Tag Archives: stroll health

Big Data? How About Quality Data?

While talking about data has become trendy — with terms like big data, small data, dirty data all good candidates for buzzword bingo — the reality is that, big or small, even if it is clean, data is useless unless it drives actionable insights.

Data is the foundational layer that underpins almost every industry, and it is a survival requirement for business today. Industries like retail, travel and finance have all tapped into the power of data to drive consumerization. And, while the health insurance sector may have fallen behind these industries, it is catching up, as today’s health insurance consumers are demanding actionable information in the form of choice, transparency and simple user experiences.

The good news is that innovators in the space are responding to these consumer demands by creating ground-breaking tools — tools that leverage modern technology, powerful software design and quality data. Today’s health insurance innovators are making waves in the insurtech industry by building products and features that truly solve consumer pain points.

So, who are these innovators? What are they creating? And why is the underlying data so crucial?

Who are the innovators?

According to CB Insights, $1.7 billion was invested in insurtech in 2016. Essentially, the insurtech category encompasses all new technologies, companies, apps and business models that are pushing to revolutionize the insurance industry itself. And, thanks to advances in technology and funding, this category is seeing rapid growth.

See also: Why to Refocus on Data and Analytics 

Jump Capital recently pulled together its view of the movers and shakers that are disrupting the insurance industry. With so many new vendors in the market, it is safe to say that there is definitely a lot of moving and shaking going on in insurtech.

These companies are finding different ways to meet consumer demands and remove the complexity associated with the insurance industry. The companies included in the healthcare segment of this infographic are, for the most part, delivering new ways to help consumers find, buy and receive health insurance. Collectively, health insurtech platforms answer a consumer cry for help. But none of these platforms are functional, let alone useful, without a foundational layer of quality data on which to build.

What are the innovators creating?

Health insurtech innovators are working to answer a variety of consumer demands. They’re creating tools that simplify the health insurance shopping experience. Tools that help doctors find prescription drugs that are covered by a patient’s insurance plan. Tools that help consumers find doctors that are in-network. The problems that these platforms solve are many.

Here are just a few examples of innovative tools and features being created to deliver value to health insurance consumers:

1. Decision Support Tools for the Individual Market

A variety of web-based entities (WBEs) have popped up to help individual consumers find and purchase a health insurance plan that is right for them. PolicyGenius is a good example of an innovative platform doing just that. The company prides itself on delivering simple benefits that are personally designed for the individual. A consumer enters a few bits of information, and PolicyGenius recommends health insurance plans for that individual — all delivered through a seamless digital experience.

2. Analysis Tools for the Small Group Market

Certain broker-facing platforms are starting to build analytical tools that help strengthen group health plan recommendations. These tools allow platforms to compare and contrast different health plans, including each plan’s network, aiding in disruption analysis and delivering value to their employer customers.

3. In-Network Provider Search and Notification Features

Many health insurtech platforms offer customers provider-network search and notification features. Stroll Health, for example, delivers personal recommendations for imaging centers based on a patient’s insurance plan. And some HR and benefits administration platforms now have the ability to notify employees if an employee’s preferred doctor drops out of network. Thoughtful features like these save consumers time and money.

See also: Next Step: Merging Big Data and AI  

Why is the data so crucial?

While data may not be the sexiest element of a tech platform, the data layer enables all features. For example, for those broker-facing analysis tools to be useful, the broker platform must have access to accurate and timely data on the benefits and rates of every health plan they’ll compare. For an HR and benefits administration platform to alert an employee when a doctor drops out of network, the platform must first know when that doctor drops out of network. This means the platform must have access to an accurate and extremely granular database of providers in the specific network being tracked. Quality data is what informs today’s innovators, pushing them to take action and build exciting applications that solve real problems.

Health is a complex space, but there are many brilliant minds working to improve the health insurance industry. Putting the right data into the hands of these innovators allows them to do what they do best — solve problems with creative technology solutions. Continuing to do this will allow today’s innovators to respond to consumer pain points and transform the health insurance industry.

Are Patients Ready to Take Control?

In 1980, the actor Steve McQueen traveled to Mexico to receive unorthodox (and ultimately futile) cancer treatment. The widespread coverage that McQueen’s trip received in the mainstream press can, of course, be attributed to his celebrity. But it was also because the actor had taken the reins of his healthcare from the medical establishment, something that was seen as brazen.

Back in those days, we wouldn’t have used the term “consumerization of healthcare” to describe what McQueen did. However, his approach has become an accelerating trend over the past decade, when Americans have taken more control over their health, and the healthcare experience. Consumers are more informed about choice, more demanding about the services being offered and more focused on how they pay for it.

