‘A Decrease in Need’: Home Care Agencies Face Less Profitable Transportation Lines Amid COVID-19

Over the past several years, many home care agencies have invested heavily in transportation business lines to help their clients stay connected and active within their communities. The industry’s turn to transportation has been so popular, that ride services are often seen as core offerings for many agencies.

But while transportation services remain important, the ongoing coronavirus emergency made those business lines less profitable in the near term.

Prior to the COVID-19 crisis, there was a clear effort to “Uberize home care,” especially in regard to on-demand transportation services. Now, that’s not so much the case, Kerin Zuger, chief of strategic growth at Right at Home, told Home Health Care News.


Omaha, Nebraska-based Right at Home is a home care franchise system with nearly 500 locations in the U.S. The company is a subsidiary of RiseMark Brands.

Often built on partnerships with Uber (NYSE: UBER) and Lyft (Nasdaq: LYFT), transportation services garnered a lot of attention in the home care world in 2019 and early 2020. In addition to keeping clients connected, agencies also saw transportation services as a way to keep clients safe after leaving the hospital while maintaining visibility.

Internally, transportation programs also helped keep workers happy, as many home care agencies used them to coordinate rides for caregivers going from client to client. Furthermore, transportation offerings additionally allowed for some agencies to begin dipping their toes into government money by making headway in the Medicare Advantage (MA) world.


In MA, transportation is covered for non-medical purposes under the new Special Supplemental Benefits for the Chronically Ill (SSBCIs) initiative.

But currently, the Centers for Disease Control and Prevention (CDC) is urging those who are 65 and older to stay home whenever possible. The CDC is doing the same for those who have an underlying health condition,too.

“I would speculate, as an industry, that there is going to be a huge decrease [in transportation line volume],” Zuger said. “CDC actually recommends not using services like Uber and Lyft, particularly for those over the age of 65. So with everybody right now referring to the CDC and their recommendations, that’s just kind of scary.”

Los Angeles-based 24 Hour Home Care, which has its own transportation platform — RideWith24 — was one of the first home care companies to get into the transportation business and to partner with a ride-sharing giant like Lyft. The agency provides professional caregiving services to older adults and individuals with developmental disabilities in California, Texas and Arizona.

24 Hour HomeCare has experienced the COVID-19 transportation fallout first hand.

“We’ve faced quite a few challenges,” Irene Perez, 24 Hour Home Care’s community partnerships coordinator, told HHCN. “We have seen a decrease in clients calling in for transportation, and we’ve seen a decrease in contracts and ride requests. And a lot of that was about clients feeling uncomfortable.”

24 Hour Home Care used to experience a volume of about 2,500 rides per month. That total decreased almost 50% to 1,300 in April, though it has since rebounded slightly to over 1,500 per month.

In order to curb some of its woes, 24 Hour Home Care has relied on its partnership with Heal, which is an on-demand doctor service. Heal does house calls for patients who can’t or aren’t willing to leave their homes for doctor visits, which is one of rides home care agencies used to facilitate.

Right at Home, like 24 Hour Home Care, has partnerships with Uber and Lyft. For its clients, Right at Home has tried coordinating rides ahead of time so they know who the driver will be.

Both companies also try to reduce risks in other ways, like ordering larger vehicles instead of more compact cars.

Otherwise, putting a caregiver or patient in a rideshare could be considered risky, given the inherent closeness between the driver and rider in most car situations — and the amount of potential exposure.

“I think one thing we want to emphasize with all of our clients is that we cannot eliminate risk — period,” Gavin Ward, a regional director of strategy for 24 Hour Home Care, told HHCN. “What we can try to do is mitigate risk.”

Relying on Lyft and Uber has presented other challenges as well.

If there are fewer Uber and Lyft drivers available — which there have been — that means longer wait times and less efficient transportation overall, which was one of the perks of transitioning to ridesharing in the first place.

More headwinds

Another headwind for transportation lines has been the uptick in telehealth.

Telehealth claim lines increased 8,336% in the U.S. from April 2019 to April 2020. It used to represent 0.15% of medical claim lines; it represented 13% of claim lines in April, according to new data from FAIR Health’s Monthly Telehealth Regional Tracker.

A claim line is an individual service listed on an insurance claim.

If patients can experience visits virtually more often, the transportation line is immediately devalued.

“Before the pandemic, we were seeing this really big shift to Uber in home care, right?” Zuger said. “It’s [going to] be interesting to see what happens to those organizations [who invested so heavily in that]. … I have to think that those types of organizations have seen a pretty significant decrease in need.”

Still, in the end, transporting caregivers, patients and resources will continue to be a need.

Companies will just need to increase their creativity for their transportation lines for the foreseeable future — especially if they view them as a crucial revenue stream.

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