Mountainous areas facing such demographic problems as depopulation and aging, have yet to get over difficulties in securing a means of transportation for people to visit medical facilities. Asuke Hospital, located in a mountainous district of Mikawa, Aichi Prefecture, has worked on the project to improve living conditions for years with a view to laying the foundations for the inhabitants to continue to lead a healthy life. As part of the project, we started shuttle services on a trial basis in 2010 and 2011. As a result, we reaffirmed that there was a pressing need of door-to-door services on the part of patients and members of their families. It was also made clear that, if transportation services are to be an economically feasible project, there must be more users and that users would have to pay a certain amount of money as a fare on the user-pays principle.