Article July 27, 2018

Healthcare in Transit

As the elderly population in the US continues to grow, so too does the necessity for non-emergency medical transportation services to cater to this demographic in both urban and rural areas nationwide.

The transportation services provided by these companies are vital to the accessibility of routine healthcare services and survival of patients who otherwise would not be able to make it to routine medical appointments. Some of these potential barriers may include a lack of mass transit options and significant distances to their providers. In addition, a patient’s physical disabilities and/or financial circumstances can also further complicate access to these services.

The rising need for these services can be felt even more palpably in rural areas as these geographic regions statistically contain a larger portion of elderly inhabitants than do urban areas where providers are located at significantly closer distances. Further to this point, the geographic isolation of patients residing in rural areas typically carry with them the burden of more chronic health conditions, poverty and consequently, poor health outcomes.

To highlight this point, studies have uncovered that nearly four million Americans have experienced some type of transportation complications which have led to them missing scheduled appointments. This also levies a devastating blow to healthcare providers as no-show rates, in some instances higher than 30% have cost providers more than $150 billion per year.

The impact of patients’ inaccessibility to affordable and convenient transportation services has not gone unnoticed by the Tech industry, however, as we have recently seen on-demand transportation app giants Lyft and Uber make their entrance into the healthcare field. Lyft, working in conjunction with the healthcare information exchange platform Allscripts have partnered to integrate “ride-hailing functionality” into AllScripts database platform which will allow for nearly 200,000 providers to request transportation services for their patients through the Lyft application. Similarly, Uber has recently launched Uber Health which deploys a comparable ride-hailing functionality for the patients of its partner healthcare systems, most notably MedStar and LifeBridge.

Uber and Lyft’s presence in healthcare transportation may well prove to be an effective remedy to an ailing community of patients who otherwise would have less accessibility to healthcare appointments and quality outcomes. However, this does not come without the gleaming risk exposure that current and longstanding emergency and non-emergency medical transportation services are faced with on each and every patient transport. Perhaps the most prevalent source of claims faced by these companies are the result of injuries sustained by patients during the loading and unloading phases of the transport. As many of the patients requiring these services have significant physical limitations, this puts the onus on the company to ensure that all employees have been properly trained to perform these tasks. Other sources of claims in this class which may lead to a sustained bodily injury by the patient(s) in transit include but are not limited to collisions with other vehicles or objects, failing to secure or improperly securing a patient to their seat, failing to properly secure wheelchair bound patients, the improper use of chair lifts and potentially leaving patients in extreme or unsafe conditions unattended.

With these risk factors in mind, it will be the responsibility of tech companies like Lyft and Uber and surely many others who follow suit to ensure that they are employing competent, well-trained and vetted employees who are only providing transportation services to patients which are in line with the safety installations of the vehicle they are operating, such as four-point tie downs for wheel chair and stretcher bound patients.

Overall, this industry class will only continue to be relied upon as a necessity in the years to come and it is primarily important for providers in this space to hold its employees to the highest standards of training and risk mitigation. Non-emergency transit appointments have the potential to quickly escalate into emergency transports due to an unexpected change in the patient’s condition along the way which, if not properly handled, can lead to a delay in services that may subsequently lead to a loss of life. It is also crucial for insurance brokers who will be placing coverage for non-emergency medical transit companies to fully understand the risk exposure presented by these companies and ensure that the carrier will not be excluding claims for some of the fundamental services provided, such as loading and unloading.