Why hospitals are becoming increasingly popular Uber and Lyft destinations

Transportation barriers prevent an estimated 3.6 million people in the United States from obtaining needed medical care each year. Transportation barriers include not having access to a vehicle, inadequate infrastructure, lengthy commutes, expensive transportation costs and adverse policies that affect travel. 

Without access to transportation, individuals must miss or delay their health care appointments, resulting in poorer health outcomes and increased health expenditures. 

Mary Wolfe, a UNC doctoral candidate, and Noreen McDonald, professor and chairperson of the Department of City and Regional Planning at UNC, conducted a nationwide scan to investigate how innovations in ride-hailing technology are changing health care transportation in the U.S. 

“This was an opportunity to evaluate a different, but very important connection between transportation and health,” Wolfe said.

Recently, ride-hailing companies like Uber and Lyft, which allow users to book rides and pay for car service through a smartphone app, have started filling the gaps in non-emergency health care transportation.

Over the course of several months, Wolfe and McDonald conducted a keyword-based search of periodicals, press releases and academic sources to catalog any formal instance is which ride-hailing technology was used to facilitate non-emergency health care transportation. 

The most common innovation Wolfe and McDonald observed is health care providers using ride-hailing technology to book rides for patients. Some transportation companies have tailored the ride-booking process to the health care industry by making it HIPPA compliant, meaning that it protects patients’ information and privacy. 

In March 2018, Uber Health launched. Using Uber Health, health care providers can schedule rides on behalf of patients without smartphones and track their trips to reduce the number of no-show patients. 

The second innovation Wolfe and McDonald identified is insurers partnering with a ride-hailing company to expand or start offering transportation services to beneficiaries. While they did not find this to be common, they suspect these partnerships will grow as insurers realize the important role of transportation in remaining healthy. 

In May 2017, Blue Cross and Blue Shield partnered with Lyft to ensure Americans are not missing medical appointments because they do not have reliable transportation.

Another innovation Wolfe and McDonald noted is transit agencies providing special transportation to people with disabilities, called paratransit providers, partnering with a ride-hailing company or subsidizing its trips through pilot projects to increase the flexibility and reliability of ride-sourcing.

Wolfe presented these findings at the Association of Collegiate Schools of Planning Annual Conference in October 2018 and at the Transportation Research Board meeting in January 2019. 

“It would be great if our work helped to demystify this new and rapidly evolving area of transport offerings,” Wolfe said. “We hope that it offers some structure and language for patients, care coordinators, health care providers and transportation planners who are curious about what these services might mean for them."

Locally, UNC Health Alliance is exploring the complex factors involved in how to provide transportation to patients that demonstrate a need. UNC Health Alliance is piloting a program for a subset of its aligned Medicare patients to learn the most effective way to provide transportation. 

“We understand as a health care system that transportation is an enormous barrier to care,” said Devon Brady, UNC Health Alliance communications manager.

On average, transportation barriers disproportionately affect patients who are low-income, people of color and people with chronic illnesses and disabilities. The innovations and new services offered by ride-hailing companies are making health care more accessible to these groups. 

However, Wolfe said it is unclear how, or if, these new offerings will expand access to care for people in rural areas where inequities in health care generally result in poorer health, since ride-sourcing is tied to population density.

Because many Americans live in areas where medical care is beyond the reach of walking, biking or using public transportation, innovations in ride-hailing have made health care more accessible for many individuals.

“More Americans are going to have access to Uber and Lyft in the future and this is going to change all their travel, and getting to health care is one of the most important trips,” said McDonald. “We also think this will be particularly important for older adults as they transition perhaps away from driving as this provides a way to access health care and other needed activities.”

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