Patients turn to Uber, Lyft for medical transportation

Although some transportation companies are dedicated to medical rides, many patients are turning to ride-hailing services like Uber and Lyft to take them to EDs, kidney dialysis, cancer care, physical therapy, and other types of medical visits.

Some of these rides are also over long distances, especially as more rural hospitals close and patients must commute two or more hours to reach treatment facilities.

According to data from Lyft, their drivers completed thousands of rides that were greater than 50 miles each way to medical treatment centers in Atlanta between April 2022 and April 2024. Although 75% of these trips were under 100 miles, 21% were between 100 and 200 miles, and 4% were over 200 miles.

Currently, some insurance companies, cancer treatment centers, Medicare Advantage plans, and state Medicaid plans pay for ride-hailing services for their patients to reduce the number of missed appointments, said Krisda Chaiyachati, an adjunct assistant professor at the University of Pennsylvania medical school.

In 2024, 36% of individual Medicare Advantage plans and 88% of special needs plans offered patients transportation services. A report from HHS also showed that, between 2018 and 2021, Medicaid paid for up to 4 million beneficiaries to use nonemergency medical transportation services each year. Patients who lived in rural areas used ride-hailing and nonemergency transportation services at the highest rates.

According to David Slusky, an economics professor at the University of Kansas, Uber and Lyft rides can save both patients and insurers money since they cost a fraction of the typical ambulance ride fee. In a study by the Texas A&M University Transportation Institute, researchers estimated that the total federal and state investment in nonemergency medical transportation was around $5 billion in 2019.

Challenges to medical transportation services

While some insurers cover medical transportation or organizations offer free rides, social workers say that many patients are still left without a way to get to their medical appointments. According to a study from the Robert Wood Johnson Foundation, 21% of adults nationwide who did not have access to a vehicle or public transport went without needed medical care in 2022.

"The ability to get to a doctor's appointment can be a barrier to care," said Rochelle Schube, a cancer support group facilitator in Atlanta. "If I give a patient $250 in Uber cards and they live far away, that gets spent quickly."

Rural areas that need more transportation services may also have fewer of them available, furthering complicating access to medical care. "When you move to rural areas — which you could argue have a higher need — you see fewer services," Chaiyachati said.

In addition, not all ride-hail drivers are comfortable transporting medical passengers who may need additional assistance, especially since they are not paid extra to accommodate these riders.

"It can be stressful," said Damian Durand, a ride-hail driver. "I do feel like Uber and Lyft are trying to catch me off guard. When I can see that the ride is going to the hospital, I try to avoid or cancel the ride."

Rather than relying on ride-hailing services to get patients to their medical appointments, Timothy Crimmins, a history professor emeritus at Georgia State University, said the state should expand Medicaid, which would help more rural hospitals stay open and allow citizens to seek medical care closer to their homes.

According to KFF, over 1.4 million Georgians have been left without health insurance since state lawmakers decided not to accept a federally funded expansion of Medicaid. Rural hospitals have also been negatively impacted when these patients use their facilities and then cannot pay their bills.

However, until more patients are insured, Crimmins said that Georgia should subsidize ride-hailing services for less prosperous patients who need help getting to Atlanta for medical care. "We might be talking about $100 to $150 round-trip," he said. "That can be subsidized." (Scaturro, KFF Health News, 10/17)

Explore our Lessons from the C-suite series with  Bassett Healthcare CEO Dr. Tommy Ibrahim to discuss how rural health provides a natural incubation ground for digital health, and how Bassett is charting the future course for U.S. rural healthcare.