Transportation Assistance is Needed More Than Ever
By Ayesha Azam, Vice President of Medical Affairs
Here at PAN, we recognize that financial obstacles to accessing treatment often go beyond the inability to afford medication co-pays. This year, PAN is preparing to expand our transportation assistance to adequately support people on Medicare living with a broad range of illnesses.
Understanding the need
According to the Community Transportation Association of America, 3.6 million Americans missed medical appointments last year because they lacked reliable transportation.
In 2019, we operated a transportation program that provided 249 patients with rideshare grants to book up to 10 Lyft rides with a $14 subsidy per ride.
To better understand the challenges that patients experience when it comes to transportation, we surveyed 4,460 patients seeking to learn more about transportation barriers to physician care and the ability to pick up prescriptions from pharmacies.
A vast majority of survey participants said they have been diagnosed with cancer or another chronic disease, with conditions including multiple sclerosis, Parkinson’s disease, heart disease, asthma and more. Three major findings surfaced from the survey data gathered.
1. Providing transportation assistance helps seniors resolve several barriers to receiving care.
While some national organizations and hospitals provide transportation assistance, the programs often have nuanced, restrictive eligibility criteria, and few patients qualify. This excludes the majority of people suffering from serious illnesses from finding resources and forces them to depend on others for rides to see their doctor or pick up their prescriptions.
Several transportation-related barriers prevent seniors from seeing their physicians, including:
- »Relying on others for transport
- »Tardiness to appointments due to unreliable transportation
- »Missing appointments due to transportation problems
- »Costs of transportation are too high
- »Accessibility issues
Of all survey respondents, 61 percent reported having trouble getting to doctor's offices. More than a quarter of respondents delayed scheduling doctor appointments in the past year because transportation is "too much trouble." An additional 14 percent said that transportation-related costs prevented them from seeing their doctors.
These results tell us that there's a need to provide patients with greater independence and support to get to and from their medical appointments.
2. Accessibility issues limit types of transportation available to access care, such as:
- »Limited mobility, such as ambulatory vs. wheelchair use.
- »Geographical challenges, such as coming from rural areas with limited transportation resources.
- »Lack of familiarity with rideshare services.
- »Inability to pay out-of-pocket costs remaining after subsidy.
- »Use of canes, crutches, walkers and wheelchairs limit transportation options.
Most survey respondents (86 percent) are ambulatory or use a cane, crutches or a walker. Among those respondents, 21 percent said physical disabilities, vision problems or mobility limitations prevented them from seeing their doctors.
Almost two-thirds relied on family members, friends or caregivers for assistance in the past year.
3. Travel assistance is needed more for doctor’s office visits than for pharmacy visits:
- »Rides from family member and friends are often used for picking up medications.
- »Pharmacies are often closer to home, and transport is not dictated by the pharmacist’s schedule and do not require the patient to be present.
- »Physician visits required a greater distance to travel and are scheduled in advance.
Another goal of the survey was to ascertain the types of travel assistance needed. As the survey showed, arranging transportation to doctor’s visits is a greater need than getting to the pharmacy. Almost all respondents (98.9 percent) visit a doctor at least once every six months. Over half also said their doctor was more than 10 miles away.
Contrast this with a local pharmacy: More than two-thirds of respondents said their local pharmacy was less than one to five miles away from their homes.
What's next for this initiative
We believe we can improve patient access and adherence to treatment by supporting travel to and from medical appointments. Our research found that existing transportation assistance programs have narrow eligibility requirements and are typically limited to patients with rare diseases. Additionally, most programs are restricted in the design of their benefits (e.g. they might only provide flights, or ride-sharing services), this further impedes a patient’s ability to access appropriate resources.
In structuring a more flexible program which allows for a wider scope of covered transportation services, PAN can bridge the gap for patients who need transportation assistance, but currently struggle to find sufficient support. We’re committed to developing a travel program that will truly provide patients with a broad range of illnesses access to the assistance they need to receive treatment.
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