The Impact of Ridesharing Platforms on Healthcare Access

Abstract

The vast majority of people in the United States do not access the recommended healthcare services, and missed opportunities for prevention are costing the country an estimated $55 billion annually. Healthcare access is particularly important for older patients, who face a higher risk of adverse health outcomes if potential issues are not detected early. The recent rise of ridesharing platforms has been proposed as one possible solution to the problem of getting patients to their healthcare appointments. This paper uses two exogenous shocks in Austin-the abrupt exit and re-entry of Uber and Lyft in May 2016 and May 2017-to investigate the impact of ridesharing platforms on healthcare access for Medicare patients. By comparing data from Medicare Part D claims in Austin and other cities in Texas, we find that while the initial exit of Uber and Lyft had an insignificant impact, their subsequent re-entry led to a 7.1% decrease in total claims filed by medical providers. We further show that providers with higher percentages of low-income patients, providers with higher health-risk patients, and providers who are less accessible by public transportation are disproportionately affected. We then demonstrate two ways that increased transportation costs, both financial and in terms of convenience, are important drivers behind the observed effect. First, using traffic data, we show that the presence of ridesharing corresponded to an increase in traffic, likely increasing the inconvenience of traveling to healthcare visits. Second, we provide evidence that the re-entry of Uber and Lyft negatively impacted nonprofit transportation organizations that serve older people and individuals with mobility problems. Our investigation of the mechanisms suggests that ridesharing platforms, aided by federal funding, need to devote more resources to bridging the gap between the transportation they offer and the nonprofit transportation they seem to be replacing.

Keywords: Healthcare Operations, Healthcare Access, Platform Operations, Empirical Operations, Natural Experiment