Missed appointments are one of the big frustrations of any medical practice. Unlike other industries that can overbook to make sure they don’t miss out on revenue (hello jam-packed airplane), the medical industry just has to suck up the annoyance and loss when patients don’t show up. And these are big losses.
It turns out, that many of these missed appointments are due to a very simple thing: some patients have no reliable way to get to their doctor’s offices.
In fact, some 3.6 million appointments are missed annually due to unreliable transportation. A figure that costs the U.S. healthcare system approximately $150 billion a year.
Now ride-sharing companies such as Lyft and Uber have identified this need in the industry and are working to try and bring that number down by providing non-emergency medical transportation (NEMT) services. The theory goes that if patients no longer have to worry about finding a ride to their appointments, there won’t be so many missed consults and everyone saves (or makes money).
Patients don’t even need to use the Uber or Lyft App
So, how does it work? Unlike using Lyft or Uber as a regular consumer, for patients needing rides to or from their appointment, there’s no need to even use the app. Users don’t need to be tech-savvy, nor do they even need to own a smartphone. In fact, the patient isn’t involved in the process at all.
Nor do they cover the cost of the ride.
Ordering a car and paying for the ride is taken care of either by the insurance company or by the healthcare providers themselves. While this sounds like it could be expensive, paying for a cab ride or two is cheaper than the cost of yet another missed appointment.
How a free ride can lead to big health improvements
Health care is a huge business in the United States. The country spends 16.9% of its GDP on health, compared to 10.4% in Canada and 9.9% in the UK. According to the Transit Cooperative Research Program, an independent research organization in the U.S., $3 billion a year goes toward non-emergency transportation with Medicare and Medicaid covering much of this expense.
There’s a good reason why.
When patients miss appointments, health problems that could have been solved relatively easily and cheaply go undiagnosed, which can lead to longer, more complicated and more expensive medical care in the long run.
Lyft, Uber and other transit companies in the medical transportation space
As the NMET space grows (according to Dan Trigub, head of Uber Health, it’s already worth an estimated $15 billion annually), other disruptors will likely enter the arena. Currently, however, the main companies are Lyft, Uber and even – believe it or not – Ford Motor Co.
Lyft’s NMET subsidiary is called Concierge and it has partnered with medical providers such as Blue Cross Blue Shield. It is a covered transportation option for Medicaid beneficiaries in Arizona and as of January 2019, had partnered with nine health systems and 10 NEMT firms to provide rides.
Uber launched its Uber Health subsidiary in March 2018 and is now working with over 1000 health care organizations.
Each of these companies has had to ensure that its NMET service is HIPAA compliant. This means the only information passed to its drivers is the name of the patient, the pickup and drop off time, and the collection point and drop off location. No protected health information is passed to the drivers.
And they are already having a positive effect. Even before Uber Health officially launched in 2018, the company was having an impact on resources. According to a study released in 2017, Uber was already shifting low-risk patients from using ambulances.
Lyft looking to expand their offering
The whole space is so lucrative that Lyft is also looking to move into other areas in the healthcare system (and no doubt others will follow). According to CNBC, the company is already working with pharmaceutical companies to get people to clinical trial sites and arranging rides for physical therapists to treat patients in their homes.
And that’s not all. “There’s home care, there’s delivery of goods and supplies — it becomes a market in the tens of billions of dollars if you’re looking at logistics opportunities in health care,” said John Brownstein, co-founder of a company in the space called Circulation Health that partners with Lyft.
Of course, there’s also transportation for patients post-surgery. While there are guidelines in place regarding hospitals or surgical facilities releasing patients who intend to use an Uber, Lyft or even a cab on their own, there’s no reason these programs can’t be more widely used if the patient is accompanied by a responsible adult.
Does ride-sharing actually improve missed appointment rates?
Will this new service be the solution to patients missing appointments? While on the surface it seems ideal, others are less convinced. According to a study quoted in the Wall Street Journal, Lyft offered free rides to patients at two primary-care practices, and only 20% of patients took advantage of the offer. What’s more, missed appointment rates for those who were offered free rides and those who weren’t, were the same.
One of the stumbling blocks is that people who are most in need of the service (low-income families and older people) are also among the least tech-savvy, which could lead to a high rate of skepticism or simply misunderstanding about the service.
According to a Pew Research Center study, quoted by PMC, only 15% of U.S. adults have used ride-sharing services and 33% have never even heard of them. No wonder then that the idea of a free ride has some patients feeling like they’re, literally, being taken for a ride.
Riding into the future
But it’s a long road, and we’re just at the beginning of the journey. So while the number of missed appointments may not have dropped – yet – patients who choose to take up this service now have a more comfortable, convenient and reliable way of getting to and from their appointments. And, another added bonus – they don’t have to worry about parking!
As people grow more comfortable with the idea of free rides, there should be a bigger uptake on the service with the money the medical industry is currently hemorrhaging on missed appointments being put to better use – for the good of patients everywhere.