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November 21, 2022 12:57 PM

Uber Health’s Caitlin Donovan on how big tech slips up in healthcare

Brock E.W. Turner
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    Caitlin Donovan Uber Health
    Uber Health

    Caitlin Donovan, Uber Health’s global head

    Uber Health expanded its ride service for patients needing reimbursed, non-emergency health transportation to commercial and self-insured employers last week.

    Previously, the company had focused its attention on Medicaid and Medicare populations, but data showed gaps in commercially insured patients, said Caitlin Donovan, Uber Health’s global head.

    “Employers were looking at the average across their population rather than the more nuanced data,” Donovan said. She cited internal data that found more than one in four employees on self-insured plans live at 200% of the poverty line or less.

    The ride sharing giant will initially focus on large companies with large populations of workers in call centers, manufacturing or retail environments, Donovan said.

    The company launched Uber Health in 2018 with a service that enables healthcare providers to schedule rides for patients who need transportation to non-emergency medical visits. Since then, Uber has struck partnerships with healthcare organizations and software companies, including a partnership with CVS Health. It also launched a prescription delivery service.

    Donovan discussed how Uber’s healthcare strategy differs from others, where big tech slips up when entering healthcare and how the company plans to grow this service line. The interview has been edited for length and clarity.

    Download Modern Healthcare’s app to stay informed when industry news breaks.

    What’s the difference between Uber Health and the Uber app that’s on so many of our phones?

    Uber Health is billed slightly differently, meaning it’s purposely not an app that you can find on your phone. We’re a web-based dashboard or [application programming interface] that is intended to be care coordinator facing. [That] means for provider offices, call centers or case managers, the intention [is] that we serve the most vulnerable population at scale who either doesn't know how to, can't, or won't navigate the system on their own. Historically, we've done this in the Medicaid and Medicare populations and now we're applying that to a commercial and specifically a self-insured employer population.

    How do you see Uber Health evolving? Will we see more of these partnerships that allow Uber to connect different entities in healthcare together?

    On the Medicaid side, a transportation benefit has existed since 1966. On the Medicare Advantage side, more than 50% of plans offer these benefits. But there are administrative burdens in the system that prevent them from being utilized in a way that maximizes patient outcomes and minimizes cost. And that's really where we fit in.

    Where we're spending a lot of our time is saying this tool exists, it works. There are proven case studies to show it works. For users, it's about thinking through how to design your benefit, where you put that tool, so it's administered correctly. Pre-planning for these extension of benefits scenarios goes a long way in fixing the system at scale.

    Do you think having the Uber name attached to this helps payers recognize the value? Would it be more difficult to do this if you were a start-up without the name?

    In my experience, payers react to data. I think that whatever company can execute this in a way that drove the appropriate outcomes and cost reductions will have the ear of the payer. That said, when there's a new concept, understanding the core competencies of a company you're working with can go a long way. And in the case of Uber, [we’re] known for consumer engagement, which translates well to member engagement, which is correlated with Medicare Advantage star scores.
     

    Quote teal solidA lot of tech companies—especially in healthcare—believe if you build it, they will come. That's not the way the ecosystem works in healthcare."
    Caitlin Donovan, Uber Health


    Employer-insured patients tend to be younger, healthier populations. What are you hearing from employers? Is there a real desire and cost savings here?

    Employers were looking at the average across their population, rather than the more nuanced data. So, in aggregate, the more nuanced data suggests that 27% of employees that are on self-insured plans live at 200% of the poverty line or less, use preventative services 50% less and see four times more preventable admissions [than general employer-served populations]. When I think about my personal experience, way before I was at Uber, I used to run call centers and I used to run them for healthcare companies. So, you’d think that we tried to align incentives to make sure that our employees were staying healthy. But candidly, we didn't. We rewarded employees based on their attendance. We didn't give a lot of PTO days. [Why would] someone risk not having perfect attendance, why would someone use a precious PTO day just to take a full day off to take three bus lines to an appointment that they may or may not have needed? That's the wrong incentives. So, thinking through what an employer might want for a call center population, manufacturing population, retail population, how do you think about the incentives driving those employees to be at work and to stay healthy at the same time?

    What makes Uber Health different from other big tech forays into healthcare?

    Our healthcare system in the U.S. is very, very complicated and very hard to change, unless you know how it works. Big tech in the U.S. is incredibly innovative and works really well, but it is hard to marry those two ideas. This is why I think it's important to take the approach that Uber and Uber Health have taken, which is hiring folks who understand the value of technology and modernizing the system as well as understanding the system itself.

    So you can work from within the parent parameters that are table stakes, as opposed to building a product and hoping folks will follow. A lot of tech companies—especially in healthcare—believe if you build it, they will come. That's not the way the ecosystem works in healthcare.

    This story first appeared in Digital Health Business & Technology.

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