The list of changes is long and growing, focusing on:

  • Wellness
  • Easily accessible online repositories of medical information and advice
  • Medical tourism
  • Physician ratings
  • Walk-in clinics at stores like Walmart and CVS
  • Health spending accounts
  • A proliferation of insurance options

As technology advanced, consumerization was enabled, and, as healthcare costs increase, it’s grown in importance. But the question remains: Do consumers have what it takes to control their health and healthcare as they both consume it and pay for it?

See also: Healthcare Buyers Need Clearer Choices  

What’s driving the consumerization of healthcare?

Thanks to the wealth of information available on the internet (product and service details, pricing info, ratings and reviews), consumers have more control over what they spend their money on, and where and how they spend it. Consumerization began with product shopping but quickly moved into the service sector (financial services, travel services, healthcare).

Whether consumers are covered by group plans in their workplace or by individual plans, they are paying more for their coverage and experiencing higher out-of-pocket costs. A recent Kaiser Foundation study showed that, from 2015 to 2016, deductibles increased by 12% for those covered by employer-sponsored plans. While deductibles have grown more rapidly than premiums – this is, after all, the tradeoff – premiums have still been rising more rapidly than wages. More now than ever, people are more conscious of what they’re spending.

Consumers have become more active

Today, consumers are increasingly relying on technology to manage their health. This trend cuts across generations. Baby boomers were perhaps the first truly “health conscious” cohort. Running, as a popular activity, took off on their watch, as did an interest in (and willingness to spend on) healthier foods. At the same time, boomers are focusing on the health and the healthcare experience of their elderly parents. Boomers are taking advantage of monitoring technology that enables them to keep a remote eye on their parents while helping them remain independent. Then, of course, there’s tremendous interest coming from millennials — digital natives who are used to ubiquitous technology and to shopping around and finding the best deals in all aspects of their lives. Millennials are more likely than boomers and Generation X-ers to own a fitness tracker, search for a physician online and base physician choice on reviews. Millennials are also more likely than other generations to go online and research a medical problem before consulting a physician. Technology, in fact, is bringing about a merger between health and healthcare. When employers are buying Fitbits and sponsoring wellness programs for their workforce, they’re hoping to achieve the dual benefits of healthier employees and more cost-effective healthcare.

There is a growing body of evidence that consumers want more active involvement in their healthcare, and the adoption of digital health tools and applications is a good proxy. For the past several years, Rock Health has surveyed consumers on their use of digital health. In a 2016 report, Rock Health found that 46% of those surveyed have adopted three or more forms of digital health tools. They’re using a fitness tracker, engaging in some form of telemedicine or contacting their physician via email or text message. The survey also found that the majority of Americans would like an electronic version of their healthcare record, and that, in the six months prior to the survey, 20% had requested or downloaded a copy.

Do consumers have the tools and knowledge to manage cost?

Consumers are showing an increasing willingness to take control on the payment end of things. But they may not yet be in a position to do so. Policy Genius, which offers online tools for buying all types of insurance, surveyed consumers on their understanding of some of the basic concepts underlying health insurance. Only 53% picked the right definition of “co-pay.” The term “coinsurance” was understood by just 22%. Roughly half couldn’t define “deductible.” So, while consumers may express a greater desire to take control of their healthcare, they may lack awareness and understanding of how to best utilize their insurance to pay for it.

See also: Consumer-Friendly Healthcare Model  

There’s an app for that

The good news is that technology applications are making consumer control possible. We’ve already seen plenty of apps that help manage so many aspects of health and the healthcare experience: apps for checking symptoms, chatting with a physician, monitoring medications, tracking vitals and even accessing healthcare records. Applications that focus on the cost and payment side of the equation have been slightly slower in arriving to market, but they are coming.
There is an emerging array of insurance-related (insurtech) apps that are making it possible for consumers to gain control of their insurance buying experience, apps that enable them to figure out whether their physicians are part of their network, whether their prescriptions are covered and just what that coinsurance-copay-deductible means to their pocketbook. These insurtech platforms include businesses like GetInsured, which helps individuals purchase the right health insurance plan; apps like Stroll Health, which brings transparency and efficiency to the imaging referral process by delivering personal recommendations based on what is covered by the patient’s insurance plan; and GlucosePath, an app that looks at the 6 million combinations of drugs available to treat Type 2 diabetes to find the regimen that is affordable (based on the patient’s insurance), effective and has the fewest side effects.

Given that Steve McQueen was famous and wealthy, he probably wasn’t worried about the cost or payment side of his treatment. But taking control of his own healthcare the way he did may have helped spark a major consumer trend. Today, consumers continue to push for active control in their health and in how they consume and pay for their healthcare. And, through technology, the healthcare industry is inexorably delivering solutions to fill any gaps that keep consumers from exercising even more control.