Transportation, Access, and Healthcare

The recently publicly traded companies of Lyft and Uber have been in the news almost every day, but we picked up on a part of their business plan that may have flown under the radar for most:  Both companies are teaming up with Medicare Advantage plans to provide Medicare beneficiaries with safe and reliable non-emergency medical transportation (NEMT) to-and-from their healthcare provider1,2. With the incorporation of new rules which allow for proper reimbursement in various states, patients will finally be able to solve for a major issue that has been adversely affecting the healthcare world for years: access to care.

Access can singlehandedly break the healthcare system because patients can’t get healthcare if they don’t have a way to get to their doctor, and patients can’t receive prescriptions if they don’t have transportation to the pharmacy. Also, from a Social Determinants of Health perspective, senior patients can’t resume normal life activities if they don’t have the capability to get to religious services, mahjong club, or even their local community center. Lyft and Uber’s plan to solve for the access issue will largely open up opportunities that have been plaguing the healthcare industry, and our Medicare beneficiaries, for years.

Since 2010 the Medicare population has been growing at a steep rate of about 5.1%3, and according to the Kaiser Family Foundation, Medicare Advantage is predicted to grow 47% by 20294. With this fast-growing elderly population, it’s important to ensure that patients are able to see their providers on a regular basis so to manage chronic conditions, render preventative services, and address acute healthcare problems that can unexpectedly arise.

Mature white female holding up smartphone to camera with rideshare app open

This presents the perfect time for ride sharing organizations to get into the healthcare industry. Transportation, as a benefit, alone has a chance to expedite Medicare Advantage’s ascendance as the health plan-of-choice for America’s senior population. It would also save CMS a considerable amount of money, and when you consider that 3.6 million individuals do not have access to medical care because they experience transportation barriers (it’s the third leading cause of missing a medical appointment for seniors)5 you start to see how all the puzzle pieces could fit together in the very near future. Hospitals and private practices are behind this initiative because it could cut down the number of no-shows that they routinely face, which present their own operational and financial challenges.

Among those who face transportation barriers, some of the issues they face include5:

  1. Long travel distances
  2. Lack of vehicle
  3. Transportation cost
  4. Inadequate infrastructure
  5. Adverse policies affecting travel

What’s important to note here is that three of the five challenges listed above are going to be solved with ride sharing by Medicare Advantage. Long travel distances can’t necessarily be solved, but that challenge can be mitigated if a patient is willing to sit in a Lyft or Uber for a 45 minute ride if need be. At a minimum, it simplifies the process for those who may have had to rely on public transportation, requiring multiple stops or transfers, to get to their doctor. Disabilities can be an issue, too, as vehicles with modifications to support wheelchair-bound patients are expensive. Thankfully, Uber also offers wheelchair accessible transportation which means those beneficiaries with disabilities will also have access to transportation.

Finally, there are other cost-savings to consider. A study at the University of Kansas found that there was at least a 7% decrease in the rate of ambulance use based on data from the National Emergency Medical Services Information System and Uber6. This implies there is ambulance use when there’s no real need, tying back to a previous Salient Healthcare blog about ER Overutilization. Increased transportation and access opens the door for several other beneficiary benefits such as home care and delivery of durable medical equipment.

For a healthcare system that needs considerable modification, the availability of ride sharing options to Medicare Advantage beneficiaries stands to be one of the most impactful, and welcome, changes to population health. It gives many people a chance at a healthier life, a chance to participate in the community, and provides many beneficiaries something they may not have experienced in a long time…hope.

RESOURCES

  1. https://homehealthcarenews.com/2019/05/lyft-to-partner-with-majority-of-largest-medicare-advantage-plans-by-2020/
  2. https://www.forbes.com/sites/brucejapsen/2019/05/30/lyft-hails-medicare-advantage-as-its-next-profitable-ride/#2126126341d1
  3. https://www.kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/
  4. https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage-in-2019/
  5. https://www.aha.org/system/files/hpoe/Reports-HPOE/2017/sdoh-transportation-role-of-hospitals.pdf

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