With the push toward population health, health systems and on-demand transit companies like Uber and Lyft see a real opportunity to improve overall care via partnerships to proactively get patients to and from their appointments.
More often than not the reason patients cancel or reschedule appointments is because of transportation issues. “If the patients can’t get to us or we can’t get to the patients, it makes it difficult to impact their health and address their health needs,” Dennis Pullin, president of MedStar Harbor Hospital in Baltimore, MD, and a senior vice president of MedStar Health, told Healthcare Dive.
MedStar, a nonprofit, community-based health system that operates 10 hospitals in Maryland and Washington, DC, announced earlier this month nonemergency patients needing transportation to or from one of its hospitals can now schedule a ride with Uber when they make their doctor appointment by simply pressing the “Ride with Uber” button on the MedStar website. In addition to arranging a ride, Uber provides the wait time, the approximate cost of the ride, and a reminder that prompts them to call for the ride on the day of the appointment.
Over time, MedStar hopes to team the Uber option with other patient platforms to better address the needs of specific patient populations. For instance, the service could be used to get low-income patients to a hospital or another venue for recurring chemotherapy treatments at no cost to the patient since the ride would be covered under their Medicaid benefits. That not only benefits patients by getting them to appointments, it also helps to hold down the healthcare costs by not having patients delay care until they are much sicker.
“We want to give the patient the best opportunity possible to be compliant with their care, whatever that might be, and if it means we have to support it in that way with our Medicaid patients, we’re willing to do that,” said Pullin.
“There are other ways that patients can get to the hospital—taxis and ride shares, things of that sort. We just feel that Uber is a much more reliable and easy way for our patients to get transportation,” he added.
Driving the move to on-demand rides are a couple of things, said Billy McKee, president of National MedTrans Network (NMN), which recently partnered with Lyft to provide rides for its ambulatory New York City customers using Concierge, Lyft’s new web-based dashboard. Transportation benefits are growing with Medicaid expansion and the move to managed care in most markets. That’s forcing health plans to compete for customers and one of the ways they’re doing that is by sweetening their transit benefits. “It used to be you had a benefit to go from here to there. There are plans now that are saying …we need to get more members to their appointments, so we’re going to proactively schedule it and send them transportation,” McKee said.
The entire healthcare system needs to think more efficiently, and patient transport is one area where there are mass inefficiencies, said Steve Welch, founding partner in DreamIt, a venture capital firm that focuses on seed-stage startups. In 2013, the firm invested $50,000 in Stat, a mobile app that hooks ambulance drivers up with nonemergency clients to cut down on ambulance idle time and patient wait time.
When a patient is going to be discharged from the hospital, it’s often hard to know exactly when that will occur, explains Stat’s founder and CEO Jason Ervin. Rather than call the ambulance first thing in the morning and have it sit around while the doctor is signing the discharge papers, someone can push the Stat button as the patient’s going down in the elevator and the request goes out to all the ambulance companies and the closest idle truck gets the call.
Stat partners with ambulance companies and gets a percentage of the standard transportation fee without having to deal with the payer side of the equation. The company currently operates in Philadelphia and Austin, TX. Ervin is also working to bridge over to the emergency transport side, but that involves getting 911 involved, as most emergency requests must go through that service.
But it’s the nonemergency medical transport industry that is seeing most of the activity from on-demand ride services. Collaborating with services like Uber and Lyft should cut down on cancellations, late or missed appointments, and fraud, experts say. According to The Washington Post, Medicare paid more than $50 million in potentially fraudulent claims from ambulance companies for rides to seniors in 2015.
For NMN, which contracts with managed care plans to provide transportation for Medicare and Medicaid enrollees, the opportunity to partner with Lyft was a no-brainer. The firm had already been internally developing some technology to improve patient transport “and we literally sat there and [asked] why reinvent the wheel,” said McKee. For Lyft’s part, they were more than ready to assume the added responsibilities and compliance requirements that go with working in the healthcare industry, he said.
The result has been not only the on-demand transit component but heightened transparency, such as real-time confirmation people actually made it to their appointment, went to their doctor’s office, and the time that they went. “The amount of data is just incredible,” McKee said.
Historically, the firm has booked rides for customers in New York, California, and Florida using 600 to 700 different transport companies. But that’s set to change. The company is currently booking 2,500 of its 25,000 weekly NYC rides through Lyft and, by the end of March, plans to provide all rides in the three-state network via Lyft.
Uber has also partnered with Sarasota Memorial Health Care System in Florida and Asia-based Practo to provide quick, convenient rides to nonacute care patients. For the past two years, the firm has offered for one day only on-demand flu shots at the customer’s home or workplace for a flat $10 fee. Uber is working with an advisor at Boston Children’s Hospital to determine other opportunities in the healthcare space, said spokeswoman Sarah Maxwell.
There’s pressure on the medical system to operate as close to 100% efficiency as possible, and not sit at 10%, as the medical transport segment has, explains DreamIt’s Welch. “Uber and Lyft make sense … and I’ve no doubt that their same model will work for medical transport. It will have some specialty to it. You’ll need to add infrastructure associated with both payments and medical need, but I’ve no doubt that the market’s going that way.”