By Rebecca Vesely
Ridesharing companies Lyft and Uber are making inroads – so to speak – in the health transportation space with new partnerships and platforms this year that aim to help patients get to their medical appointments.
These partnerships seem like a win-win-win for providers, patients and the ride sharing companies. Missed medical appointments are costly for hospitals and can lead to unnecessary ER visits and readmissions. Lack of reliable transportation has been cited as a cause of missed medical appointments. And as patient experience scores become more important for hospital reimbursement, ridesharing could be a relatively cheap way to improve patients’ perception of their care quality. For ridesharing companies, patients are another revenue source and a way to introduce themselves to new customers.
But there are many ways that ridesharing for medical appointments could fall short of its potential.
What services are offered
In March 2018, Uber launched Uber Health, an online dashboard that allows health care providers to book rides for patients. Patients don’t need to have a smartphone or the Uber app to coordinate their ride. Passengers receive a call or text to tell them about their scheduled ride and again when the car is on the way. The medical provider pays for the ride, and rides can be scheduled up to 30 days in advance.
Similarly, Lyft Concierge is a platform that allows providers to request rides for patients. In March 2018, Lyft announced a partnership with AllScripts, a healthcare IT company, to enable functionality of the Lyft application in AllScripts’ Sunrise electronic health record and open API (Uber also launched an open API for providers). Integration into the EHR allows providers to track patient rides, according to both companies.
Who pays
Today, it’s mostly hospitals that pay for patient rides. Reimbursement from insurance companies is atypical. One exception is the Blue Cross and Blue Shield Association, which has a partnership with Lyft, announced in May 2017, to provide rides to members who live in “transportation deserts.”
Can ridesharing reduce missed appointments, or so-called ‘no shows’
Maybe not. Offering rideshares did not reduce missed primary care appointments, according to a study published in JAMA Internal Medicine in February 2018. Out of 786 Medicaid patients in Philadelphia included in the study, there was no significant difference in no shows between patients offered a free Lyft rideshare compared to those who were not offered the service.
The study authors told Lisa Rapaport of Reuters Health that a high percentage of patients did not agree to use the service, and it’s possible that the way it was presented or a “lack of familiarity“ depressed interest and acceptance by patients. Only 85 people, or 29% of those offered a Lyft, used the service.
Other experts interviewed for the Reuters Health story said that ridesharing might work better in suburban or rural areas, and with more patient education on how the service works.
What about patients with disabilities
Uber and Lyft have received criticism from disability rights groups, who say ridesharing services are not accommodating enough to people with disabilities. Disability Rights Advocates sued Uber in 2017, claiming the company violates New York City’s human rights law by providing too few vehicles that can accommodate wheelchairs. Other lawsuits with similar claims are pending. Uber does have a service with wheelchair accessible vehicles called UberWAV, but the lawsuits claim that this service is limited.
Should patients trust ridesharing companies
Both Uber and Lyft say their medical appointment ridesharing services are compliant with HIPAA. However, Uber especially has not such a great reputation for respecting user privacy. A Center for Investigative Reporting investigation in 2016 found that the company wasn’t doing enough to safeguard user accounts, even after multiple privacy scandals including tracking a Buzzfeed reporter’s movements without her permission.
A CNN investigation in April 2018 found that 103 Uber and 18 Lyft drivers have been accused of sexual assault or abuse. In response, nine members of Congress sent a letter to ridesharing companies asking them to detail their practices to ensure rider safety. Also in April, Uber added a feature in its app that allows a rider to dial 911 directly during a ride. However, it’s notable that patients using ridesharing services wouldn’t be using an app because their provider arranges the ride.
Who’s on board
More than 100 health care organizations have signed onto Uber Health, and Lyft’s deal with AllScripts reaches 2,500 hospitals and 180,000 physicians and an estimated 7 million patients.
Tips for journalists
- What populations of patients are being served by ridesharing programs? Are they rides for specialty care or primary care visits?
- Learn the cost and potential return on investment for the health facility.
- Will rides be offered to patients with disabilities?
- How is the hospital ensuring patient safety and privacy with these rides?
- Is the facility tracking usage and patient satisfaction/experience?
- When can the hospital share these data with reporters?
