HMN 2025: How Transportation boundaries impacting Hawai’i rural well being care, coverage options proposed

Long ambulance response occasions, pricey and unreliable non-emergency transportation, and inadequate insurance coverage protection for travel-related well being care bills are among the many key findings of a new report launched by the University of Hawai?i Rural Health Research and Policy Center (UH RHRPC).

“The Impacts of Transportation and Travel Access on Rural Health in Hawai?i” underscores the widespread challenges confronted by residents in rural and neighbor island communities when attempting to entry well timed and inexpensive well being care, and presents coverage options to deal with boundaries.

Although about 30% of Hawai?i’s inhabitants lives in rural areas unfold throughout six publicly inhabited islands, most specialty care is positioned on O?ahu. The report discovered that residents of Moloka?i and L?na?i routinely face flight delays or cancellations, usually lacking pressing medical appointments and ready months for rescheduling.

The report additionally highlights gaps in insurance coverage protection, particularly for sufferers who don’t qualify for Medicaid, and the excessive out-of-pocket prices for journey, lodging, and meals related to medical visits. Maternal-fetal well being providers are notably difficult, with some pregnant sufferers needing to relocate from neighbor islands to O?ahu for prenatal and supply care or danger emergency medevac transport.

“Improving entry would require coordinated efforts throughout well being care, transportation and coverage sectors,” mentioned John Desfor, UH RHRPC coverage and knowledge analyst. “We hope this analysis will information significant motion to enhance transportation entry for well being care in rural communities throughout Hawai?i.”

Some of the shared coverage choices to deal with these challenges embody:

• Enhance emergency air and floor ambulance fleets
• Support neighborhood paramedicine packages and broaden major care groups
• Mandate non-emergency medical transportation protection in Medicare and personal/employer-based insurance coverage in Hawai?i
• Establish a grant program for community-based organizations to help housing for maternal-fetal sufferers relocating for prenatal and supply care
• Support regional well being hubs and cell maternal well being clinics in rural areas
• Expand interisland flight packages and discover cost-effective and sustainable different modes of transportation for well being providers
• Address airline reliability considerations and improve airline competitors by leveraging the U.S. Department of Transportation Essential Air Service program
• Enable hospitals and clinics to be reimbursed for transportation

The four-part report contains a literature overview, interviews with 40 stakeholders, coverage suggestions and a targeted sub-report on maternal-fetal telehealth.

“We admire the numerous neighborhood engagement on this venture from begin to end,” mentioned Aimee Grace, UH RHRPC principal investigator and UH Strategic Health Initiatives director. “Many stakeholders met with our group to share their tales or contribute context and coverage concepts. We sit up for working collectively to share these coverage choices additional.”

The Hawai?i Public Health Institute will host a webinar on this venture on August 18, 2025, midday–1 p.m. (register here).