How transportation access can support HEDIS performance

First, what are HEDIS scores?

HEDIS stands for Healthcare Effectiveness Data and Information Set. Developed by the National Committee for Quality Assurance (NCQA), HEDIS is a widely used set of measures for evaluating healthcare quality and health plan performance.

HEDIS measures cover areas such as preventive screenings, chronic condition management and follow-up care. Put simply: they help show whether people are receiving recommended care and whether healthcare organizations are closing important gaps.

What types of care do HEDIS measures evaluate?

HEDIS measures span many aspects of healthcare, including preventive screenings, chronic condition management, follow-up care, and medication adherence. Together, they help organizations understand whether patients are receiving recommended care and identify areas where gaps may exist.

That matters because many HEDIS measures depend on something deceptively simple: patients being able to access care when they need it. A screening can’t happen if a patient can’t get there. A timely follow-up can’t happen if a patient misses the recommended window. And chronic conditions are harder to manage when patients can’t consistently attend appointments.

Why do patients miss appointments?

There’s rarely just one reason. Cost, scheduling, work and family responsibilities, care coordination, and transportation can all make it harder for patients to get the care they need.

Transportation is one of those barriers—and one healthcare organizations may be able to address. In fact, 57% of healthcare professionals estimate that 11–20% of missed visits are directly tied to transportation barriers.*

Where transportation access can affect HEDIS performance

Transportation isn't itself a HEDIS measure. But difficulty getting to care can contribute to gaps across several areas:

• Preventive screenings: Breast cancer, colorectal cancer, and other screenings depend on patients completing recommended visits. When transportation gets in the way, those screenings can be missed. The resulting gaps may affect HEDIS performance.

• Chronic condition management: Conditions such as diabetes and high blood pressure require ongoing monitoring and follow-up. Missed visits can make it harder for patients to complete recommended care and for organizations to meet relevant HEDIS measures.

• Follow-up care: Some HEDIS measures depend on patients receiving follow-up care within specific timeframes. Transportation barriers can make those windows harder to meet.

• Medication adherence: Transportation-related gaps in ongoing care can also complicate medication management, particularly for chronic conditions that require regular monitoring and prescription updates.

• Utilization and outcomes: When transportation gets in the way of routine and follow-up care, organizations may have fewer opportunities to manage health needs before they become more urgent.

Four ways to address transportation-related care gaps

1. Identify where transportation is contributing to missed care. Look at no-shows, recurring appointments, and high-priority populations to see where transportation may be creating friction. Patterns across locations, appointment types, or patient populations may help teams identify where transportation support could make the greatest difference.

   
   

2. Plan transportation around the care journey. Consider where transportation needs can be anticipated, from screenings and follow-ups to recurring care and care transitions. Planning ahead can help keep transportation from becoming a last-minute obstacle, particularly when care needs to happen within a specific timeframe.

   
   

3. Make transportation easier to coordinate. Look for ways to reduce the manual work involved in arranging rides for staff, while giving riders greater flexibility where appropriate. The easier transportation is to coordinate, the easier it becomes to incorporate it into existing care workflows rather than treating every ride as a separate logistical problem.

   
   

4. Measure what’s happening. Track transportation utilization and spend alongside relevant quality measures to understand what’s working, where gaps remain, and where transportation may be playing a role. Over time, that visibility can help organizations make more informed decisions about where and how transportation resources are used.

One less barrier between people and care

Improving HEDIS performance requires healthcare organizations to address gaps from many directions. Transportation is one of them.

When getting there is the problem, a better transportation program can help patients stay connected to recommended care—and give teams greater confidence in the transportation they coordinate.

Care has enough barriers. Transportation shouldn’t be one of them.