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APHA Scientific Session and Event Listing

Recorded presentation

Stephen Borders, PhD¹, Craig H. Blakely, PhD², Sherry Bame, PhD³, Dennis Perkinson, PhD⁴, and Don Sweeney, PhD³. (1) School of Nonprofit and Public Administration, Grand Valley State University, 401 W Fulton Street, Grand Rapids, MI 49504-6431, 616-331-6569, borderss@gvsu.edu, (2) Department of Health Policy and Management, School of Rural Public Health, 1266 TAMU, College Station, TX 77843, (3) Landscape Architecture And Urban Planning, Texas A&M University, MS 3137, College Station, TX 77843, (4) Texas Transportation Institute, Texas A&M University, 3135 TAMU, College Station, TX 77843

Transportation is frequently cited as a barrier to care, but rarely have researchers analyzed the problem in depth. Most studies simply indicate transportation is one among a sundry of barriers to access to care. A recent evaluation sought to assess the role transportation plays in EPSDT utilization in Texas. Although the Medicaid population is of low-socioeconomic strata, they are a diverse group of individuals with a wide variety of mobility limitations. Thus, developing a taxonomy or systematic categorization of the subgroups of the Medicaid population into a coherent scheme may be useful in targeting those that need the most assistance in overcoming their transportation barriers. Using cluster analysis, we identified subgroups of families with children eligible for the Texas Medicaid program who are experiencing significant transportation barriers that lead to lower EPSDT utilization. By examining impedance factors faced by Medicaid recipients, our analysis resulted in an optimal solution of four clusters. As expected, there is a stark inverse relationship between EPSDT utilization and transportation barriers. As barriers such as automobile ownership, difficulty paying for gasoline and parking expenses, and proximity to care rose among the clusters, self-reported utilization of EPSDT visits fell. By identifying subgroups within the overall Medicaid population with particular acute transportation barriers, policy makers can more readily address specific segments of the population. In turn, attention can be given to assist those with severe access problems and low utilization of preventive services to overcome those barriers and improve the overall health of the Medicaid population.

Learning Objectives:

• 1)Recognize the different transportation barriers affecting Medicaid recipients.
• 2)Recognize how transportation barriers impact EPSDT utilization.
• 3)Identify and discuss the challenges and strategies for targeting Medicaid recipients with numerous transportation barriers to improve EPSDT utilization.

Keywords: Access to Care, Medicaid

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation