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National Association of Medicaid Directors

Rideshare for Medicaid?

This could make sense.

Rep. Dade Phelan

Texas would soon start relying on Uber, Lyft and other ridesharing services to shuttle Medicaid patients to and from the doctor, if a new House bill becomes law.

The state is one of several eyeing rideshare as a way to save money and ensure Medicaid patients make it to their health care appointments. Each year an estimated 3.6 million people delay or forgo care due to lack of transportation, studies have found, leaving providers with cancellations and patients with potentially more costly medical issues in the future.

“It’s about better outcomes for patients, health care providers and, at the end of the day, much better outcomes for the taxpayers,” said state Rep. Dade Phelan, R-Beaumont, who authored the bill, HB1576.

The proposal, which has wide support in the Texas House, comes roughly a year after Uber and Lyft broke into the health care market with services that let hospitals order rides for patients. With some 4.3 million low-income residents on Medicaid, most of them children, the bill could dramatically expand the business in Texas.

The state already pays several transportation firms roughly $160 million a year to arrange free rides for Medicaid patients to visit the doctor, dentist and pharmacy. But the trips must be scheduled at least two days in advance, Phelan said.

His bill would let Medicaid managed care companies order a ride for patients who can’t give advanced notice, including those who come down with a sudden illness or are discharged from the hospital early. The legislation would also let the existing transportation firms use rideshare, in addition to their own vehicles.

[…]

Under the bill, Medicaid managed care companies would take on the responsibility of ordering rideshares for patients. The Texas Association of Health Plans, which represents many of the managed care companies, didn’t return a request for comment.

Hannah Mehta, with the group Protect TX Fragile Kids, said there’s no question the Medicaid transportation system needs improvement. A 2017 report by the Legislative Budget Board found the shifting of rides to private firms increased costs and client complaints, while decreasing access.

But Mehta is worried about handing the coordination of rideshares over to Medicaid managed care companies, which a recent Dallas Morning News series found have denied patients critical care. Mehta, whose son is covered by Medicaid, also questioned which patients would qualify and how that would be determined.

“Accessibility is a great goal,” she said. “But the devil’s in the details.”

Here’s HB1576, which as you can see has a slew of co-authors. The story notes that ensuring accessible rides for people with disabilities would be necessary; having the managed care companies in charge of arranging the rides, which would include the existing transportation companies as options, should handle that. The basic idea here is to make transportation to medical services for people who need it easier to arrange, which is something Uber and Lyft are good at, and presumably also to reduce costs. This at least sounds good in theory, but we’ll see how it develops.