Residents in rural western Massachusetts are struggling to access healthcare, and one of the biggest roadblocks is their ability to physically travel to see a doctor, according to new data from The MassINC Polling Group.
There were 600 rural Massachusetts residents surveyed as part of the poll, largely from the western part of the state. Most respondents reported experiencing transportation challenges when seeking medical care: around 55% said they had to reschedule an appointment in the past year because they couldn't secure a ride. More than 30% had to skip an appointment altogether.
That's in part due to the larger distance residents in rural communities need to travel to receive care, either from a primary care provider or a medical specialist. Nearly half of western Mass. residents polled said they've traveled more than 25 miles to see a doctor.
Issues surrounding transportation compound with other healthcare hurdles unique to rural areas, like extended wait times to schedule appointments, and an overall lack of health care providers. Less than 10% of local residents said they were able to see a medical specialist within a week of trying to schedule an appointment. A third said the process takes upward of two months.
"If you're having trouble getting an appointment in the first place, and then you need to cancel that appointment or you miss that appointment because you can't get there, then you're looking at another 'X' number of months out in order to get that rescheduled," said Rich Parr, vice president of The MassINC Polling Group. "That is going to have an impact on people's lives, on their schedules, on their levels of stress and even on their health."
Those navigating these healthcare challenges do consider it taxing on their health, with more than 30% saying transportation issues have had a "negative impact" on either themselves or people they are caring for.
The poll was commissioned by Transportation for Massachusetts, a transit-focused nonprofit. The group has been studying the impact of transit services in sectors like healthcare through a partnership with the UMass Donahue Institute.
They found when prospective patients miss or skip medical appointments due to a lack of transportation, it has a knock-on effect: they may end up delaying critical care and wind up in an emergency department, which is more costly. That missed appointment also represents a loss for a rural healthcare provider often already operating on slim margins, said Michael McNally, senior research analyst at the Donahue Institute.
"If a rider can't make it to their appointment because their own car doesn't work and they don't have access to transit, that can cost a physician $200 per hour, which can really add up," McNally said.
Rural residents polled expressed support for a number of different solutions, like expanded telehealth services from healthcare providers, or even vouchers for rideshare programs like Uber or Lyft to alleviate transit problems.
They were also in favor of expanding funding for micro-transit services: small organizations dedicated to providing transport, ferrying people to medical appointments, shopping centers and more.
"The flexibility of micro-transit allows it to fill transportation gaps in rural communities, making sure people get to important appointments and stay connected to their community," McNally said. "It makes rural regions more livable."
Expanding access to healthcare in the rural regions of Massachusetts is a major goal laid out in the state's most recent Rural Policy Plan, released by the Rural Policy Advisory Commission last month. That report echoes concerns about physically disparate health care providers and long wait times to schedule appointments. It recommends bolstering telehealth services and regional transit authorities with state funding to close those gaps in care.