Credit: Quinn Dombrowski.
As more and more hospitals sign ridesharing agreements with Lyft and Uber, other executives are no doubt watching the trailblazers to see whether or not offering free services to the high number of low-income patients missing medical appointments because of unreliable transportation delivers a return on investment.
But a new study from Penn Medicine researchers published in JAMA Internal Medicine found that offering a free Lyft ride to Medicaid patients for an upcoming medical appointment did not, in fact, reduce the rate of missed appointments. At least it has not thus far.
The study, which included nearly 800 West Philadelphians who were patients with Medicaid at one of two Penn Medicine primary care practices, found that the missed appointment rate for those offered a free Lyft ride and those not offered a ride was virtually the same: 36.5 percent and 36.7 percent, respectively.
The findings suggest that ridesharing -- a relatively simple, inexpensive approach to address transportation barriers -- may not be the easy fix some believe it to be.
While it's a negative finding, the authors added that it can help inform future efforts to improve attendance rates, and address some of the social barriers that persist when it comes to caring for poorer patients.
Every year, around 3.6 million people -- many of whom are low-income -- miss their medical appointments because of transportation issues. Because of this, they often shift their care to more costly, acute-care settings out of preference and convenience. What's more, missed appointments have a negative effect on clinical productivity, and unused clinical space and staff time equate to loss of revenue.
Nonemergency medical transportation, or NEMT, is a Medicaid benefit designed to decrease transportation barriers. Yet despite its availability, many patients still end up missing their appointments.
The design of NEMT may be contributing to the problems, the authors found. It requires advanced scheduling, often days in advance, and pick-up wait times can be long. NEMT, which typically hires taxi cabs, also doesn't have the technology to track drivers to make sure they're picking up patients in a timely manner and taking them to the correct location.
More clinical trials examining the effect of interventions designed to address transportation barriers are needed, the authors said, as well as broad studies looking at interventions that address multiple social determinants which may be having an additive effect.