A nascent partnership between Lyft and CareMore means less waiting and more reliability for one patient cohort: the population with the most chronic disease.
Sure, ridesharing has disrupted the taxi business, but can its technology do the same for healthcare?
CareMore, an operationally independent combined senior health plan and medical group subsidiary of Anthem Inc., is convinced it can, and recently published the findings from a pilot study in the Journal of the American Medical Association that it claims proves it.
President Sachin Jain, MD, says his organization's early partnership with ridesharing service Lyft has helped it achieve what he calls the "healthcare trifecta" of better outcomes, lower costs, and improved patient experience.
And CareMore is just getting started.
During the course of the May-through-June 2016 California pilot project detailed in the NEJM study, during which patients took 479 rides through a ridesharing service, paid for by CareMore:
- Average wait times compared to the traditional medical transportation control group were down by 30% (to 8.77 minutes from 12.52)
- Average per ride costs decreased by 32.4% (to $21.82 from $31.54)
- The patient satisfaction rate was 80.8%.
Some traditional non-emergency transportation, says Jain, is plagued with poor service and high prices, and the Lyft partnership, which has been ongoing since the pilot ended, can address those problems.
Perhaps more significantly, says Jain, it can also address the problem of prevention and effective treatment of chronic disease, although this was beyond the scope of the study.
Still chronic disease treatment is a big issue among CareMore's patient population, which consists of Medicare beneficiaries through its Medicare Advantage offerings.
The company is essentially capitated through these plans, as it also provides care through its physician practices. So money spent in one area, transportation, can significantly affect areas far outside that narrow service, such as whether patients are effectively treated for their maladies. Transport to and from medical appointments is covered as a benefit to Medicare Advantage members of CareMore.
Transportation Has Been Tricky
"[Transportation] has always been one of the greatest satisfiers of our members but it's also one of the greatest sources of disappointment, because of the way the transport industry operates," says Jain.
"You can assume the patient will be picked up on time, usually, but as for returning them home from an appointment, that's unpredictable—we're not sure when it's going to end. If you've got COPD and CHF and you're standing and waiting for an hour, you're not going to be happy."
You might be unhappy enough to forego your next medical appointment for fear of inconvenience and discomfort, which could worsen your condition. That's why it's so incredibly important to get the transportation right beyond the issue of patient satisfaction because it has such potential to adversely affect the ultimate outcome and medical costs associated with that patient, Jain says.
Similar programs are emerging. But why haven't others moved more quickly to try to disrupt a costly and unreliable nonemergency transportation system to incorporate technology that has already improved basic transportation for the general public?
For one, most healthcare organizations still aren't capitated, which adds a powerful incentive for care providers to transform this dissatisfier.
CareMore does not just dispatch any Lyft driver for any patient. It takes into account the special needs of that patient, and has undertaken direct training for drivers interested in driving seniors to medical appointments.
"There's a difference between transporting people to airports versus an elderly population to medical appointments and they might need higher levels of assistance or support," Jain says.
"A Lot of Partnerships Yet to be Built'
The company initiated training for Lyft drivers to get them thinking about the different types of service they need to provide seniors through its CareMore Academy, which trains company partners ranging from ride companies to coders.
Also, the partnership extends to some of the traditional nonemergency transportation companies because of the need for specialty vehicles such as those that offer wheelchair assistance. National MedTrans, a nonemergency medical transportation benefits manager, handles the interface between members, who request medical transportation 24 hours in advance and drivers, which are dispatched using a web-based product called Concierge that allows organizations to request rides for customers through Lyft.
"One of the benefits of the CareMore model is that we're both payer and provider," says Jain. "That allows us the flexibility to do common sense things for our patients and this just one example."
He explains further that ridesharing has the potential to save time and dissatisfaction in other areas, such as getting patients out of the hospital on time. One of the barriers to discharging many patients is transportation. And there are other potential efficiency benefits.
"What if it could help patients after ambulatory surgeries? Could you turn over your ASC faster?" he muses. "There are a lot of partnerships yet to be built. The truth is you need to be in a full risk environment to be able to find the dollars to do these things."
Philip Betbeze is the senior leadership editor at HealthLeaders.