For sufferers of the Neighborhood of Hope and Mary’s Middle clinics in Washington, D.C., attending to their medical appointments generally is a problem — many reside removed from public transit or lack automobiles. In the event that they’re pregnant, the fallout could be particularly dangerous in the event that they miss prenatal physician visits, risking the newborn’s and mom’s well being.
That’s why ride-sharing firm Uber, which has for years been looking for a viable manner into the $4 trillion well being care market, swooped in to supply tons of of pregnant sufferers in D.C. free rides to appointments in 2021 and 2022. Uber says sufferers who participated within the pilot had been barely extra prone to get prenatal care, and it’s purchasing the information round to insurers in a bid to get them to pay for the service.
Medicaid plans sometimes supply sufferers a profit protecting non-emergency medical transportation, but it surely usually requires suppliers to name right into a third-party dispatch service that may be tough to coordinate with sufferers in actual time, Neighborhood of Hope perinatal care and transportation coordinator Hannah Low instructed STAT.
Utilizing a client app like Uber may make the method of organizing and taking rides simpler each for employees and sufferers — particularly when clinics have a chosen trip coordinator to information them, she mentioned. “I can get on a name with a affected person and discuss by way of, ‘that is the place the automotive is,’ or sufferers will name me and say, ‘I can’t see the automotive,’” she mentioned. “You don’t essentially have that capability should you don’t have an individual who’s ready to enter the system and try this.”
The stakes for lacking prenatal appointments are excessive, particularly as maternal mortality charges surge yr over yr; america has among the many worst charges for top earnings nations. Black and Indigenous girls are two to 3 occasions extra probably than white girls to die from pregnancy-related points, in response to Facilities for Illness Management and Prevention information.
“The implications of not getting prenatal care are devastating,” mentioned Sarah Coombs, director for well being programs transformation on the Nationwide Partnership for Ladies & Households, which was not concerned within the pilot. Other than troubling maternal mortality dangers, infants whose moms don’t get prenatal care are extra probably than different infants to expertise issues, she mentioned.
Uber isn’t the one tech firm searching for to deal with missed appointments. Some, like Babyscripts, supply digital blood strain cuffs and scales to make it simpler for clinicians to observe pregnant sufferers, particularly once they can’t make in-person appointments. Clinics providing Babyscripts to their sufferers instructed STAT earlier this yr that the gadgets may assist scale back emergency division visits later in being pregnant.
However clinics that deal with largely low-income and underserved populations are restricted by what insurance coverage corporations comply with pay for, as a result of they and their sufferers may not have sufficient money to pay for providers out of pocket. And convincing insurers to supply new advantages takes time, Coombs mentioned.
“It’s a return on funding. They’ve to point out proof that it really works, proof that it saves cash, proof that it really works throughout the nation.”
Contained in the pilot
In the midst of final yr, a well being habits analysis firm referred to as Surgo Well being approached Uber with the concept for the pilot. The objective was learning the impression of geography on well being inequities; some members of Surgo’s board knew folks at Uber, which was keen to soak up the price of rides briefly. Uber’s social impression crew additionally labored on the pilot.
“It’s actually apparent that the areas which can be the best threat, the place well being inequities are taking place, are distant from hospitals and never at all times tremendous accessible through public transportation,” mentioned Hannah Kemp, a vice chairman at Surgo.
Between January 2021 and June 2022, Mary’s Middle and Neighborhood of Hope supplied roughly 450 sufferers about 4,500 free Uber rides, both by way of a particular app for coordinators or by giving sufferers a voucher they may use on their very own apps. Rides to and from may run as much as $200, Low mentioned.
A lot of the legwork fell on trip coordinators, who spoke to sufferers often and understood their particular person challenges, reminiscent of whether or not they most popular textual content messages or relied on a landline. “Having somebody embedded within the clinic who can discuss to a affected person about their rides and their appointments and no matter care coordination wants they’ve is admittedly particular,” Low mentioned.
Nonetheless, sufferers ran out of minutes or modified telephone numbers, and it wasn’t at all times straightforward to succeed in them, Low mentioned.
Surgo and Uber mentioned the pilot elevated appointment attendance amongst individuals who confronted transportation challenges by about 5 proportion factors, and that about three-quarters of sufferers mentioned it could be harder to get care with out the free rides. Sufferers additionally mentioned they saved an hour of time per appointment throughout a complete of a couple of dozen prenatal appointments.
Following the conclusion of the pilot, some state Medicaid plans and managed care teams have agreed to pay for the service, however Uber’s objective is to get extra of them to take action exterior the scope of the pilot, mentioned its international head of well being, Caitlin Donovan. “We consider in a world the place you don’t resolve an issue grant by grant, examine by examine.”
Now, Uber’s “spending a variety of time speaking with Medicaid plans about easy methods to construction that [transportation] profit design, and easy methods to administer that profit,” Donovan mentioned. “Existence of the profit alone will not be sufficient.”
Nonetheless, merely administering rides isn’t sufficient to deal with troubling maternal mortality charges and racial disparities going through low-income sufferers, Katherine Hempstead, senior coverage adviser on the Robert Wooden Johnson Basis, instructed STAT. “After all the standard of prenatal care issues too, which is an issue that may’t be solved with transportation.”