Why Rideshare in Healthcare Is Key to Value-Based Care Success

February 03, 2022 - Across the nation, fee-for-service is giving way to value-based care contracts. And as those scales tip, Buck Poropatich, the new head of healthcare for Lyft, thinks rideshare will be key to value-based care success.

This comes after nearly two years of a global pandemic in which Lyft and other rideshare services demonstrated how well they could scale up patient access to care. When COVID-19 caused a slowdown in public transportation and multi-load vehicles, there was a tremendous void left in the healthcare industry.

As patient access to COVID-19 testing started to ramp up, and last winter huge swathes of people became eligible for the COVID-19 vaccine, Poropatich said companies like Lyft were able to fill in the blanks. Lyft was responsible for getting the numerous people without a ride to a testing or vaccine site to access their care without a hitch.

“A lot of modalities were pulled away, then all of a sudden there was this acute window where you had to get a highly vulnerable population to critical appointments, vaccine being most relevant, quickly,” he told PatientEngagementHIT in a recent interview. “We stepped into the void, and we just basically expanded our propensity or populations of rides in which we service.”

Poropatich suggested this COVID-19 use case set the stage for how rideshare could support medicine into the future. Now that Lyft has showcased its capabilities during the pandemic, the rideshare company can work with the medical industry with other pressing medical transportation needs.

“COVID isn't the first vaccine we've ever had,” Poropatich pointed out. “There are other preventative and primary care appointments, and the light bulb is going off. This is a bit of a litmus test for value-based care. If you're truly focused on value-based care and underserved populations and vulnerable populations, transportation is key.”

Importantly, COVID-19 offered a value proposition for investing in rideshare partnerships and medical transportation, Poropatich added. Take, for example, the number of adults who were interested in getting the COVID-19 shot but who couldn’t because of transportation barriers.

In May 2021, about a fifth of the low-income folks who still hadn’t gotten the jab said they would if they had a free ride to their vaccine appointment, Poropatich said, citing figures from the Kaiser Family Foundation. Rideshare programs to offer that free ride were instrumental to getting the nation’s vaccination rate up to where it is now.

And at the end of the day, offering up those free rides helped organizations stave off higher costs in the long run.

“The CDC said that a senior who's fully vaccinated had a 94 percent less likelihood of being hospitalized,” Poropatich said. “And we know that hospitalizations can cost $20,000, $30,000 for a COVID patient. The math became rather obvious.”

The about $15 per patient rideshare investment considerably offset the potential cost of a hospitalization, he added.

And now, in an industry increasingly defined by value-based care (most of the healthcare payments made in 2020 were tied to value, according to Health Care Payment Learning & Action Network), rideshare can continue to provide that kind of return on investment, Poropatich maintained.

“Transportation, specifically Lyft, is going to be a necessary, needed ingredient for value-based care,” he asserted. “Don't take my word for it. Look at the organizations that have successfully managed capitation and financial risk, especially the Medicare Advantage context. Look at ChenMed, look at Oak Tree, look at Iora, look at Cano Health. Go down the line.”

“They all have been offering transportation for decades. They've recognized this is a vulnerable population,” Poropatich continued. “They see it as a greater use of preventative care, greater use of primary care, lower use of emergency services, lower use of inpatient services.”

To be clear, Poropatich knows rideshare cannot solve every healthcare problem, and not even every healthcare transportation problem. Rideshare companies have emphasized that they are appropriate for fully ambulatory patients who do not need specialized medical equipment or medical attention during their rides.

But it’s that specialization that makes Lyft and rideshare a key tool for value-based care. Why incur the non-emergency medical transportation expense for the generally healthy, fully ambulatory patient who simply needs a ride?

Or, perhaps more importantly, why defer that in-demand NEMT resource when rideshare can fulfill basic transportation needs for ambulatory patients?

“Those transportation providers that have focused on healthcare traditionally, unfortunately there's less of them today,” Poropatich said. “Lyft is just having to step in and play a larger role, because our model, we could scale up and down to meet demand much more rapidly and fluidly.”

As far as the medical transportation space goes, rideshare lets those traditional NEMT and EMT providers practice at the tops of their licenses, so to speak, Poropatich argued.

“To the extent there are wheelchair accessible vehicles, ambulance, stretchers and everything else—let them focus on that high-need, high-touch, high-acuity population,” he suggested. “If somebody's pure ambulatory, fully cognizant and appropriate for rideshare—which not everybody is—but if they are, let us take that off their hands.”

At the end of the day, there is a serious medical transportation need, and Poropatich indicated Lyft has both the expertise and the obligation to do its part.

“Lyft Inc. has spent billions of dollars over the last decade focusing on how we improve people's lives with the world's best transportation,” he said. “Shame on us if we can’t find a way to repurpose and re-engineer all of those efforts for healthcare.”

“There are many other ways that we can use rideshare, specifically Lyft, to counter all hurdles,” he concluded. “Grease the skids to get people in, whether it's a flu shot, whether it's in a wellness visit, or whatever it might be, that's going to help bend the cost curve and help make sure that we're getting people to and from.”