In the United States, 10,000 people turn 65 each day, and around 80 percent of that aging population live with at least one ailing condition. As the country continues to grow older, the elderly face health problems and social isolation that are exacerbated by transportation hurdles.
Fortunately, the growth of ride-share provides a solution to some of these issues. Dan Trigub, the head of Uber Health, leads the segment of the company that is soon to have a much larger presence in Dallas. He has been in a variety of healthcare and ride-share positions, but has personal experience with the challenges to an aging population when he was the caretaker for his grandmother, who lacked a driver’s license and was often confined to her apartment in old age.
Trigub says that Uber Health’s genesis occurred when a physician at Boston Children’s connected with Uber to see if he could send providers into the field to deliver flu shots into the community in 2015. After a few thousand flu shots were delivered this way, Uber Health was born as its own business.
The independent LLC is under the Uber umbrella, and built a HIPAA compliant platform for healthcare professionals to be able to order rides on behalf of patients. Trigub says this is more efficient and safe than the normal discharge process which usually involves a bus or taxi voucher. Through ride-share, providers can see that the patient actually made it home, which doesn’t usually happen with a taxi or bus. It avoids fraud, waste, and adds a layer of accountability that is an improvement on other methods of transportation, Trigub says.
Most people interact with Uber through the app, but for a patient base that is often older and not as familiar with technology, the rides can be arranged through a text message or landline as well.
Often times, hospitals provide taxi transportation out of pocket, but Medicare Advantage plans regularly pay for non-emergency medical transport, which can pick up the tab for ride-share as well. Around one percent of Medicaid is spent on non-emergency transportation, around $4 billion a year, and using the service could improve quality and reduce costs, Trigub says.
As payers become more creative in addressing upstream costs of the healthcare system, they may begin to pay for rides for isolated seniors to church, social events, the grocery store, the pharmacy, or other places that help address the social determinants of health, with outsized downstream impacts in healthcare costs. Regularly taking medication, making it to preventative or follow-up appointments, as well as proper nutrition are all impactful ways to avoid return trips to the hospital, which is costly for Medicare and the entire system. “Insurance companies are looking to pay to get them to social activities, which can have a profound impact,” Trigub says.
Uber Health is available wherever Uber is in service, and the drivers don’t know whether it is a normal ride or being booked through Uber Health. Some markets have wheelchair accessible Uber vehicles, and others have Uber Assist, which has trained drivers who help those with disabilities get into vehicles and deal with wheelchairs, walkers, and scooters. Uber Assist and wheelchair accessible vehicles are not available in Dallas, though there is Uber Comfort, with larger vehicles and more leg room.
Trigub says he has seen a 400 percent of growth in the business since its beginning, and as payers and providers continue to be more cost-conscious, ride-share and healthcare partnerships will only grow.
That said, Uber has seen a number of unfortunate headlines in recent months. Despite the $24 million the company received in incentives to bring 3,000 employees to Dallas, investors are starting to doubt the sustainability of the business model. After several years in business, Uber posted a $3 billion loss in operations in 2018. More worrying for the vulnerable population that may take a Uber Health ride, the latest safety report said that there were 6,000 incidents of sexual assault in Uber rides between 2017 and 2018. There were also 464 rapes, and 16 deaths, even though 99.9 percent of rides were free from any incident. Uber says it is revamping its background check system and adding other security measures such as an emergency button to notify police if an incident is occurring.
Uber Health could be a great solution to add safety, reduce costs, and open up opportunities for North Texas’ isolated seniors. Let’s hope they hang around long enough to make an impact. “We want to better serve our most vulnerable populations,” Trigub says. “It can provide independence, and allow seniors to not be socially isolated and access care.”
