When a woman experiences a medical complication during pregnancy it can be dangerous for her and her unborn child. It’s imperative that she gets timely care.

But what if she doesn’t have a car or a ride to get to her doctor or the hospital? Such was the predicament for “Sandra,” a resident of the urban South Jersey island known as Atlantic City, where door-to-door public transportation options for at-risk patients are extremely limited.

A prolonged delay in fetal monitoring and examination by her doctor could have easily escalated into a serious problem that would have required hospital intervention for both Sandra and the baby she was carrying. That delay didn’t happen, though, because Sandra (whose name is fictitious but experience is real) was one more than 800 of Atlantic City residents who have benefited from an innovative ride program piloted by AtlantiCare and supported by Horizon.

“We tend to think that a person’s health is driven by the traditional factors of proper nutrition, healthy lifestyle, good medical care and effective medicine,” said Valerie Harr, director of Community Health for Horizon. “While all this is true, we also understand that non-medical social circumstances, such as a person’s access to affordable transportation to and from doctor appointments and treatments, can loom large as a determining factor for their health and wellness.”

Harr said these so-called “social determinants of health” (SDoH) extend to a wide range of other factors, such as food insecurity, where a person may live in an area where grocery stores are scarce, i.e. food deserts, or they may not have the economic means to purchase nutritious meals. As head of Horizon’s “Neighbors in Health,” an SDoH program in which community health workers assist thousands of Horizon members to connect with local resources and to meet their health and wellness needs and stay healthy, Harr has seen first-hand how medical outcomes improve when non-medical obstacles are overcome.

“We screen our patients for social determinants of health to gain an understanding of what barriers they may be experiencing to accessing the care and treatment they need,” said Samantha Kiley, MPH, MBA, executive director, Community Health Advancement and Development, of AtlantiCare. She explained that these barriers can have a domino effect both on the person, whose medical condition can easily worsen when they cannot access care, and the healthcare system in general, in the form of higher re-admission rates and overuse of the ER for non-emergency purposes. “When our clinical workers learn that a patient in Atlantic City can’t keep medical appointments or pick up medication or supplies they need to stay well due to a transportation problem, we have a powerful tool at our disposal to help them overcome this barrier.”

The tool is Roundtrip, an online platform that AtlantiCare is using to connect patients to easily accessible, reliable, and timely transportation. The rides are both pre-scheduled and on-demand rides, including rideshare and medical sedans with Uber and Lyft drivers.

The platform is being supported through some financial teamwork between Horizon and AtlantiCare. Horizon provided $50,000 grants in 2019 and 2020 to the AtlantiCare Foundation’s Greatest Community Needs Fund. The Foundation matched the Horizon grant to enable AtlantiCare to purchase the RoundTrip software.

AtlantiCare’s clinical team uses the software to arrange transportation to and from any AtlantiCare facility in Atlantic City, and to and from specialists located within 25 miles of the city. Patients can also use the service to pick up medical supplies and other care items within that radius so they don’t go without the necessities to treat their conditions.

Since AtlantiCare implemented the program two years ago, 862 individuals benefited from it. Of those who used the service that year, 85 percent kept their medical appointments. Not surprisingly, 163 of these rides – nearly 11 percent -- were for AtlantiCare’s Maternal Fetal Medicine patients from Atlantic City, like Sandra.

Among other 2020 results:

• Patients reporting improved quality of life: 87%
• Participants receiving community-based referrals or services for social needs: 100%
• Patients reporting increased ability to self-manage their health & social needs: 100%
• Patients who decreased inappropriate or excess utilization of ER/hospital visits: 71%

Rides have increased from 280 in 2019, to 1,513 in 2020, to 3,112 in 2021.

“We’re thrilled by the results of this program, and they reflect a shared commitment between Horizon and AtlantiCare to overcome underlying factors that create health inequities in the communities we serve,” said Jonathan R. Pearson, Executive Director of The Horizon Foundation for New Jersey. Pearson added that based on the program’s success, The Foundation Board in September approved a third round of funding to support the Roundtrip platform for the next year.

“Having access to transportation for ourselves or loved ones is something so many of us take for granted,” said Kiley. “Getting a ride is critical to the health and wellness journey of at-risk individuals. We look forward to expanding this pilot program that has made such a meaningful difference for our patients and our community.”