Rideshare giant Lyft released data it says shows its non-emergency medical transportation (NEMT) program improves health access for Medicaid beneficiaries by shifting the reliance on emergency services to upstream preventive primary care.
In one example, year-long use of Lyft led to a 40% decrease in emergency room utilization and a 12% drop in ambulance use for 11,400 Medicaid members of AmeriHealth Caritas in Washington, D.C., based on claims.
Uber and Lyft in recent years have touted their NEMT plans to potential health system and payer clients, while traditional transportation brokers argue the consumer-focused behemoths aren’t able to meet the niche needs of many U.S. patients.
Rideshare companies have struggled since March as the coronavirus pandemic keeps people indoors. In second quarter earnings, Uber’s revenue was down almost 30% year over year to $2.24 billion, while Lyft’s was down 61% to $339 million.
But Uber and Lyft, which formed their health divisions in 2018 and 2016, respectively, see the multi-billion dollar NEMT market as fertile ground to drive growth, contending they can reduce patient no-shows that can cost providers valuable revenue and exacerbate health conditions. An estimated 4 million U.S. patients miss medical appointments annually due to a lack of transportation.
The pandemic has compounded the problem as high-risk individuals avoid public transit. And some NEMT options, like multi-load shuttles, have been banned in areas like New York to avoid potential COVID-19 spread.
Lyft is not shuttling any COVID-19-suspected patients, Megan Callahan, Lyft’s VP of healthcare, said, though it does cover some 29 million vulnerable Medicaid beneficiaries across 14 states and Washington, D.C.
Centene, the largest Medicaid managed care provider in the U.S., also piloted Lyft programs at four subsidiary health plans in Ohio, Florida, Georgia and Texas in 2018 and found it reduced average patient wait time for a vehicle to seven minutes, down from 28 minutes for a traditional NEMT ride.
Following the pilot, Centene has been using Lyft in all Medicaid markets that allow rideshare, Shea Long, Centene’s VP of innovation, said. Centene is also moving to implement Lyft in non-Medicaid markets like Medicare Advantage and the ACA exchanges, where there are fewer restrictions.
Generally, payers and providers contract with traditional transportation brokers like San Diego-based Veyo, allowing case managers, social workers or medical professionals to request rides based on a patient’s specific needs, from a simple rideshare to a wheelchair-accessible van.
Traditional NEMT companies say their model is superior to Uber’s or Lyft’s as they’ve invested in driver training, specialized vehicles and services and are familiar with the complex Medicaid regulatory landscape that shifts state by state. However, the massive footprint and driver network of the San Francisco-based rideshare companies is a plus for potential clients.
Though NEMT is traditionally a Medicaid benefit, more lax regulations on coverage from the Trump administration have spurred interest from employers and commercial plans, though the ROI of the service is less clear in a healthier and wealthier population.
Despite that, the volume and type of clients for Uber and Lyft have grown significantly since both divisions started. Lyft doesn’t break out specific numbers, but says it has thousands of partnerships across payers and providers, including one with Chicago-based operator CommonSpirit announced in January. Uber Health had more than 1,000 clients going into 2020.