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Getting to treatment should be the least of a patient's worries

Getting to treatment should be the least of a patient's worries

Medicare’s annual open enrollment period has begun. Still, as seniors consider their options for the coming year, one need that likely won’t be met by their chosen plan is transportation for routine care. 

In 2017, 5.8 million Americans delayed medical care because they did not have transportation, according to social scientist and researcher Mary Katherine Wolfe of the University of North Carolina at Chapel Hill. That’s equivalent to the entire population of Colorado having to go without medical care. If transportation to and from appointments and pharmacy pick-ups isn’t available, seniors won’t start and stay on treatment and many will face greater health challenges. Amid a global pandemic, the need for safe and reliable transport is even more urgent.  This is making charitable patient assistance programs even more essential, but more help is needed.  

As is so often the case, this barrier disproportionately impacts people living with chronic health conditions and lower incomes, particularly seniors on Medicare. 

For instance, Mimi Gordon is no longer able to drive because of multiple chronic conditions, which require ongoing treatment. But the North Carolina resident often can’t find anyone to give her a ride to the doctor’s office. She already struggles with the high co-pays for her medications, and her reliance on others for transportation means she frequently cancels her medical appointments. 

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Multiple types of transportation barriers

Our research shows that transportation challenges are significant factors in a person’s health journey and differ depending on their mobility, health conditions, geographic location, and family members’ support. 

In our 2019 survey of 4,000 older adults with serious conditions, 61 percent reported at least one transportation barrier in getting to their medical appointments. More than 20 percent of respondents said they faced accessibility issues, including vision or mobility limitations that prevented them from driving or taking public transportation. Another group couldn’t afford the costs of transportation. 

From scheduling appointments based on family members' availability to missing appointments altogether, these patients reported that it was often tough to see their doctors.

Cost barriers exist for rural, suburban, and urban residents

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Most of our patients report traveling more than 10 miles to get treatment. For some, like Gail Munk in Nevada, it’s much farther. Gail must make a 220-mile round trip each time he visits the oncologist. His story isn’t unique for many in rural America.

Even in more urban locations, the cost of a taxi or non-emergency medical transport can be prohibitive for people who need ongoing treatment. Maria Cabrera, who receives treatment for colorectal cancer in New York City, shared her experience getting to medical appointments: 

"The challenges I face traveling to and from chemo financially affect me,” she said. “My immune system is compromised, so it is not safe for me to take public transportation. Because of this, I have to take a cab or a car delivery service. [It] can be a big burden.”

The costs of traveling to and from regular medical treatment are higher than one might think. Taking a taxi or rideshare service to treatment twice a month for one year could add up to $2,000 or more. For people who need to travel farther to see a specialist, the average round-trip airfare can be as high as $1,000. And that doesn't include lodging or other travel expenses needed during treatment.

Safety net services should include transportation

Currently, support for transportation is limited to some eligible Medicaid recipients and specific health institutions. Some Medicare Advantage plans may cover some transportation. Ultimately, there are few programs available for the millions of people struggling with transportation access. 

The PAN Foundation recently started offering transportation assistance to give our patients who are already struggling with out-of-pocket prescription medication costs autonomy, flexibility, and support in getting to their appointments. As the COVID-19 pandemic continues, patient assistance charities start, but more help for seniors is needed.

Dan Klein has served as the president and CEO of the PAN Foundation since 2014, and previously, he served as senior vice president for the Cystic Fibrosis Services specialty pharmacy at the Cystic Fibrosis Foundation.