We spoke with the head of Uber Health about how his team built a healthcare organization within a $70 billion tech company

Although the healthcare industry has been notoriously resistant to change, its transformation at the hands of digitization has recently picked up pace. With that shift, nontraditional players are starting to see new openings to establish a presence in the lucrative industry.

One such area where these firms are stepping in is transportation. Because access to affordable and convenient transportation so heavily impacts public health - transportation issues cost the US health system around $150 billion annually - improving the process for patients has captured the attention of healthcare providers. Tech-facing transportation companies like Uber and Lyft have seen this as an opportunity to leverage their reach and advanced technical capabilities to help get patients to appointments and, in turn, tap into a multibillion-dollar nonemergency medical transport (NEMT) market. However, entering a space as complicated and heavily regulated as healthcare doesn't come without challenges, even despite the industry's newfound openness to digital innovation.

Business Insider Intelligence recently spoke with Dan Trigub, head of Uber Health, to discuss how his team built out the ride-hailing giant's health service, which officially launched after a year of development in March 2018 at the annual HIMSS conference. We also delved into what Uber Health's advantages may be over competitors in NEMT, a business Trigub estimates is a $15 billion adjustable market, and what's next for the unit.

The following has been edited for brevity and clarity.

Business Insider Intelligence (BII): Can you give us a little background on how the Uber Health service works?

Dan Trigub (DT): There are two ways that our service can be accessed, and both are through a B2B relationship - we develop partnerships with payers and providers directly. Uber Health is not intended for direct consumer use. The main reason we do this is because care professionals have teams of case managers and clinicians that can tap into the specific needs of patients - we never suggest that Uber is going to be a good fit for the entire patient population. We empower our partners to make decisions on who is the right person to put into an Uber, and at that point, they can schedule ambulatory curb-to-curb rides for their patients directly from our web portal.

The other way to access our services, which is where we see the future going, is deep API integrations - embedding our HIPAA-compliant API within the workstream of our partners that already exists. So it could be with a traditional electronic medical record (EMR), mobile apps, or other types of software that our partners utilize.

BII: How does the transaction work? Are patients billed directly?

DT: Our business relationship is with our partners - whether that's the provider, payer, or NEMT broker - we have a billing relationship with them. We track all of the rides we do with our partner and we send a monthly invoice to them. It's up to them to do what they would like to do from there, whether they submit that for reimbursement from Medicare and Medicaid or eat the costs themselves. For example, many health systems spend millions of dollars a year out of their own pocket on taxi vouchers. By leveraging Uber Health, they are able to save a significant amount on costs because we are 30-40% more cost-effective than the traditional livery operator or taxi provider, so they'd rather pay out of pocket for our rides. And then we have other partners who offer transportation as a value-add service to those that they care for, so they might pass the cost to their patients. It's really up to our partners.

BII: As you began to build the service, what did that look like? Are you developing your current workforce, or are you looking externally to bring in professionals with healthcare experience?

DT: In the year prior to HIMSS we spent a significant amount of time with about 100 beta partners who were utilizing our solutions and our platform, in order to specifically build our service for the healthcare industry. We knew we wanted to be deeply embedded with providers and payers, so we engaged a nationally recognized third-party, HIPAA-compliant solution provider. We worked with Clearwater Compliance to really make sure we did this the right way from the outset.

In terms of our workforce, it's certainly the combination of the two. We have folks who we brought up speed on the needs of our healthcare partners, but we also built a deep bench of professionals. We now have a tremendous team of people who come from healthcare, spending decades within the industry. Our teams and staff are fully trained internally; all of the people who work on Uber Health go through deep HIPAA training, security training, privacy training, all of these things that are required by our partners. Our team is very familiar with the obligations of business associate agreements (BAAs) under HIPAA. We've spent a lot in terms of building the right infrastructure and awareness around HIPAA obligations because HIPAA is an ongoing thing - it's not like one day you decide to become HIPAA compliant, flip a switch, and it just happens.

BII: Given how entrenched politics is within healthcare, has Uber Health done anything to keep track of the conversation? What are some things you've seen in the space that you've taken notice of?

