Patients rely on Uber and Lyft for long-distance medical care

Michael Scaturro
KFF health news

When Lyft driver Tramaine Carr delivers elderly and sick patients to Atlanta hospitals, she feels like both a friend and a social worker.

“When the trip is an hour or an hour and a half long, mostly on the freeway, people tend to tell you what they’re going through,” she said.

Drivers like Carr have become an important part of the medical transportation system in Georgia, as well as in other countries. Washington, DC, Mississippi, Arizonaand in other places. While some patients use transportation companies that specialize solely in medical rides or non-emergency ambulance rides to get to their appointments, San Francisco-based Uber and Lyft also take people to emergency rooms, kidney dialysis, cancer treatments, physical therapy and other medical visits.

But Georgia taxi drivers serve more than just patients living in Atlanta or its sprawling suburbs. When rural Georgians are too sick to drive themselves, Uber or Lyft are often the only way to get medical care in the state capital.

Closing of rural hospitals in Georgia mean that people battling cancer and other serious illnesses must now travel two or more hours to get to treatment facilities in Atlanta, said Brian Miller, director of psychosocial services at Atlanta Cancer Foundationan offshoot of medical practice that aims to ease the financial burden of cancer patients and their families.

According to Lyft, from April 2022 to April 2024, Lyft drivers completed thousands of trips of more than 50 miles each way that started or ended at Atlanta-area medical centers, including Winship Cancer Institute at Emory University and Emory University Hospital in city ​​center. Elevator.

According to the company, 75% of those trips were less than 100 miles, 21% of them were between 100 and 200 miles, and 4% were more than 200 miles, showing that even Georgians living within a few hours of metro Atlanta rely on to the taxi platform. to get medical care there.

Uber Health global head Zachary Clark declined to provide comparable ridership data. Uber Health is a division of Uber that provides medical transportation for certain Medicaid and Medicare recipients, health care workers, prescription drug delivery and others seeking reimbursement for Uber rides related to medical care. according to Uber website.

Lyft also has a healthcare division that offers programs like Lyft Assisted and Lyft Concierge to coordinate patient rides.

Across the country, some insurance companies and cancer treatment centers, as well as Medicare Advantage programs and state Medicaid plans, pay for such ride-hailing services, often to reduce the number of missed appointments, according to the data. Krisda ChayachatiAssociate Professor at the University of Pennsylvania Medical School.

In 2024, 36% of individual Medicare Advantage plans and 88% of special needs plans offered transportation services, the data shows. Ginny Fuglesten BinickAssociate Director of Medicare Policy at KFF, a health policy research, polling and news organization that includes KFF Health News. A special needs plan provides additional benefits to Medicare beneficiaries who have severe and chronic illnesses or certain other health care needs, or who also have Medicaid.

And Medicaid, the federal government’s state insurance plan for people with low incomes or disabilities, paid up to 4 million beneficiaries According to a report from the Department of Health and Human Services, non-emergency medical transportation services will be used annually from 2018 to 2021. Patients living in rural areas were more likely to use taxis and other non-emergency transportation services, the report said.

It is estimated that the total federal and state investment in non-emergency medical transportation in 2019 was approximately $5 billion. according to research Transportation Institute at Texas A&M University.

Even with some insurance covering travel or charities offering travel credits, many sick patients are still left without travel, social workers say. Nationwide, 21% of adults without access to a vehicle or public transportation went without needed health care in 2022. according to research Robert Wood Johnson Foundation. People who lacked access to a vehicle but had access to public transportation were less likely to miss needed care.

Analytics company Geotab put Atlanta on a draw ranks second in the country in terms of accessibility of the public transport network.

“Being able to get an appointment with a doctor can be a barrier to getting care,” said Rochelle Schube, coordinator of a cancer support group in Atlanta. “If I give a patient $250 with an Uber card and they live far away, that money gets spent quickly.”

The fact that Uber and Lyft are harder to find in rural America compounds the lack of access to health care in these areas. “When you move to rural areas, where you could argue the need is greater, you see fewer services,” Chaiyachati said.

Finding drivers who are able and willing to provide medical transportation can be a challenge. Atlanta startup MedTrans Go connects patients and healthcare providers with vetted drivers, many of whom offer wheelchair or stretcher rides, in Georgia and 16 other states. Many of its drivers are medically trained, transporting patients to and from medical facilities or homes and can handle complex situations for vulnerable patients, said Dana Weeks, the company’s co-founder and CEO.

The company’s app can also send direct messages to Uber or Lyft for patients who don’t need specialized care, she said.

Uber and Lyft rides can save patients and insurers money because they cost a fraction of the typical ambulance ride fee, he said. David Sluskyprofessor of economics at the University of Kansas, who studied The impact of taxi services on medicine.

But instead of all this, he claimed Timothy CrimminsProfessor Emeritus of History at Georgia State University and former director of the school’s Center for Neighborhood Studies, a better solution would be Georgia Expands MedicaidThis way, more rural hospitals will be able to stay open and Georgians will be able to seek medical care close to home.

Georgia lawmakers’ decision not to agree to a federally funded Medicaid expansion has left more than 1.4 million Georgians without health insurance. according to KFF data – and it hurts rural hospitals when these patients use the facilities and can’t pay their bills. In Georgia, 10 rural hospitals have either closed or ceased inpatient operations since 2010, according to the agency. report for 2024 from health consultant Chartis, and another 18 are at risk of closure.

Until more patients are insured, Crimmins said the state should subsidize Uber and Lyft rides for poorer Georgians who need help getting health care in Atlanta. “We’re probably talking about $100 to $150 round trip,” he said. “It can be subsidized.”

However, transporting patients is not something every taxi driver can do. Damian Duran said his Chevrolet Equinox SUV is large enough to accommodate a medical passenger who requires a wheelchair, but he is not paid extra for transporting people with medical needs. He said some of his recent passengers in Atlanta were Medicaid recipients with mental illnesses or disabilities.

“It can be stressful,” he said. “I feel like Uber and Lyft are trying to catch me off guard. When I see a trip going to the hospital, I try to avoid or cancel the trip.”

Although Duran’s experience with medical transport has been mostly negative, Carr loves the job and appreciates the opportunity to help older Georgians, who she says often tip her well. For her, working as a taxi driver remains a good option, even if it involves calling a doctor.

“It’s not stressful for me,” she said. “I worked a good 20 years in customer service. Human communication is important to me. I tried working from home and I really didn’t like it. I prefer it because I can connect with people.”

(KFF health news is a national news service that produces in-depth journalism on health issues and is one of the core operating programs of KFF is an independent source of health policy research, polling and journalism.)

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