Missouri is partnering with a group of community organizations on a program delivered over a virtual platform that matches patients who lack transportation with volunteers who can drive them to their medical appointments.
When patients lack transportation, the staff of the SSM Health hospital's medical group offer to use the portal from a program called HealthTran to identify a volunteer driver.
Tonya Pehle, vice president of operations for SSM Health, Mid-Missouri Medical Group, says with this system, "patients can get to the right care at the right time. It is a better utilization of care because there are fewer no-shows."
Suzanne Alewine is principal partner at Community Asset Builders, and her daughter Reagan Alewine-Douglas is director of HealthTran, an initiative of the Missouri Rural Health Association. Community Asset Builders is a for-profit organization that helps nonprofits build and maintain their work. It manages HealthTran.
Alewine-Douglas says few people grasp how interconnected transportation and health outcomes are. Alewine says getting to medical appointments is sometimes a matter of life and death.
Complex set of factors
Alewine says the factors that impact health care access can be complicated. Some people can't afford a vehicle or the insurance, gas, taxes and other expenses that come with it. Some families only can afford to have one car. Some people, especially the frail elderly, can no longer drive because of their health. Some are isolated and have no nearby family or friends to drive them around. Isolation is a particular issue for rural patients, notes Alewine.
Alewine-Douglas says while Jefferson City does have a bus system, the schedule rarely aligns with appointment start and stop times, and it can be difficult for people with physical limitations to get to the bus stop. Cabs and ride-sharing services such as Uber can be expensive. Alewine says those paid rideshare services also do not offer the more personal touch that HealthTran volunteers provide.
And, as Alewine explained in an article she wrote for Politico titled "Why doctors should consider giving their patients a ride," transportation services from Medicaid and other organizations can be difficult for patients to access.
According to SSM Health St. Mary's 2024 community health needs assessment, nearly 10% of the people in the hospital's service area lack reliable transportation. The report notes that this is an area of increasing concern.
Partnering on a solution
The Missouri Rural Association contracted with Community Asset Builders to use a grant from the Federal Transit Administration to build out and pilot the HealthTran program using a platform for ride coordination. Community Asset Builders and the Missouri Rural Health Association are in their third grant round. A federally funded organization called the Coordinating Council on Access and Mobility Technical Assistance Center supports the work.
Its primary goal is to address transportation issues affecting people's health.
Once Community Asset Builders and the Missouri Rural Health Association built out the platform, the United Way of Central Missouri engaged Central Missouri hospitals and other health care facilities in signing on to use the system. Organizations that use HealthTran pay a startup fee to go live.
HealthTran recruits volunteer drivers, interviews and screens them, conducts background checks and drug testing, ensures their vehicle is registered and insured, and provides them with safe driving education. Six volunteers serve Central Missouri. Volunteers get a stipend for mileage. SSM Health St. Mary's foundation covers this and other costs, which were less than $10,000 last year.
SSM Health St. Mary's and its medical group began using HealthTran to coordinate rides for patients in 2024. Before its launch, Pehle ensured patient-facing staff knew how to use HealthTran's platform to enter patients into the system, and the medical group spread the word about the program, including by posting flyers in its clinics.
Pehle says the program is getting popular. In 2024, 183 patients used the service. In 2025, 304 patients used it.
All walks of life
Alewine-Douglas says patients of all walks of life use the service. It has been especially helpful to patients who need cardiac rehabilitation, behavioral health services and wound care — as these patients often must make repeated trips to medical appointments and the repercussions of missing them could be dire.
Alewine says the ride service directly addresses the financial and mission interests of health care providers. Given that most payers only reimburse for completed visits, having a patient not show up for scheduled appointments can be costly. Additionally, missed medical appointments can increase the chances of health deterioration, which could lead to an emergency department visit for the patient, which may not be the most cost-effective site of care.
And, from a mission perspective, having a patient healthy at home is a top goal and helping them maintain their preventive care can achieve this, says Alewine.
'She's more like my family'
Marlene Anderson is a Jefferson City-area resident who drives a patient named Larnice to a SSM Health St. Mary's clinic every Friday.
Anderson walks Larnice from her home to the car and helps her in, drives her to the clinic, pushes her in a wheelchair from the car to her appointment, then reverses the process to get her back home. Sometimes Anderson will take Larnice on a quick errand or to another medical stop.
In a video that the Coordinating Council on Access and Mobility Technical Assistance Center posted on its website, Anderson says not only is her volunteerism a way to give back to her community, she benefits from her time with Larnice.
"I look forward to every Friday," she says. "We talk about anything and everything when it's just the two of us."
Anderson adds that Larnice "just brings this joy to my life — now she's more like my family. I enjoy her and she's great."