AUSTIN — 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.

LogistiCare and MTM, Inc. — two of the state’s largest Medicaid transportation brokers — declined to comment on the bill. But a spokesman for MTM. Inc, said the company operates in 20 other states and some of them already allow rideshare.

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Across the country, states are frustrated with a lack of Medicaid transportation options that can mean long waits for patients, said Matt Salo, Executive Director of the National Association of Medicaid Directors.

While rideshare offers hope, Salo said, challenges exist too. For one, Medicaid patients can range from healthy adults and children to those with serious disabilities, who require specially outfitted vehicles or trained staff.

“Getting to the doctor when you’re in a wheelchair, you’ve got to make sure the physical transportation is adequate,” Salo said. Similarly, not all patients have smart phones, which are typically used to hail a rideshare service.

But Phelan said the bill addresses both those concerns by putting Medicaid managed care companies in charge of coordinating the rides and leaving transportation firms in place, so those with complex medical needs still have options.

He predicts, however, that more rideshare companies will add adaptive vehicles if the bill becomes law.

Uber concedes its service isn’t suited for all patients. But the company has already started developing a fleet of drivers trained to work with patients who have fold-up wheelchairs, walkers and scooters, said Head of Uber Health Dan Trigub.

The company is already active in Texas, he said, shuttling some patients to addiction treatment and others to clinical trials at a hospital.

“We're seeing a lot of these states like Texas be very progressive around this,” Trigub said. “They realize the unique model of rideshare, not only for cost, but the overall experience level ... for the member.”

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In a statement, Lyft said that it applauds the effort to “help millions of Texans on Medicaid access expanded transportation services for their health care needs.”

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.”

The bill has yet to come up for a public hearing. The Texas Health and Human Services Commission, which oversees Medicaid, is currently analyzing the bill for the fiscal impact, said spokeswoman Christine Mann.

With some 120 House members backing the measure, passage seems certain. It remains to be seen, however, whether the policy gains traction in the state Senate.

Phelan and other sponsors see the opportunity for greater accountability, since most rideshare companies use GPS to track their trips and then send an immediate electronic receipt. And they hope to cut down on the patient wait times and make it easier for parents to bring children to an appointment when daycare isn’t available. Phelan cites a study published this year in the American Journal of Public Health that found ridesharing has the “potential to generate substantial cost savings” and improve patient experiences.

“We didn’t have smartphones when this model was created,” Phelan said. “The technology is there to make this an easy holistic approach to transportation.”

amorris@express-news.net