Dual-eligible enrollees — those covered by both Medicare and Medicaid — often face barriers to getting timely, high-quality care. Digital platforms like Zocdoc and Solv, or what some call the “OpenTable for urgent care”, could help by making it easier for patients to find providers and schedule appointments quickly.
The United States’ (US) health care system often falls short in delivering coordinated, accessible care for the 12.5 million dual-eligible Americans, who are typically older (65+), living with chronic health conditions or disabilities, and have limited income or resources. This is largely due to the combination of fragmented networks, unmet social needs, and provider shortages.
While only one solution, digital health care marketplaces can address many of these barriers to care.
Fragmented Networks
Despite ongoing reform efforts, dual-eligible enrollees still struggle to navigate a fragmented system. Medicare and Medicaid weren’t designed to work together and differ in benefits, provider networks, and eligibility — with state-by-state variation adding to the confusion. Integrated care models aim to streamline services, but currently reach few enrollees, and evidence of their impact remains limited.
Digital health marketplaces, like Zocdoc and Solv, help make it easier for patients to find care by allowing them to search for and book appointments with providers who accept both insurances. Zocdoc, founded in 2007, covers over 250 specialties and includes providers at federally qualified health centers. Alternately, Solv, a younger start-up, focuses on urgent care. Though, both platforms offer real-time appointment availability — often within 24 to 72 hours — shortening the long wait times many patients typically face. They also include features tailored to dual-eligible users: Zocdoc lets patients enter secondary insurance via intake forms, and Solv allows users to upload both insurance cards to their account.
Unmet Social Needs
Unmet social needs are widespread among dual-eligible enrollees and are another reason access to care is tricky. Factors like poverty, housing instability, limited digital literacy, language barriers, and lack of transportation frequently have led to delays or missed appointments.
While digital tools can’t eliminate all barriers, platforms like Zocdoc and Solv offer features that help some. Both platforms offer artificial intelligence assistants to support users with limited digital literacy and provide telehealth services that help reduce transportation barriers. Zocdoc further integrates with Google and Apple Maps to assist patients in navigating to in-person appointments. Zocdoc also provides multilingual support, provider filters for language and gender, and reviews to guide patients toward culturally responsive care.
Provider Shortages
Finding providers who accept both Medicare and Medicaid is especially difficult in areas experiencing provider shortages. One study found that a third of counties with the largest dual-eligible populations face significant primary care shortages—particularly in Southeastern states, where restrictive laws limit the roles of nurse practitioners and physician assistants. These gaps make timely care harder to access and leave patients with few alternatives.
While platforms like Zocdoc and Solv can’t directly fix this systemic issue, they do help patients navigate the options that are already out there. For example, in 2022, around 15% of Zocdoc bookings were made by federally funded patients, including dual-eligible enrollees, and over 85% of its providers (excluding mental health) accept Medicare or Medicaid. However, it remains unclear what percentage of these bookings were exclusive to dual-eligible enrollees. This data is not publicly available from Solv either.
Limitations
There are notable limitations to consider with these marketplaces.
First, there are few alternatives in the market, and limited evidence on how well these platforms perform. While one study suggests that booking through Zocdoc is associated with lower no-show rates, another study indicates Medicaid patients have fewer nearby appointment options than Medicare and private patients despite overall availability.
Second, because Zocdoc and Solv are primarily appointment-booking platforms, they do not provide ongoing care coordination and cannot address structural access or coverage issues. This requires legislative action from policymakers to strengthen existing programs.
Third, these platforms only seem to work if enough providers participate, but provider fees may continue to discourage involvement. Zocdoc now charges doctors between $40-140 per new appointment, a shift from their previous, controversial annual subscription fee of $3,600. While Solv does not publicly disclose its pricing, they report that fees are charged by location (rather than per user), with annual, quarterly, or monthly payment options available.
Lastly, there are still some usability issues with the platforms. For example, Zocdoc and Solv do not currently allow users to select multiple insurance providers simultaneously when filtering search results. Adding this functionality would significantly streamline the process.
Next Steps
With the dual-eligible population projected to grow by 6% annually—reaching over 15 million Americans by 2028—addressing these limitations is becoming increasingly urgent. Zocdoc appears to be moving in this direction by enhancing provider engagement through partnerships with the Department of Veterans Affairs, electronic health record systems, and practice management software companies. Solv, likewise, is broadening its reach, having partnered with the Urgent Care Association on a consumer awareness campaign.
Digital tools won’t fix a broken system—but they can make it easier to navigate. For dual-eligible enrollees, platforms like Zocdoc and Solv are helping bridge the gap between intention and access. With the right support, they could become more than just the “OpenTable for urgent care”—they could be the front door to a fairer, more connected health care system.
Research for this piece was supported by Arnold Ventures.
