Missed medical appointments have negative effects on patient health and the healthcare systems that serve them, leading hospitals to search for new ways to boost attendance. Since a lack of reliable transportation can impact the ability of low-income patients to make their appointment – contributing to an estimated 3.6 million missed appointments each year – healthcare systems have partnered with ridesharing companies like Lyft to offer free rides to certain patients.
But how well is this initiative working? The results of a new study published in JAMA Internal Medicine suggest that providing Medicaid patients with a free Lyft ride to their appointments does not have a significant impact on attendance.
In fact, in a study of 800 Medicaid patients receiving healthcare from one of two Penn Medicine facilities in Philadelphia, the researchers found almost no difference between the rate of missed appointments between patients offered a Lyft ride, and those that weren’t. Patients offered free transportation to their appointment showed a 36.5 percent missed appointment rate, compared to 36.7 percent among those not given a free Lyft credit.
While ridesharing is a simple and relatively inexpensive solution to providing patients with transportation to their doctor’s appointments, the results of the current study suggest it may not be enough to improve attendance rates among certain patient groups.
“Transportation is often a barrier to care for many patients, but solutions that don’t address other barriers may not be enough to help patients get to doctor appointments,” said lead author Dr. Krisda H. Chaiyachati, a VA advanced fellow at Penn Medicine. “While it may be a negative finding, it’s an important one because it can inform future efforts to help improve attendance rates and highlights the complexity of social barriers when caring for poor patients.”
Before ridesharing was introduced, the nonemergency medical transportation program provided through Medicaid largely relied on taxi cabs. While it’s widely available to Medicaid patients, it’s been underutilized due to issues of convenience and oversight. Patients using this nonemergency medical transportation service are required to book their cab days in advance of their appointment, and administrators of the service aren’t able to track whether cab drivers are picking patients up on time and delivering on their side of the agreement.
Ridesharing apps like Lyft and Uber have appeared to be an ideal solution to this issue of missed appointments, as these services are trackable and less expensive when compared to cabs. In 2016, Circulation, a nonmedical emergency transportation company made a deal with Uber, while another medical transportation company, American Medical Response partnered with Lyft.
“One of the takeaways here is that we need to be thoughtful about how we design and test new programs that address social barriers to health care,” said senior author Dr. David Grande, an assistant professor of Medicine at Penn’s Perelman School of Medicine and a senior fellow and director of policy at the Leonard Davis Institute of Health Economics. “While we want hospitals and health systems to address patients’ social challenges that impact health – we need to rigorously evaluate new programs to make them successful. In this case, addressing transportation alongside other barriers could make a difference or doing a better job identifying who needs the services.”