Jessica Kim Cohen October
28, 2019
The nation's two ride-sharing
giants are continuing their push into healthcare, announcing major expansions
of their work within days of one another.
Uber on Monday announced its
healthcare arm plans to integrate an app into Cerner Corp.'s electronic health
record system, which would allow caregivers to schedule rides for patients.
Lyft last week said it is now providing covered rides for eligible Medicaid
beneficiaries in Georgia, Michigan, Missouri, Tennessee and Virginia.
Healthcare is a massive opportunity
for on-demand transportation companies like Lyft and Uber, according to
analysts, and the companies—despite two very different announcements this
week—are largely tackling the industry with similar strategies, beginning with
a focus on providing patients with free or affordable rides to non-emergency
medical appointments.
Lyft last year unveiled a
collaboration with EHR vendor Allscripts. Uber is also
offering rides to Medicaid beneficiaries in some states, including Arizona. Lyft
has been working with LogistiCare, and Uber
with American Logistics—two
companies that manage patient transportation to medical appointments for
providers and payers.
"Healthcare consumes almost
20% of our economy—it's a massive area," said Joshua Mark, healthcare
analyst at CB Insights, a firm that analyzes data on venture capital and
startups. He added that home care and transportation from the home will becoming
increasingly important as more seniors opt to age there.
Lyft is seemingly in the lead when
it comes to government and payer space, while Uber has struck significant
partnerships in the provider and employer sides, according to Mark.
Through Uber's new integration,
healthcare organizations that use a Cerner EHR will have the option to add an
app from Uber Health—an initiative Uber launched early last year
to enable providers to schedule rides for patients in need of transportation
help. With the app, caregivers will be able to book rides for those patients
from within the EHR workflow.
Uber Health charges the healthcare
organization, not the patient, for rides booked through the service. It's meant
to help older and low-income patients, who might not have easy access to a car
or public transportation.
"Given the growth of
ride-share, and given the growth of Uber, we really think we can help these
underserved populations," said Dan Trigub, head of Uber Health.
He said he expects Cerner's U.S.
customers will be able to integrate Uber Health's app by year-end.
Lyft in June became the first on-demand
transportation company to be designated as a covered option for eligible
Medicaid beneficiaries, thanks to a policy change Arizona's Medicaid agency finalized
in May to allow ride-sharing companies to provide rides for beneficiaries who
can't secure their own transportation to medical visits.
Lyft is now providing rides for
eligible Medicaid beneficiaries in six states, though the company's work in the states
varies. In Tennessee, the company is still in a pilot stage and is
working to launch services at a handful of managed-care organizations as part
of a yearlong study; Lyft is available as a covered option for the other five
states.
"Really, what we have been
working on is connecting and talking to forward-thinking regulators in various
states to get (transportation network companies) or ride-share formally
included into their Medicaid programs," said Meghan Callahan, who assumed her post as
Lyft's vice president of healthcare last year.
Non-emergency medical
transportation is a "growing commercial opportunity," largely driven
by healthcare's shift toward value-based care and new flexibility in Medicare
Advantage plans, said Michael Abrams, managing partner of Numerof
& Associates. By some estimates, the
healthcare industry loses approximately $150 billion per year due to missed
appointments.
It can be worth the investment for
hospitals and insurers to pay for some patients' rides to appointments, said
Pam Arlotto, president and CEO of healthcare consultancy Maestro Strategies, particularly
when managing patients with chronic conditions.
"Sometimes a missed
appointment can lead to significant increases in cost of care," she said.
But while ride-sharing sounds like
a promising solution to patients' transportation challenges, early research has
been mixed.
A 2018 study found that providing
ride-sharing services did not improve the no-show rate for primary-care
appointments among Medicaid patients in West Philadelphia, with the no-show
rate among patients offered free rides 36.5%, compared with 36.7% for those who
weren't offered free rides, according to results published in JAMA Internal Medicine.
That might be due to the patient
population studied. Ride-sharing services might not be as impactful in areas
close to healthcare facilities or with strong public transportation systems,
like West Philadelphia, said Callahan. The study also didn't screen patients
for transportation insecurity before offering rides.
"I'm never going to suggest
that Uber Health is the solution for every single patient population,"
Trigub said. "Certainly, there are populations where transportation does
make a big impact." He pointed to a recent pilot study at a
pediatric hematology clinic at Boston Medical Center, which found ride-sharing
services reduced the clinic's no-show rate by 8.5 percentage points.
Uber and Lyft, like the healthcare
industry at large, have also been turning their attention to social
determinants of health outside of traditional medical care—such as looking at
ways to connect patients living in food desserts with healthy meals.
Lyft's grocery access program,
available in 12 cities, provides discounted rides for
people in need to travel to grocery stores. Uber, according to Trigub, is
considering ways to deliver healthy meals to people in food desserts through
its food-delivery service Uber Eats.
"There's a big untapped need
to support overall health, which transportation has a big overall role to play
in," Callahan said.
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