The risks and rewards of rideshare in health care and human services

Over the last few years, health care and human services organizations have learned a lot about how the insurance market can influence their everyday operations—and it’s been a sharp learning curve. This is especially true as organizations look at their auto and fleet risks. Some industry leaders are looking at alternate solutions to handle patient transportation and ridesharing has appeared on the scene to be one such solution. On the surface, ridesharing seems to be beneficial for many organizations in terms of long-term financial costs and best practices for patient care. However, upon digging deeper, it can greatly affect their insurance program too—for better or worse. Before your organization moves forward with implementing this solution, there are four key risks and rewards you should keep in mind.

1. There are benefits in not fighting the auto insurance market. 
   As seen in Marsh McLennan Agency’s Q3 2021 US Business Insurance State of the Market Report, average auto liability rate increases of 10–20% and up continue to occur. Organizations with bigger fleets are more heavily impacted by this increased cost, though all will be affected regardless of size. For those working in the health care and human services industries, this can present challenges not only for the budget but also in bringing the best care to their patients. Many organizations do not have the option to move forward without transportation for their patient population because of its essential role in not only providing crucial access to care, but also in affording organizational staff more reliability and consistency in scheduling. Ridesharing can help bridge the gap between scheduling and staffing, allowing patients to make appointments without the need to alter personnel levels at care facilities. 
    

2. It’s important to understand the how ride share might affect risk in other areas and how your insurers will respond. 
   Ridesharing may positively affect automobile liability for organizations with fleets of any size. However, a ridesharing decision may modify other market risks in unexpected ways. Some unexpected impacts and risks may include:

   • Loss of quality control in transportation service 
     The drivers, vehicles, and branding are no longer part of an organization’s employee count, fleet, or mission—making them an unknown factor rather than a certainty.

   • Liability for assault or sexual misconduct 
     With ridesharing, the most vulnerable are now in the position of passenger and the direct risk is transferred from the organization to the ridesharing business—and entirely out of an organization’s control.

   • Third-party EPL claims such as harassment 
     Claims of harassment outside of ridesharing are already rising on a yearly basis in health care and human services and so, although expected, ridesharing may just be another door opening an organization to third-party claims.

   • Additional cyber liability exposure 
     In an already difficult cyber market, this may be the biggest hurdle to ridesharing solutions as increased flexibility and access is met equally by cyber risk and potential for devastating security breaches as patient information and other potentially sensitive data is also placed in the hands of a third-party.

   • Increased general liability exposure 
     You may need to reassess risks associated with loading and unloading patients with a trusted insurance broker to make sure that your coverage is where it needs to be. This is true whether transporting patients with internal resources or via a third-party.

   • Exclusions/limitations in insurance policies 
     Your current insurance policy may be the overarching challenge present in implementing this solution until you start digging into what your current limits are, what may be excluded, and what needs to be changed if an organization wishes to pursue a ridesharing partnership.

1. Not all contracts are created equal. 
   Specific ridesharing programs for human service and health care industries are alive and thriving but currently there is no baseline for what contracts look like to utilize these potential partners. A good contract can make all the difference in determining how risky the partnership is. To put it most simply: no organization can afford to overlook the contract risks. Before signing anything, the contracts should be carefully reviewed and you should fully understand how it affects your current insurance program. This deeper understanding and willingness to negotiate contract terms can make all the difference in whether ridesharing will be beneficial and a risk worth pursuing. Your broker can be instrumental in fostering better conversation with ridesharing groups and help you understand what the contract says about taking on more risk by using this patient transportation solution.

2. The math is not always simple. 
   There’s no denying it: the costs between insurance coverage, operations, staffing, and missed patient appointments all add up. The long-term effects of missed appointments can be significant, making reliable transportation key to better treatment and better patient outcomes. Depending on your organization and fleet size, implementing ridesharing can have varying impacts on insurance-related costs. Alongside the overall costs of risks, an additional factor to add to the calculation is the time and effort spent tracking vehicles. Organizations may handle vehicles in a variety of ways, but in general, there are two types of vehicles: corporate-owned and employee-owned. Employee-owned vehicles can pose a logistical nightmare for organizations, as dealing with individualized auto insurance plans and tracking maintenance adds greater complexity to the process. Health care and human services leaders could transfer the initial costs of oversight, management, and claims handling by transitioning employee-owned vehicles in their fleet to ridesharing partners, streamlining risk management, and affording organizations more valuable time with patients.

Overall, if the contract is good and the services are able to address your organization’s needs, ridesharing can create better long-term financial practices—but this is only after fully assessing the risks. Marsh McLennan Agency has a national footprint of experts who understand the health care and human services industries’ need to get creative with solutions.

Reach out to your local MMA representative or Senior Vice President of Business Insurance Steven Light with questions about ridesharing, contract review, and risk management solutions for your organization.