Health insurers are racing to roll out new digital tools that give them a deeper role in health care, aiming to reduce costs and improve convenience for consumers.
The latest sign is a new app from Anthem Inc.
that is set to be introduced next week in one state, but later reach the big insurer’s full geographic territory. The app will let consumers, including those who don’t have its insurance, schedule and pay for medical visits through their smartphones, as well as learn potential diagnoses and text with doctors.
Companies including UnitedHealth Group Inc., CVS Health Corp. and Cigna Corp. are all competing to introduce offerings that they hope will smooth the fragmented experience of getting and paying for health care. Often, such tools can also serve to steer consumers’ decisions about their care in ways that reduce costs.
“We want to be able to expand access to care and help with navigation, and we want to do it for all consumers, not just Anthem members,” said Rajeev Ronanki, Anthem’s chief digital officer. “Clearly, this is an opportunity to innovate on the business model.”
Insurers and employers have been offering remote access to doctors for years, via phone, messaging or video, with mixed results. A 2017 study in the journal Health Affairs found such services may actually increase costs overall, even though the remote visits are cheaper than in-person ones. A 2018 analysis by the Kaiser Family Foundation showed that the virtual visit services had very little uptake among workers with employer coverage.
Insurers say new services aim to go beyond one-off telemedicine encounters, with personalized doctor recommendations, online appointment-booking and pricing information, as well as a growing array of mental-health offerings. “How do we use technology to guide people to the care that’s best for them?” said Firdaus Bhathena, CVS’s chief digital officer. “We’re working on the actual connected end-to-end experience.”
This year, Humana Inc. started testing a new plan that links patients to primary-care doctors whom they can see for regular video visits, using Doctor On Demand Inc. Patients get tools including blood-pressure cuffs at home. The doctors get patient health histories from Humana, and they are supposed to track their care and coordinate follow-ups. Premiums for the digital-first plan are significantly lower than many competing products, Humana said.
Insurers hope to save money by using the digital services to promptly detect and respond to health problems that can result in costly emergency-room visits. They also want to use digital tools to steer members toward lower-cost care, including their preferred specialists, pharmacies and imaging centers. That would short-circuit hospital systems’ ability to refer patients to their own, often costlier offerings.
“If a plan can deploy consumer-facing interventions to reduce admissions, it saves money,” said Dan Mendelson, an operating partner at Welsh, Carson, Anderson & Stowe, a private-equity firm.
Oscar Insurance Corp., a smaller insurer that has focused closely on integrating digital care, recently did a test with about 1,000 members whose birth-control prescriptions were due to lapse. The women got a notice that they could use a virtual visit with an Oscar-affiliated physician to get the prescription renewed. About 8% did so, and roughly half of them moved to a lower-cost generic. Oscar said it saves between $120 and $150 when a member does a virtual visit rather than going to see a physician in person.
UnitedHealth points to an app called Recover, which it has been ramping up and will be offering in 25 major markets by the start of next year. The Recover app tells patients where they can go for various services tied to the surgery, such as imaging, and another app tells how much each will cost. Recover sets up text messaging with the surgeon’s office. After the operation, patients can use the app to take pictures of their surgical site that are analyzed by the technology. If there are signs of a problem, the doctor’s office is automatically alerted.
“The provider knows what’s going on in real time,” said Grant Verstandig, UnitedHealth’s chief digital officer. In a test with hip- and knee-replacement patients, the Recover app helped cut costs around 11% and was tied to reduced readmissions, the company said.
Anthem’s plan to make an app available to people who don’t have its coverage is unusual, because most insurers’ digital tools are aimed at their own customers.
Anthem said it would begin testing the app, currently dubbed CareSpree, in Indiana the last week of July, and later roll it out across its 14 main states, including New York, California, Virginia and Georgia.
The Anthem app will incorporate technology from K Health Inc., a New York-based startup. K Health uses a chat function powered by artificial intelligence to suggest potential diagnoses for consumers who enter symptoms and other information, then lets them connect with a doctor via text for follow-up advice. “The idea, front and center, is to make it really easy. Otherwise people won’t use it,” said Allon Bloch, chief executive of K Health.
Anthem’s new app will also tie in other features, including video doctor visits. For services including in-person doctor visits, magnetic-resonance-imaging scans and X-rays, the app will let users—including those who aren’t enrolled with Anthem—schedule appointments and pay a pre-negotiated price through their smartphones, though the list of options is limited to start. In Indiana, Anthem has cut deals with around 10 health-care providers, including some large hospital systems.
The same features will be made available in versions customized for people with Anthem insurance, but rather than a stand-alone app, they likely will be incorporated into other digital offerings, said Mr. Ronanki. For Anthem members, the app will tie into their health history and benefits structure, letting them pay out-of-pocket charges via smartphone. The insurer also plans to offer a new digital personal health record for its members, starting later this year.
Date: 24 July, 2019
Source : WSJ