Why Uber and Lyft want to take you to the hospital

Uber and Lyft both are making in-roads with heathcare providers that offer rides to those in need of transportation to doctors appointments.

SAN FRANCISCO — It's no good having health care if you can't make the appointment. For house-bound patients, the answer may increasingly come in the form of an Uber or Lyft — rather than a medical-transport van or taxi. 

Both companies are pushing hard into the health care transportation space in order to add scale to their operations while helping providers improve their level of care.

Hospitals and doctors are flocking to the alternative for the same reason millions of individuals have tapped on an app to call a ride: It's a cheap, door-to-door option you can track at a glance. 

The move is one more way the ride-hailing companies, which rely on fleets of independent contractors, are cutting into established transportation routes and the businesses that have served them, an impact city residents and leaders are only beginning to understand. 

Last week, Uber Health went live after an eight-month trial with 100 health care providers that tested the ride-hailing service as a way to ensure that eligible patients weren't no-shows for appointments.

Rival Lyft on Monday built on a two-year effort to offer doctors its platform with a partnership with medical records company Allscripts that adds an estimated 7 million patients through 2,500 hospitals and 180,000 physicians.

Screen shots of Uber's new Uber Health platform, which allows doctors and hospitals to easily schedule pick up and drop off rides for patients.

Nationally, missed appointments cost health care providers $150 billion a year, with no-show rates as high as 30%, according to SCI Solutions, which provide IT services to the health care industry. 

"Obviously helping patients is a good thing, but there are also financial ramifications of making sure your level of care is consistent," says Gartner analyst Tom Handler. "If you get penalized (for not following up with patients), there's incentive for you to track them better, and sometimes that means helping them get to you."

With both Uber and Lyft, health care providers use a custom desktop platform that allows them to schedule multiple rides at once. Providers determine who is eligible based on need, and costs are covered by providers and sometimes defrayed by insurance.

In some cases, hospitals and doctors may get a higher insurance reimbursement rate for a low level of readmissions, an incentive to make it easier for patients to make their follow-up appointments. 

"I'd say 70% of the time we're using Uber is to make sure that a patient that's been discharged makes it back for a critical follow-up visit," says Chris Needham, director of Member Health and Wellness at Renown Health, which serves urban and rural patients in northern Nevada.

John Zimmer, right, president of Lyft, is shown here during a recent stint as a driver in Nashville, one of more than a hundred new cities opened up by Lyft in 2017.

Needham says that in the past, deserving patients — ranging from the indigent to seniors with dementia — were accommodated with taxis, "but that would require us to hand them a voucher in person, so this (ride hailing) is much more efficient."

Taxi vouchers, he said, could be a problem because it was never certain if the person would use it for the return to the hospital. 

But these new services are limited. Uber and Lyft rides to see doctors won't work for disabled individuals. Last week, Disability Rights Advocates filed a class-action lawsuit against Uber, challenging the popular ride-sharing service’s lack of transportation for those in wheelchairs.

"Based on our investigation, in most major (U.S.) cities, wheelchair access for Uber users is either rare or non-existent," says Melissa Riess, staff attorney at Disability Rights Advocates. Reiss said Uber has not yet responded to the lawsuit. "This is not an unsolvable problem."

The ride-hailing company does offer the option of ordering Wheelchair Accessible Vans, so-called UberWAV, through pilot programs in London, Toronto, Austin and Chicago, according to Uber's website.

Lyft for the moment is "focusing on ambulatory patients," says chief business officer David Baga.

Other Lyft partners include LogistiCare, a service that coordinates transportation to non-emergency medical appointments, and Hitch Health, a Minnesota-based non-emergency health care transportation company that uses a health care provider's electronic health records to identify patients who may benefit from a free ride and automatically sends patients SMS texts with details. 

epa06357430 Taxi drivers protest in Madrid, Spain, 29 November 2017, during a strike called by taxis against the public administration and to demand the observance of the law for VTC (Tourism Vehicles with Driver) like Uber and Cabify.  EPA-EFE/JJ GUILLEN ORG XMIT: GRAF266

If a patient doesn't own a phone but are in the office, they are provided with a print-out listing the ride share car's arrival details by health care staff.

Such appointments may previously have been filled by local tax fleets, which have seen their service drop with the advent of ride-hailing apps. 

Backed by billions in venture capital, Uber and Lyft have yet to show a profit. Paying the driver, even as a non-employee, eats up much of the ride revenue. As a result, both are trying to eliminate driver costs by creating self-driving car fleets. 

But until autonomous cars dawn, the tech start-ups believe they can improve their bottom line through scale, which is why they're aggressively pursuing doctors and hospitals as a source of new customers.

Uber deployed prototype self-driving Volvos in San Francisco in late 2016.

Consumers have already showed their willingness to swap Uber and Lyft for renting or owning cars, taking buses and more specialized staples of transit. A University of Kansas survey of ambulance usage rates in 43 states found a 7% decline was explained by a growth in ride hailing.

Neither Uber nor Lyft's new health care services is meant to replace an ambulance.

Sometimes patients heading to the hospital or a doctor might need a driver that has some medical certification, and that's where Lyft and Uber also fall short, says Michael Coleman, executive vice president of operations for Veyo, a 2-year-old non-emergency transportation broker.

"All our drivers have background checks and have the same qualifications a commercial (health care) driver would have, including CPR," says Coleman, adding that Veyo has Uber and Lyft drivers in its service but only those that are trained to meet its standards of care.

"We'll give drivers instructions that can include walking patients from their homes to the car, which isn't the norm for average (ride-sharing) rides," he says. "I'm not sure new entrants into this market can do what we do."

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