Decreasing the cost of health care, one ride at a time

Getting to the doctor can be difficult. Making it to an appointment on time requires transportation, scheduling flexibility, and a certain amount of financial stability. For low-income patients facing all of these problems at once, setting and keeping appointments can be a daunting task. And the costs of failure add up over time, for patient and clinician alike—billions of dollars are lost annually when patients miss their agreed-on meetings.

A second-year medical student at Yale hopes to change that. Sumun Khetpal is a board director and one of the co-founders of Ride Health, a web-based, HIPPA-compliant company that seeks to eliminate physical barriers to patients’ access to health care, and use physicians’ time more efficiently.

“Almost 4 million Americans each year miss their appointments due to transportation,” says Khetpal. “Providers can’t bill for no-shows and lose almost $4 billion in revenue. And some estimates put the dollar cost to the system on conditions that develop or progress because of these missed appointments at $40 billion.”

Khetpal saw the need for Ride Health while a student at the University of Pennsylvania. Enrolled in a health care entrepreneurship class at Wharton, she was volunteering at the Children’s Hospital in Philadelphia one night when she encountered a family of three in the reception area.

“They were distraught, and I wondered what was happening,” says Khetpal. “Was it a medical emergency? The father said that their ride had cancelled, and they didn’t have a way to return home safely. It was dark and raining. As an undergraduate student, I had not encountered this situation before. It caught me by surprise.”

Normally, hospitals have institutional mechanisms for providing free transportation for qualified families. On that night, though, those options were all closed. “The hospital was out of vouchers. And Logisticare wasn’t running for some reason,” says Khetpal. She personally booked the family an Uber car back to their home.

Per their home page, Logisticare is the nation’s largest provider of non-emergency medical transportation programs for state governments. It offers other services as well, but attempts to accomplish a similar goal to that of Ride Health—improved health outcomes using affordable or free transportation.

A startup built by classmates

Imran Cronk, the chief executive officer of Ride Health, had a similar experience that led to his co-founding the company. "[Sumun and I] met at Penn, and both had experiences with the phenomenon of transportation issues as a barrier to effective health care," he said. "When I was a hospital volunteer five years ago in North Carolina, a patient who had been discharged from the hospital didn't have a ride home and the facility did not have the resources to help him out. I ended up driving him home, which got the gears turning in my mind."

Cronk, like Khetpal, sees providing disadvantaged patients with transportation assistance as a way of increasing access to health care. Ensuring that access makes health care lower-cost, higher-quality and more effective for those patients and the organizations that care for them.

"The overall goal is ambitious, but simple," said Cronk. "Every patient, everywhere, can access transportation to their medical appointments. Transportation can be the connective tissue of the system—and should be in place wherever logistical barriers prevent people from reaching care."

Ride Health now works with healthcare providers, health insurance plans, accountable care organizations (ACOs) and other organizations - including the American Cancer Society - across 18 states. It has provided thousands of rides to date, ranging from standard ride-share vehicles to ambulances with basic life support, and was a finalist at the 2018 Startup Yale competition.

An impact on New Haven health

Khetpal has been working hard to roll Ride Health out to needy communities in the greater New Haven area. It has reached agreements with behavioral health and substance abuse centers in Connecticut, expected to launch later in the fall of 2018, and the health care startup is live at the HAVEN Free Clinic, a student-run primary care clinic that provides uninsured adults in New Haven with treatment, free of charge. Earlier this year, for her efforts, Khetpal won the Audience Choice Award as a finalist at the American College of Physicians annual meeting in New Orleans.

According to Bradley Richards, MD, assistant professor of medicine in the Department of Internal Medicine and co-director at the clinic, Ride Health is operational and providing a useful service to people at risk of missing appointments due to transportation. “In terms of numbers we are at 60 rides since January at HAVEN,” said Richards. “We see how social determinants can have a really big impact on health, and this is one of those services that tries to address them.”

Richards spoke positively of Khetpal. “She hasn’t been here long, but she’s already made a positive impact.”

Cronk agrees. “Sumun is a terrific co-founder,” he said. “She’s involved with the company on a strategic level—helping steer the ship, essentially—but she’s still very engaged tactically, creating opportunities wherever and whenever she can.”

Taking care of local health needs is good, but Khetpal has grander ambitions. She believes that expanding Ride Health to take advantage of resulting cost savings could save lives, and increase the quality of life for thousands or tens of thousands of people. For Khetpal, this is just the beginning.