Paratransit Agencies Find Scale & Efficiency in New Assisted Rideshare Service Model

The world of public transportation is undergoing a longevity transformation. As America’s aging population looks to age in place, localized paratransit programs are becoming a hot topic. Paratransit programs are designed to serve individuals with disabilities, older adults, and folks requiring additional support to carry out daily acts of living via ADA transportation services. 

These services are a cornerstone of accessibility and independence, yet if you talk to riders, it’s clear that traditional models often lack the responsiveness, equity, and quality that users see tangentially in traditional transit services.

It’s time for a fresh look at Paratransit.

Enter Companion Rides, an FTA and ADA Compliant assisted rideshare service revolutionizing the way paratransit agencies deliver fast and efficient service. The Companion Ride model, brings the flexibility, efficiency, and immediacy of a demand response program, to paratransit riders at scale (and without the capital intensive investment). Similar to traditional rideshare, Onward hires drivers who use their own vehicles, reducing costs on agencies while quickly introducing resources. 

A new arrow in the ADA service quiver for riders and agencies alike, the model closes equity gaps by offering nearly on-demand service while simultaneously saving money for the agencies without compromising service delivery. The service currently compliments traditional paratransit offerings both at the county and municipality level, depending on the region.

Understanding Paratransit: A Critical Lifeline

Paratransit is federally mandated under the Americans with Disabilities Act (ADA), ensuring that individuals with physical or cognitive impairments receive transportation options equivalent to those available to the general public. 

While these services provide a critical lifeline for millions, they often come with a host of frustrations: limited availability, rigid scheduling, long wait times, shared rides that extend travel duration, and a lack of personalized care. The programs are typically managed by public transit authorities and operated on a reservation basis, requiring 1 to 7 days' advanced notice - an immediate equity issue. 

This is the exact intersection where Onward’s assisted rideshare model is driving change.

Why is the goal: “On-Demand” Paratransit?

Answering a question with a question seems appropriate here: Why should someone that needs extra assistance be required to plan their life movements 1-7 days in advance, while able bodied folks can order transportation in a matter of minutes? 

We’re building a more level playing field. It’s all about equity. 

On-demand paratransit combines the best of multiple business models to thread a needle that society has been asking for for years. Paratransit riders require personalization at scale and the agencies operating paratransit programs require efficiency and lower cost operating services to complement existing programs. It’s complex, but a win-win for everyone involved. 

Where Traditional Paratransit Falls Short

To appreciate the value of on-demand, technology enabled solutions, it's essential to understand the shortcomings of legacy paratransit systems. Quick caveat - the work that paratransit agencies and operators do is in many cases miracle making and we recognize that it’s the systems, not the individuals that need a refresh. 

1. Inflexible Scheduling

Booking a ride multiple days in advance can be unrealistic for older adults needing urgent doctor visits, same-day discharges, running last-minute errands, or even participating in social activities. While the service works for many scenarios, last minute just isn’t one of them. 

2. Long Wait Times

With multiple passengers to drop off, a trip that would take 15 minutes point to point can quickly escalate to over an hour.  Riders frequently experience 30 to 90-minute delays, or "window scheduling" that doesn't align with their medical appointments or personal obligations.  

3. Caregiver Communication Gaps

Without real-time tracking or consistent driver updates, caregivers and family members are left in the dark, creating anxiety around a loved one's safety and making planning impossible.

4. Inefficient Rider to Driver Ratios

Traditional Paratransit buses often provide many seats and 1 driver. This bus often carries 1-2 riders at a time. These buses are capital intensive, difficult to acquire, and the routes are often one-offs. Without looking at the data, we can all expect the service efficiency to be low. 

5. One-Size-Fits-All Approach

You wouldn’t be alone if you thought that supporting traditional transit programs such as bus, metro, rideshare paratransit vans and bikes, covers all of the bases, and while these great services that work well for many, transportation isn’t a one size fits all game and finding programs that close equity gaps is the name of the game. 

That paratransit cutaway buses for instance - these work in some instances, but in general, the population served by paratransit requires personalization at scale. Companion Rides are consistently matching drivers and riders based on spoken language, an impossible task with a bus, that helps deliver the personalization at scale that these riders need. 

If you’re looking for cost effective ways to support riders who require special accommodations with same-day rideshare service… You’re in the right place. 

Market Forces Outside of Paratransit - The Rise of On-Demand Transportation Models in Healthcare and PACE

Paratransit agencies aren’t the only industry in flux - On-demand accessible transportation, driven by demographic, economic, and tech trends has been adopted by healthcare and PACE programs too.

For providers, missed medical appointments are not just a patient care issue—they represent preventable readmissions that drive billions in lost revenue annually. For patients, they can mean limited access to care, missed appointments, delayed diagnoses, worsened outcomes, or unnecessary hospital admissions. 

• Aging Population: The U.S. Census Bureau projects that by 2030, more than 20% of the population will be 65 or older.

• Healthcare Complexity: Seniors and individuals with disabilities are managing multiple providers, therapies, and appointments.

• Tech Proliferation: Mobile apps and cloud-based dispatch systems allow real-time coordination across complex networks.

• Policy Pressures: Health plans and Medicaid programs are under pressure to reduce missed appointments and improve access to care.

The results are clear, on-demand paratransit provides a bridge to timely, dependable, and dignified care.

So Who Benefits from On-Demand Paratransit?

1. Older Adults

Many older adults lose driving privileges, live alone, or require frequent medical services. On-demand paratransit enables them to maintain independence and engage in their communities.

2. Individuals with mild mobility or cognitive impairments

Whether physical, cognitive, or sensory impairments are involved, individuals gain reliable, dignified transportation suited to their personal needs.

3. Caregivers

Caregivers gain peace of mind knowing their loved one is in capable, compassionate hands, without rearranging work schedules or taking time off.

4. Paratransit Organizations and Healthcare Providers

Agencies have a dynamic tool to support riders off route and off hours that doesn’t break the bank, Doctors, clinics, and hospitals reduce no-show rates and improve patient compliance with care plans.

Food For Thought

Consider an older adult who needs dialysis 2x/week. They use a walker and are usually physically weak after their appointment. If this individual doesn’t have a caregiver, their options quickly become scarce, uncomfortable, and financially burdensome. 

The Companion Ride model meets this moment by accommodating the right level of transportation and assistance for the rider and gives families and caregivers the peace of mind to know where a loved one is along their journey.

These aren't just convenience upgrades—they're life-changing interventions and they happen every day.

The Future Is Accessible Paratransit is On-Demand — and It's Already Here

So we’re on our soap box - On-demand paratransit is an important part of the infrastructure needed to support aging in place, reduce institutionalization, and empower individuals with disabilities to lead full, connected lives.

Communities and organizations that invest in flexible, technology enabled, and compassionate transportation solutions will find themselves not only compliant—but ahead of the curve.