By Ben Keeton
Just because somebody has health insurance and a relationship with a physician doesn’t mean they have easy access to care. Transportation barriers are often cited as barriers to healthcare treatment options and healthier lifestyles. The cost and time required for daily travel between home, work, school, daycare and groceries greatly impacts the quality of life for us all. Those who can afford it live where getting around is easier. Those who cannot afford it face long commutes, crowded buses and often miss out on life-improving opportunities that they simply can’t get to on a reliable basis.
A robust, affordable and reliable transit system means better access to education and jobs, recreational and after-school activities, healthier food options, healthcare facilities, as well as friends and family. It also means fewer skipped appointments and more opportunities to identify medical concerns, help manage chronic diseases and create new opportunities to address unmet healthcare needs.
Transportation solutions can come in many forms, from established public transportation systems in an urban setting to a loose affiliation of volunteer drivers in a rural community. Either way, the goal of transportation is to remove a barrier to care for a patient who needs to see a physician, run a test or have a procedure done.
In Kentucky, transportation is a significant need of the Medicaid population. According to Kentuckians for Better Transportation (KBT), many disabled Kentuckians rely on public transportation as a lifeline to freedom and independent living. KBT advocates for a variety of agencies to work together to develop a network of public transit to ensure that patients across the Commonwealth can actively participate in their healthcare.
According to the Kentucky Transportation Cabinet, Kentucky’s transit bus systems provide approximately 31 million passenger rips per year. Nearly three million transit trips per year are taken by Kentucky’s elderly and disabled populations, providing access to healthcare and social services.
Collaboration between health policy makers, urban planners, and transportation experts could lead to creative solutions that address transportation barriers to healthcare access while considering patient health, cost, and efficiency.
We talked with Barry Barker, president and CEO of TARC, to hear how TARC works to address transportation barriers. Excerpts from that talk are below.
What is the role of public transportation in ensuring people, especially those with low incomes, have access to quality healthcare?
Transit Authority of River City (TARC) has a significant role in connecting people, including low-income people, to quality healthcare. Based on a 2013 ridership survey, 12 percent of trips on TARC (we provide about 15 million trips a year) were for medical appointments.
TARC3, our door-to-door paratransit service for people whose disabilities prevent them from riding TARC fixed (local) route buses, is heavily used for medical purposes. More than half of about 5,500 active TARC3 passengers use the service for medical purposes, based on the survey. The majority of passengers who ride local routes and who use TARC3 are low income. All local route buses are accessible for individuals with disabilities and include space for two wheelchairs.
What services are offered to help people improve access to healthcare?
TARC has 41 local routes that provide service to major hospital facilities in Louisville including Veterans Hospital and to hospitals in Clark and Floyd counties in Indiana. TARC3, the service for people whose disabilities prevent them from being able to ride TARC fixed (local) route buses, provides trips wherever the customer wants to go within the service area, including to medial facilities, many dialysis centers and doctor offices.
How do you measure your success in improving access to healthcare? How does it impact the city?
Without TARC, people taking thousands of trips for medical purposes each year would have to find another way to access healthcare that they may not be able to afford. TARC places a priority on providing access to life necessities including healthcare. We analyze routes and make adjustments as needed to ensure that priority is addressed, within resources available to provide services.
What additional steps would TARC like to take to help improve access to different health treatment options/facilities?
TARC willingly works with healthcare providers and others and will take steps to address community and healthcare needs within resources available to provide the service. We would like more communications with medical providers with a goal of better coordination of our services to meet medical needs for patients.
TARC also works with partners to make infrastructure improvements that improve access to public transit and improves access to physical activity (which leads to improved health). Infrastructure improvements include new and repaired sidewalks, accessible curb cuts and bus stop improvements.