Uber recently launched its newest service line called Uber Health. Uber Health is designed to arrange and facilitate rides for patients that do not have access to reliable transportation. The service does not require patients to have a smartphone, or even a cellphone, and the rides are arranged by a central, cloud-based dispatch portal at the provider's office. In other words, medical providers can book rides to and from the appointment on their patient's behalf and the patient receives a text or phone call with the details of the ride — time, location, driver, vehicle make, etc. The provider pays for the ride.
Not to be outdone, Lyft just announced a partnership with Allscripts, a leading medical record provider, to integrate into their workflow and provide their 180,000 physicians with the option to arrange rides for their patients. Lyft has been creating regional healthcare partnerships since it launched Lyft Concierge in 2016, but this announcement signifies Lyft’s healthcare ambitions are on a national scale.
Uber Health and Lyft Concierge are solving a real need in healthcare. Every year, 3.6 million Americans miss medical appointments due to the lack of available transportation. At a population health level, arranging and paying for transportation for these patients makes sense — increased preventive care compliance leads to a decrease in the advancement of disease and the need for critical care, which reduces costs and improves patient outcomes. The providers and the insurance companies have shown that they are willing to subsidize rides for this subset of patients due to the massive cost savings down the line as a result of increased preventive care. Uber Health was able to onboard over 100 healthcare providers prior to launch.
In the U.S., only half of all patient referrals result in a visit. That is 24 million missed visits per year, which results in $45 million of unnecessary healthcare spend annually (some experts put this number as high as $150 million). Uber and Lyft’s goal of working to reduce the number of missed appointments is a noble pursuit, however, their solutions are insufficient for two reasons.
First, it is unclear if providing rides for patients actually reduces the number of missed appointments. While it is too early to draw any real conclusions on the efficacy of these ride-booking services, the initial data shows tepid results. There are some anecdotal successes, but the empirical data is less encouraging. A study conducted by Krisda Chaiyachati at the University of Pennsylvania called, “Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments” measured the impact of ride-booking on patient compliance for one provider group over 18 months. The results show that providing rides to patients did not decrease the number of missed appointments in a statistically significant way.
Second, lack of transportation only accounts for 15% of missed appointments and ride-booking does not solve the root cause of the 24 million missed appointments each year. Ride-booking only helps patients after their appointment has been scheduled because the provider needs to know who and when to book the ride for. The root case for the high number of missed appointments is friction in the referral process. Here is how it works today: a primary care provider (PCP) refers a patient to a specialty care provider. The patient then has to locate a specialty care provider that a) has the correct subspecialty focus, b) takes their insurance and c) has availability. This process is a pain and, as a result, half of all referrals do not result in a provider visit.
Helping providers and patients find the right specialist is the necessary first step in getting patients to the doctor that must be solved before ride-hailing services can become truly effective. Lyft and Uber should partner with companies that help patients find and schedule appointments. Ideally, providers should be able to easily book the patient appointment at the point of care and then arrange a ride for the patient if he or she lacks reliable and available transportation. Integrating ride-booking into a single referral process will increase the efficacy of Uber Health and Lyft Concierge. The first and most important step is securing the patient appointment. The second step is securing the patient a ride, if necessary.
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