DT: Absolutely, we have a strong federal policy team that we've spent a lot of time working cross-functionally with. We also brought in regulatory professionals and compliance professionals who work directly on Uber Health.

A couple of things to that point, you've probably started to see regulation start to change, becoming more transportation network company (TNC) friendly. We absolutely commend Florida, Texas, and Arizona for what they are doing in changing regulation to allow ride share for trips from Medicare and Medicaid. Regulators are seeing, finally, that when it comes to reducing costs for healthcare, missed appointments are a huge factor. And when we look at things like social detriments of health, when we look at value-based care which is a huge part of the conversation, transportation is critical.

BII: How did you go about finding healthcare partners?

DT: What's really important to us, and why we have been able to build partnerships, is that we specifically designed the product for healthcare. So the way I always like to think about it is that we've built a healthcare organization within a $70 billion tech company. What that means is it's a fully HIPAA-compliant platform where it provides comfort and it provides everything that our partners need when it comes to data security. Because of that, we get lots of inbound interest, though we also have a team of professionals who do outbound work. From that combination, we've been able to add over 1,000 partners that span the entire continuum of care. That includes payers, that includes providers, and that includes traditional NEMT brokers. So we have tremendous partnerships across all different verticals within the delivery of care.

BII: Speaking of data, now that Uber Health has indirect access to large patient bases through its partnerships, do you leverage patient information?

DT: No, because the way we've built our infrastructure, we're very HIPAA focused, so in terms of patient data it's fully anonymized on our back end. We can't look at specific patient data or any personal health information. That said, our partners can certainly leverage this. When we work with an organization like Boston Medical Center or work with a large payer, we share the trip-level information with them, and they have all of that data. So it's up to them - from our standpoint, we are just focused on transportation and being HIPAA compliant.

BII: The healthcare transportation space is quite competitive. What is your advantage over both new entrants and legacy players?

DT: First, I say competition is good - ultimately competition will help improve the experience for plan members and help drive down costs. From our standpoint, our global footprint, our infrastructure, and our resources are far greater than any other company that exists today. Simply, [Uber is] in over 60 countries, and we have a strong market share in all of those countries, so I think that is certainly an area that we see an advantage. Having the Uber platform that we can leverage - which continues to get stronger and stronger with the growth of our business - is going to positively impact Uber Health because we are leveraging the same resources and infrastructure.

While we are focused on ambulatory curb-to-curb rides, we at Uber also have one of the largest wheelchair-accessible vehicle (WAV) fleets of any ride-share company, and we also have something called uberASSIST where our drivers get third-party training and can do door-to-door transportation. uberWAV and uberASSIST are available in less than a dozen markets today, but those are growing over time, and eventually, we think we can do just not curb-to-curb rides but higher levels of transport as well.

And finally, the last thing I'm going to say goes back to our HIPAA compliance and how we built Uber Health from day one, really designed for healthcare professionals and this use case.

BII: Looking forward, what does the future look like?

DT: I think for us, first and foremost, we're just at the tip of the iceberg; in the grand scheme of things Uber Health has only been around publicly for about a year now. And ride sharing in healthcare has only really been a talking point for the last three years. I think the future is where transportation, ride share specifically, is just table stakes. I think the future is definitely a world where NEMT will continue to be a covered benefit by Medicare and Medicaid plans, and ride share will provide most of that benefit. The regulatory environment is evidence of that. When the Centers for Medicare and Medicaid (CMS) first put out regulations for NEMT, it was in a world before ride share ever existed. They never thought of a TNC model for a company like Uber, and I think now they are really starting to incorporate it.

The other piece of the future is meal delivery. Medicare Advantage plans are now incorporating meal delivery and grocery delivery - I think there are some interesting things that we can potentially do there in the future. Uber Eats is the largest meal food delivery platform in the world outside of China - can we leverage that to get a hot, healthy meal to someone in an area without access to fresh food? Certainly Uber started with our rides business, but when we look at all of the things we are doing beyond just that, pharma delivery and durable medical equipment (DME) delivery are things that are certainly interesting to us.