For a group of Medicaid patients in Buffalo, getting to medical care is about to get easier, more efficient, and less expensive. The Greater Buffalo United Accountable Care Organization is now partnered with ride-hailing service Lyft to provide its most frequent users of emergency rooms and in-patient care with rides to more appropriate alternatives.
Chief Executive Officer Dr. Raul Vazquez said GBUACO was looking for a different approach to managing its “top utilizers” – 30 patients that use emergency rooms and in-patient care centers more than any of the company’s 10,000 clients.
As a Medicaid accountable care organization, GBUACO has a contract with Western New York-based health care company YourCare for a value-based pilot program – the only one in Upstate New York, according to Vazquez. The more GBUACO creates savings and meets metrics for quality, the more money gets returned to their network. That’s where ride-hailing service Lyft can be of assistance.
“What we’re trying to do is divert the patient from going to the emergency rooms, which – a lot of times – they’re there for the wrong reasons,” said Vazquez. “If you’ve got a sore throat, ear ache, things like that – the ER’s not the place to do that. But these patients, because of the social determinants of health, really never had transportation after hours or at times when they get sick.”
GBUACO worked with Lyft to create a special dispatch procedure for a month-long pilot program that begins immediately. Each of the top 30 utilizers has an individual care manager, known as a “navigator,” who can get in touch with the patient’s primary care provider to determine what services are necessary. Depending on the case, the patient will likely be taken to an urgent care center or an after-hours primary care doctor by Lyft. When the visit is over, Lyft will take them home.
Over the past four months, ER visits and in-patient care for GBUACO clients have cost the company a combined $3 million. After 30 days of use, and another 30 for claims data to be finalized, GBUACO will be able to see how much money has been saved in care costs down to the individual client level.
“So by 30 to 60 days we’ll know exactly where it’s at and then we take those resources and reallocate them to do the other things which are going to actually help us meet the quality measures,” said Vazquez.
Those “quality measures” are part of the next planned phase of the Lyft partnership – expanding to transport patients to primary care services such as going to a doctor for shots and other preventive medicine, secondary prevention such as mammograms and colonoscopies, and tertiary measures such as diabetes care – all aimed at cost-savings.
“So you’re not just getting these dollars and putting them in your pocket,” said Vazquez. “They’re actually helping you build infrastructure.”
GBUACO already works with care coordinator Greater Buffalo United Accountable Healthcare Network and uses their six transport vans to shuttle clients during daytime business hours. Vazquez said where GBUAHN stops at the end of business hours, Lyft can take over.