Ridesharing and Text Messaging for Patients With Medicaid—Further Information

To the Editor The Original Investigation by Chaiyachati et al¹ published in a recent issue of JAMA Internal Medicine examined whether medical transportation via Lyft could be a valuable tool in reducing missed appointments among Medicaid patients in a low-income area of West Philadelphia. As the authors¹ point out, transportation is a significant barrier to accessing health care, especially among low-income patients.² This trial¹ indicates that the high rate of missed appointments in an urban Medicaid population is multifactorial and highlights the complexity of unmet social needs in this population. Offering transportation to clinic appointments is not a panacea for complex transportation and social barriers. While some patients may have declined the Lyft intervention because they felt they already had access to suitable transportation, others may have declined owing to the necessity of using text messaging to access the ride.