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October 28, 2019 11:47 AM

Lyft, Uber expand reach into healthcare

Jessica Kim Cohen
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    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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