Transportation has always been a health care issue. In 2013, Medicare spent $1.2 billion for non-emergency health care transportation (NEMT), and Medicaid spent $1.5 billion. Most states report that utilization and cost of NEMT services are increasing (see the 2016 Government Accountability Office report, Nonemergency Medical Transportation: Updated Medicaid Guidance Could Help States). In addition to increasing costs, lack of transportation is a documented access barrier to health care services, particularly in rural areas (see Nonemergency Medical Transportation And Health Care Visits Among Chronically Ill Urban And Rural Medicaid Beneficiaries).
But the ride hailing services that have become an integral part of many American’s lives—Uber and Lyft—are now forging business relationships with health and human service entities, providing convenience for consumers, while cutting costs and improving quality ratings for provider organizations and health plans.
Last summer we took a look at the birth of this trend (see Uberizing Health Care Transportation), and over the past year, ridesharing services have continued to infiltrate health care market. In recent news, Lyft announced it is partnering with Allscripts to allow clinical professionals to request non-emergency rides for consumers. The Lyft app will integrate with Allscripts’ Sunrise electronic health record (EHR) system, with about 2,500 hospitals involved in the collaboration (see Lyft Announces Integration With Allscripts EHR, Allowing 180,000 Clinical Professionals To Hail Rides For Consumers). Earlier this month, Uber announced that it is launching a new business line call Uber Health to provide a ride-hailing platform specifically for health care providers that need to provide rides for consumers (see Introducing Uber Health, Removing Transportation As A Barrier To Care).
More provider organizations are getting on board with this trend. Franciscan Alliance, a 14-hospital system in Indiana, announced it had partnered with Circulation to use a digital platform to coordinate non-emergency medical transportation; Circulation is an on-demand, NEMT provider that coordinates rides with Uber and Lyft (see Franciscan Alliance Partners With Circulation For Non-Emergency Transportation). Other newly-announced ridesharing transportation collaborations include:
- Saint Francis expanding use of Uber Health to get patients to, from hospital
- UCHealth partners with Uber Health to offer patients, visitors discount on Uber rides
- Henry Ford Health partners with SPLT, Lyft to get patients to their appointments
- Pro Staff Institute announces partnership with Uber Health
- CVS And Walgreens Partner With Lyft To Get Blue Cross Patients To Pharmacies
- Hitch Health Launching Nationwide Service with Lyft Partnership
There are many reasons for these collaborations: improved consumer convenience, reduced no-show rates, and reduced emergency room utilization, all come to mind. What is the clinical perspective on the transportation issue? For more on that, I reached out to OPEN MINDS Senior Associate Annie Medina, who notes the importance of not just getting consumers to health care facilities, but home again.
Currently, Medicaid cabs have up to four hours, once they’re called, to come and pick up the consumer. A well-connected and dedicated staff (nurses, case managers) can sometimes get this service in 60 to 90 minutes. Given the overcrowding of emergency departments and inpatient units, getting discharged consumers out is critical to flow.
What introducing Uber and Lyft to the mix does, is allow for a faster discharge and turnover of bed, ideally allowing to serve more consumers, and improve flow (ED and inpatient flow is a huge deal). Many places have a waiting area for discharged consumers, but if multiple people are waiting, these also become overcrowded (also, especially in the case of behavioral health, just because a consumer is ready to go home doesn’t mean they’re ready to be in a small, crowded area in what is often a hyper-stimulating environment). Add to this scenario that most people, when being discharged, just want out of the hospital.
A ride hailing platform, if reimbursable, offers a couple of benefits. For hospitals, it increases the resources available in order to facilitate flow, and decreases congestion due to discharged consumers waiting on a ride. For consumers, who are often ready to leave once they know their discharge is complete, it allows them to more quickly return to their home and daily life.
Will this become the “go-to” method for transporting non-emergent consumers? That remained to be seen—but we do know that the ridesharing business model has grown quickly and immensely in recent years. Ride request for Uber increased 150% last year, and revenue increase from $800 million in 2016 to $1.75 billion in 2017 (see Despite Ongoing Turmoil, Uber’s Growth Remains Strong). Health plans are searching for, and demanding, innovative approaches to bring down costs and augment the effectiveness of services—ridesharing looks to be a business model that consumers can be happy with.
To learn more about innovation in health care, join us for “Designing & Implementing Innovative Treatment Programs: An OPEN MINDS Executive Summit & Showcase,” at The 2018 OPEN MINDS Management Best Practices Institute on August 14 in Long Beach, California.