More and more health care organizations—payers, providers and employers—are understanding the importance and cost-effectiveness of a non-emergency medical transportation (NEMT) program. It’s a benefit they can’t afford to skimp on.
In a 2018 piece, The New York Times reported that the health care industry loses somewhere in the neighborhood of $150 billion revenue annually. Researchers say that the issue has become even more pronounced thanks to the COVID-19 pandemic.
For this reason, NEMT and NEMT-adjacent companies, such as Ride Health, SafeRideHealth and Kaizen Health—are making waves through new investment funding rounds and high-profile partnerships. Naturally, the two companies that have everyone’s attention in this space are Uber and Lyft Healthcare. In April, Lyft launched a new NEMT product which allows patients to request their own rides to and from medical appointments. A few months later, the company hired Buck Poropatich as its new head of health care, succeeding Megan Callahan.
For Uber’s part, the ride-sharing giant hired industry veteran Caitlin Donovan in April of 2021 to head up its health care operation after a few years of growth under Dan Trigub. Donovan has already made waves by announcing partnerships with, ModivCare, which providers NEMT, personal care, nutritious meals, and remote patient monitoring to address the social determinants of health and, more recently, Papa, which provides companionship and assistance to older adults. On top of those partnerships, Uber works with more than 1,000 health care organizations to provide NEMT services.
Donovan recently spoke with Health Evolution about what COVID exposed about transportation as a social determinant of health, the new partnership with Papa, its overall partnership strategy, and more.
You have been there for six months – how has it gone so far?
I was in a very lucky position. I had been a customer of Uber in the past. I felt lucky to get used to the internal workings of Uber, as opposed to the industry as a whole. Most of my background is on the ancillary side, whether it’s non-emergency medical transportation or home health care [durable medical equipment]. The post-acute space. I was very excited to come to Uber to solve some of the care gaps using Uber’s bi-directional logistics network made available through their marketplace technology. That’s what Uber is at its core. To be able to connect siloed benefits through partners.
NEMT is always mentioned as a critical element of the social determinants of health. What has COVID exposed about this need?
COVID has accelerated in exposing health equity and access issues. I’m very hopeful that some of the innovations that happened during COVID stick around. Through some of the partnerships Uber has had, whether it was with Walgreens or ScriptDrop, we were able to close some of those care gaps. Starting with COVID vaccinations and prescription deliveries when people were home bound, we can take those learnings and processes and apply them to the health care industry more holistically. We can do this with a protocol-driven approach to ensure those who need low engagement/high acuity care receive the care they need. Whether that’s through getting an Uber to go to their doctor’s appointment or getting a prescription or food delivery so they can stay at home.
What are the biggest challenges these organizations are having with transportation?
There is a need to solve access issues broadly. A piece of that is disrupting the system as it exists today and modernizing it. Making it so the consumer experience is delightful, and the provider experience is delightful. Executing this in a way that keeps cost in control.
The second thing is thinking about access in a way that advances the delivery of care to reach more [people]. Right now, from my perspective, those that are receiving or accessing transportation benefits are the ones who are most in need. They are the ones who a case manager knows their name and will solve a problem for them. Or the patient is savvy enough to navigate the system. We’re really trying to help that middle patient, who is low engagement but high acuity and needs a little more help to meet them where they are. We want to enable a protocol-driven approach so the patient can advocate for themselves, or a care coordinator can easily connect the dots for a patient and streamline that care.
What’s really interesting about access is there is a need for everyone to solve [this problem]. We all think of this as a value-based care problem, where if your patient is not having the right outcome, you want to align incentives. I am excited to see the progression of value-based care models to align those incentives well. This means [appealing to] health insurance companies, specialty benefit managers…who are solving for logistics problems, or health systems themselves, particularly those entering into home health and population management.
Talk about your new partnership with Papa and what that entails?
We share the common vision of solving access issues. For them, they’ve taken the entry point of solving for social isolation. We’ve taken the entry point of solving for transportation and access. Generally, a patient that needs one needs the other. By coupling these historically siloed benefits, you solve a whole problem for a health plan/health system/patient. Their Chief Revenue Officer put it well, he said in this case, “1 plus 1 is 5.” You’re not just solving for the individual patient, but the simplicity of care coordination.
This seems to acknowledge the problem goes beyond just providing a ride.
Exactly. It’s thinking about the whole patient and whole population and how do you scale a better outcome? It’s important that you can meet patients at the appropriate site of care. Yes, that means bringing patients back into the doctor’s office, but also leveraging these new tools that have been accelerated during COVID with virtual care and last-mile delivery, whether that’s food, companionship or prescriptions.
Uber Health has been willing to partner with a lot of companies, health systems, etc. What’s your overall partnership strategy?
Patients are served best when companies lean into their own strengths and figure out how to come together and solve a real issue. That’s why you’ll see us continue to lean into partnerships. It takes a special skill to manage each of these benefits and components of care. Where we see value is being the marketplace that brings these partners together to solve these access issues. You have a care team for a reason. You don’t go to a PCP when you need to see an orthopedic surgeon. We know what we’re good at, which is having our own marketplace of independent earners that are best for low acuity patients. We can take that same concept to build that marketplace of other specialists like Papa, ScriptDrop, and some of the others.
What advice do you have for health care organizations looking to solve transportation and other access-to-care problems?
As an operator at heart, where I lean in is on figuring out how to ease the operation of executing the strategy you are pursuing. A lot of players have been focused on social determinants of health. We’ve seen a lot of pilots with great results. What I’m trying to think about is how to make it scalable. We’re thinking about how to create the right operational workflows so you can connect those dots at scale. How do you make that work in practice?
