The US has one of the most wasteful healthcare systems in the world—we spend around 17 percent of our GDP on health, but experience poorer health outcomes than most other high-income countries. Part of that excess spending is lost to no-shows: patients who don’t come to their appointments cost the health system an estimated $150 billion per year, partly because 3.6 million people can’t access adequate transport on time.
Rideshare companies have been positioning themselves to help close that gap, while angling to get government funding to take patients to health appointments. Uber and Lyft have built partnerships with insurance companies, hospital systems, and clinics in hopes they can provide more efficient, non-emergency transport for patients trying to get to their appointments. And they say they can save our healthcare system plenty of money doing it.
“For the past three years, we’ve been focused on non-emergency transport,” Megan Callahan, Lyft’s Vice President of health, told me through email. “In that time, we’ve seen endless examples of the positive impact transportation can have...not just on improving overall health, but also by saving costs and increasing operational efficiencies for our healthcare partners.”
Earlier this month Lyft announced an expanded partnership with Medicare Advantage plans from health insurance companies BlueCross BlueShield and Humana. Medicare Advantage is a government program for people over 65. Essentially, patients enrolled in these insurance plans, which are funded with government dollars, can access rides to their appointments through Lyft. The rides are billed to their health insurance plan.
The timing is strategic: the Centers for Medicare and Medicaid Services (CMS) announced last April that it would cover non-emergency transport, freeing up hundreds of thousands of dollars for the rideshare companies to absorb. “We think every rideshare company should provide a way for the healthcare industry to utilize their product,” said Dan Trigub, head of business development for Uber Health. “It’s good for Uber, it’s good for the industry.”
UberHealth, launched in February 2018, has 1,000 customers thus far. Like Lyft, it’s a private product that can be adjusted to each health system, and incorporated in a hospital’s electronic medical record system. Trigub told me that Uber designed its platform so that patients don’t need to have a smartphone to use it—providers can call cars directly.
The fact that Uber and Lyft both have dedicated teams working on their health initiatives is significant. What’s unclear is what kind of impact the companies are having on the overall healthcare system. In some studies, like this Health Affairs report on two CareMore facilities in southern California, Lyft rides proved more punctual than non-Lyft counterparts and there was a 39 percent reduction in transportation costs in first year and a half. Similarly, the Uber Health model saved Boston Medical Center $500,000 by replacing shuttle buses between campuses and clinics, and patients said they were more satisfied with the services.
But another study by University of Pennsylvania researchers demonstrated that patients did not actually go to more appointments because of rideshare services, which could suggest that a more targeted approach is needed than simply offering them cars.
Shauna Brail, an urban studies professor who researches ridehailing services at the University of Toronto, told me that new technology can help communities that public transport doesn’t reach. But she also said that cities and towns need to be involved with those partnerships, not only private health systems. “To make any lasting impact, there needs to be public investment or partnership,” she said.
Brail pointed out a partnership between Lyft and the city of Columbus, Ohio, where a pilot program was launched to connect pregnant mothers on Medicaid, a government health program for low-income families, with rides to prenatal appointments to bring down infant mortality rates.
These kind of public-private collaborations could be the next frontier, but they also can’t replace the widespread impact of good public transport. While ridesharing could be a boon for sprawling health systems looking to serve their patients and staff, improving public infrastructure still goes a long way in protecting people from injuries and death, reducing stress, boosting physical fitness, and leaving people with more money to spend on healthy food and activities.
Without a strong public component and a health system overhaul, these rideshare companies could go the way of private ambulances. Patients bear the huge burden of cost in this unregulated industry, while workers remain overworked and underpaid.
But with the tumult of our national health policies, it remains to be seen if the Trump administration will continue to slash health budgets, including funding for Medicare and Medicaid. And we don’t yet know if the privacy concerns that have plagued rideshare companies will seep into their work in the healthcare industry.
Regardless, It’s clear that companies like Uber and Lyft will be making more inroads into the health system as time goes on. “I think we are just seeing the beginning of the possibilities here,” Callahan told me. She said the company plans to expand beyond healthcare and into wellness, providing rides to grocery stores and gyms, for example.
And for those who have no access to public or private transport. That could prove as vital as the health care itself. “When you look at our aging population, the social isolation, the lack of independence that seniors have,” Trigub said. “We feel Uber gives them that independence.”