Gabriel Perna | January 20, 2021
Getting Americans vaccinated has proved to be much harder than many would have originally thought.
In the month or so since the COVID-19 vaccines were approved by the FDA, the rollout has not been as successful as public health officials would have hoped. Not only are fewer people vaccinated than was originally promised by now, but administration of the vaccination is far behind distribution. According to recent data, more than 31.1 million doses of vaccine had been distributed across the U.S., but just over 12.2 million shots have been administered.
With public health agencies starting to open the vaccine up to the general public, new challenges are starting to arise. Will there be enough vaccination sites? For this, the incoming Biden administration says it will use FEMA and the National Guard to build coronavirus vaccine clinics across the United States.
Once those are built, many Americans in underserved areas may still have trouble finding the transportation necessary to travel there. Transportation has always been a major social determinant of health—one study found that 25 percent of patients missed an appointment due to travel problems.
For this reason, Lyft Healthcare and other ride-sharing companies are launching significant efforts to help Americans with the transportation they need to get vaccinated. Lyft launched a vaccine access program with JPMorgan Chase, Anthem, the United Way and a number of other partners, with a goal of providing 60 million rides to vaccination appointments.
Lyft Healthcare Vice President Megan Callahan spoke with Health Evolution about this campaign, the biggest challenges in getting to 60 million rides, and more.
Health Evolution: What was the impetus behind this vaccine access campaign?
Callahan: We estimate 15 million Americans will face transportation barriers to getting the vaccine. This is above and beyond the tens of millions of Americans who are already using critical non-emergency medical transportation (NEMT) services through their health plan to get to/from medical appointments. Without access to reliable rides, these 15 million Americans — including seniors, uninsured and otherwise challenged members of communities in need — could fall through the cracks if we don’t step up and ensure they can get to their vaccination appointments.
This effort is designed to reach a lot of people because we’re tapping into the collective strengths and resources of both our corporate and philanthropic partners, such as JPMorgan Chase, Anthem and United Way as well as Centene, Epic and One Medical. It goes beyond donating rides — we’re creating an infrastructure where millions of people can donate rides through our customer, member and user networks. We believe this amplification opportunity of ‘people helping people’ is powerful.
Health Evolution: How do you define success in an initiative like this?
Callahan: The goal of this effort is to provide a total of 60 million rides to and from vaccination sites for low-income, uninsured, and at-risk communities. These rides will be facilitated through multiple channels:
Health Evolution: How long do you foresee the need to provide these rides for the vaccine campaign?
Callahan: This campaign is starting now and will kick into high gear as the vaccine becomes more widely available. We will provide rides for as long as it takes to ensure everyone who wants to be vaccinated has a reliable way to get there. We’re having lots of conversations with government and private health care stakeholders to ensure we can accommodate a variety of use cases for vaccine access.
Health Evolution: What are the biggest challenges?
Callahan: In a normal year, at least 5.8 million Americans delay or miss medical care due to a lack of transportation. We know that this past year has been anything but normal, so this number will grow. Unprecedented levels of unemployment and health safety issues facing public transit — coupled with the spike in demand due to vaccine availability — will lead to big challenges for traditional transportation solutions. This campaign is core to our mission of improving people’s lives through the world’s best transportation.
And from the conversations I’m having across payers, providers, pharmacies and states — there is wide variability in vaccine programs across the country. That lack of a uniform playbook increases the complexity of the logistical challenges to respond to this massive public health mobilization.
Additionally, there is a lack of clarity around who is paying for transportation to vaccine appointments when it’s needed, even among those Americans who do have insurance. We’re assuming rides for Medicaid beneficiaries will be covered under their normal NEMT benefit — but many do not use it so there is a need for general awareness and education. And for Medicare beneficiaries, we estimate that close to 10 million recipients face transportation barriers to care and have no NEMT benefit. As we know, seniors are a highly vulnerable population, so this is an immediate issue given they are eligible for the vaccine in Phase 1b. There is a need for a vaccine transportation funding for these populations and we’ve been very active in federal advocacy here. For health systems or providers that are conducting in-office vaccinations and states/municipalities that are organizing mass vaccination campaigns — none that I have spoken to thus far have the resources to provide transportation for those who need it.
Health Evolution: What have been the early results of your collaboration with Epic?
Callahan: In November 2020, we launched our Lyft for Epic integration, which allows health care staff to arrange a ride to or from a medical appointment directly from a patient’s EHR profile. This is important because more than 250 million patients have a current electronic record in Epic and nearly 30 percent of Epic customers already partner with Lyft for their NEMT programs. We are actively working with several of our existing health system partners to ensure they take advantage of this integration. We’re still in early days, but many large health systems like Ochsner Health, Denver Health, and Tampa General have already committed to using the integration. Epic has also signed onto our vaccine access program as a sponsoring organization, and we’re proud to work with them on this.
Health Evolution: What advice do you have for health system and payer CEOs who are looking to reduce the transportation barrier to care?
Callahan: We’re working with many forward-thinking policymakers and health care organizations who are looking for innovative ways to address inequities in our health care system. This spans typical patient transportation needs, as well as in-home care with things like food, equipment deliveries, and transporting clinicians or personal care aides. We’re seeing state Medicaid agencies investing in new pilots, and the federal government supporting waivers to facilitate more flexibilities like allowing NEMT providers to deliver meals. Health systems are also playing a central role in all areas of social determinants of health.
My advice to health care leaders looking for new ways to address barriers to care: tech companies can be the catalyzer for this innovation. We want to work collaboratively with these leaders to understand how we can offer reliable and cost-effective transportation options for patients and members. Together, this will allow us to meet the individual needs of those who lack access to transportation or healthcare goods or services, which will in turn lead to decreased overall medical costs.