“They aren’t offering Uberlances or AmbuLyfts, but Uber and Lyft are among ride-sharing apps that are offering Florida lawmakers potential savings in costs if they are permitted to provide Medicaid patients with non-emergency medical transportation services.
Companion House-Senate bills that would authorize the use of ride-sharing services to shuttle Medicaid patients to and from doctor appointments as a way to save money and better ensure continuous care are poised for adoption this session.
House Bill 411, sponsored by Rep. Danny Perez, R-Miami, has been approved by three committees and could be adopted by the House as early as this week.
Senate Bill 302, sponsored by Sen. Jeff Brandes, R-St. Petersburg, has cleared two committees but has not advanced out of the Senate Rules Committee since it was moved there after the Senate Banking & Insurance Committee endorsed it in a 8-0 vote on March 11.
The Senate Rules Committee meets Wednesday. It is uncertain if SB 302 will be on the agenda.
Under the bills, ride-sharing apps could contract with managed care providers who then would use Medicaid funding to pay for the rides. Proponents say it would not only save money, but make it easier for patients to make doctors appointments, improving outcomes and, in the long run, also saving money.
Patient advocates say transportation is a challenge for a significant percentage of Medicaid recipients, often requiring them to spend hours on mass transit – where and when it is available – to get to and from a doctor’s appointments.
Studies say transportation-related obstacles make it less likely that these Medicaid recipients will see doctors regularly and more likely they will only seek help when something that could have been addressed at a less expensive earlier stage now presents a more expensive, serious medical problem.
According to a recent Clinical Research Center at Stanford study, transportation-related issues force an estimated 3.6 million Americans a year to delay or forgo care, leaving providers with cancellations and patients with potentially more costly medical issues in the future, ultimately costing the medical system billions.
A Tampa Bay Times investigation found that the Pinellas Suncoast Transit Authority pays about $1 million a year providing non-emergency medical transportation for patients who choose to use its services instead of waiting around for Medicaid.
The analysis revealed Tampa General Hospital must often delay discharging patients – extending expensive hospital stays – because it can’t get patients’ rides through Medicaid.
Rep. Perez and Sen. Brandes say their companion bills would provide on-demand flexibility and potential for cutting costs, noting ride-share companies are actively expanding their services to include medical transportation.
Uber and Lyft in 2018 both unveiled programs with services tailored to transport medical patients on-demand that would be available at hospitals, clinics, doctors offices and addiction treatment centers.
Uber and Baycare in Tampa are conducting a pilot program, and Lyft has partnered with nine health systems and 10 nonemergency medical transportation firms nationwide in test programs to provide patients with rides to medical appointments.
A January survey of more than 30,000 Lyft passengers and across 54 U.S. cities determined 29 percent used the ride-sharing app for “health-care trips.”
According to Lyft, the survey revealed nearly three-quarters of those “health-care” passengers said medical appointments are “less of a hassle since they started using the app.”
In addition, according to the survey, 28 percent said without the app, they would be “less likely to regularly attend medical appointments” and 36 percent said they have gone to urgent care less frequently since utilizing the app for Medicaid appointments.
A University of Southern California study that recently examined a Lyft health-care pilot program said the ride-sharing app improved quality of life for seniors by an overwhelming 90 percent.
Medicaid’s non-medical transportation program “has the potential to yield great cost savings” if technology could supplant traditional services, according to the Clinical Research Center at Stanford, which estimates allowing ride-share apps to be Medicaid transports could save taxpayers nationwide $4 billion a year.
According to a three-year Lancaster University study of more than 500,000 patients, missing doctor’s appointments posed a greater risk of premature death for all participants, compared to patients who made it to all of their appointments.
Those who had long-term physical conditions and skipped two or more appointments per year were three times more likely to die early, the study estimated.
Under HB 411/SB 302, service would be “curb-to-curb” as with any other ride-share arrangement, but rides would be scheduled through a managed care provider rather than directly through the app on a user’s phone.
Patients would get a text message containing information about the make and model of the car picking them up, the driver’s name and the estimated wait and travel time for the ride.
Of course, Uber, Lyft and other ride-sharing apps are not trying to enter the Medicaid transport business out of benevolence but because they believe it presents a lucrative opportunity.
Lawmakers questioned in committee meetings if allowing ride-sharing services to provide non-emergency medical transport would give them a toe-hold in the ambulance business.
To address that concern, the bills require ride-share operators to be affiliated with managed-care providers with contracts for non-emergency transportation negotiated with the state’s Agency for Health Care Administration [AHCA], which manages the state’s $28.9 million Medicaid program that services 4 million state residents.
Florida’s House-Senate bills are similar to a proposed bill in Texas. HB 1576, sponsored by Rep. Dade Phelan, R-Beaumont, would allow the state’s 4.3 million Medicaid patients to use ride-share apps to make doctor’s appointments and other medical commitments.