A patient should not need a car, a day off work, and a nearby doctor’s office to receive basic healthcare. Yet for millions of Americans, access to healthcare depends less on medical need than on logistics. Mobile clinics offer a practical answer by bringing routine care to patients in rural towns, low-income neighborhoods, nursing homes, shelters, schools, and other places traditional healthcare often fails to reach. But in too many states, this simple solution is slowed by regulations written for buildings, not patients’ needs.
Mobile care is a low-capital, flexible delivery model that can address some of healthcare’s biggest access problems without requiring new hospitals, large facilities, or major public spending. It expands access and can reduce costs by physically moving healthcare to patients. That matters most for people least able to reach traditional care: rural residents who live far from providers, low-income urban patients who lack reliable transportation, nursing-home residents, people with disabilities or limited mobility, homeless populations, and communities facing provider shortages.
Many healthcare barriers are not clinical. They are logistical. A patient may skip care because the clinic is too far away, the trip requires missing work, transportation is unreliable, travel costs are too high, or the patient cannot physically make the trip. Mobile clinics reduce these frictions by delivering primary care, screenings, vaccinations, dental care, behavioral healthcare, chronic-disease management, and basic preventive services where patients already are.
Better access can lower long-term costs by catching problems earlier and making routine care less dependent on expensive institutional settings. A blood-pressure check, diabetes screening, vaccine, wound-care visit, dental exam, or behavioral-health intervention delivered at a school, senior center, rural town, shelter, or nursing facility can prevent more expensive health problems later.
Providers are recognizing the benefits. More than 3,600 mobile clinics now perform millions of visits annually, an 80 percent increase since 2013. Almost 700 community health centers operate at least one mobile unit. In 2021, the Drug Enforcement Administration authorized mobile methadone clinics to help expand addiction-treatment services in rural and underserved communities. California later used that flexibility to expand its mobile narcotic treatment programs.
More providers and regulators are beginning to see the value of bringing healthcare to patients instead of forcing patients to go to fixed sites. But not all lawmakers have gotten the memo. In many states, mobile clinics are not being held back by a lack of wheels. They are being held back by rules written for brick-and-mortar healthcare facilities. New York, for example, requires Certificate of Need approval to certify ambulatory services provided in a mobile facility, requiring providers to get permission before expanding or replacing a mobile health fleet.
In many places, healthcare regulations still assume care is delivered from fixed locations. A study by Virginia’s Joint Commission on Health Care found that most states don’t have regulations specifically governing mobile clinics. When states do regulate them, they often require a mobile healthcare service to affiliate with a brick-and-mortar location. Some also limit mobile care to a narrow radius around that site through millage caps. Maryland, for example, limits mobile dental units to 10 miles from the primary dental office in urban areas and 30 miles in rural areas.
Milage caps are arbitrarily. They provide no demonstrated safety benefits, protect incumbents that already own fixed-site facilities, and defeat the purpose of mobile care by limiting access in rural areas where patients are often spread out. A mobile clinic 35 miles from a dental office isn’t inherently less safe than one 25 miles away. But not getting dental care at all is less safe.
Regulations should focus on the risk of the services offered, not on whether care is delivered from a van or truck. Primary care, screenings, vaccinations, and vision care, are routine, low-risk services. They don’t require the same level of oversight as dentistry involving sedation, imaging involving radiological materials, or addiction treatment involving controlled substances.
Nor should a fixed-site affiliation be required as a condition of mobile care. Brick-and-mortar providers should not need special permission to expand into mobile services. Independent mobile providers shouldn’t be blocked because they don’t operate a traditional office. And access should not depend on where a provider parks the van at night.
Heavier regulations should be reserved for genuinely higher-risk services, not routine care. Providers should face only the barriers needed to protect patients. Mobile clinics are among the few delivery models that can reach underserved patients without building new facilities, hiring large administrative staffs, or waiting years for capital projects. Regulations should make it easier to deploy them safely, not force them through rules designed for brick-and-mortar providers. Too many states still regulate mobile healthcare as if it were a threat. They should treat it as part of the solution.
Justin Leventhal is a senior policy analyst for the American Consumer Institute, a nonprofit education and research organization that advocates for consumers through evidence-based analysis and data. Visit www.TheAmericanConsumer.Org or follow us on X @ConsumerPal.
