Trade Voices—How tech corporations will help medical insurance leaders meet the COVID-19 problem


Again in February, I sat down to put in writing a name to arms for medical insurance expertise leaders. The time had come, I believed, to cease investing within the legacy applied sciences which have lengthy made interactions with well being insurers such a dreadful expertise for American customers.

I had a rallying cry raring to go: Let’s cease attempting to construct programs and options ourselves and as a substitute flip to exterior expertise companions. Let’s reorient our IT groups round enterprise and product outcomes. That, I assumed, was how well being insurers couldn’t solely enhance their reputations with customers but additionally make our members—more healthy and our healthcare system extra inexpensive.

A couple of weeks later, in fact, the world modified. By late February, all my prolonged working hours had been centered on supporting my crew in serving to 3.four million CareFirst BlueCross BlueShield members and greater than 5,000 colleagues grapple with a full-blown public well being disaster.

But whereas the disaster pressured me to put aside work on my manifesto, it didn’t weaken my conviction. If something, it has proven me it’s extra important than ever for well being insurers to shift away from expertise instruments constructed in-house and towards revolutionary options constructed by nimble expertise corporations. 

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The advantages of a expertise companion for well being insurers

Once we companion with expertise suppliers who perceive medical insurance, we are able to transfer rapidly to construct options that assist our members perceive their advantages and direct them to take actions that may enhance their well being on the lowest out there value.

Final yr, we invested in a brand new expertise platform created by an organization known as Zipari. It offers a brand new buyer portal, call-center expertise with a single user-friendly interface for buyer reps, and a wealth of different instruments that give us a holistic view of our members and a brand new suite of instruments for coordinating and optimizing our communication with them.

Constructing that expertise ourselves would have taken years; Zipari’s was out there out of the field. Customizing it and implementing it for our enterprise value thousands and thousands of {dollars} much less and can get achieved exponentially sooner than if we’d tried to construct such a platform ourselves.

RELATED: UnitedHealthcare launches new app with on-demand telemedicine

Partnerships like this have three important advantages for well being insurers:

Acceleration: COVID-19 will solely speed up the business’s transition towards a consumer-driven, technology-powered future. Customers will demand the identical fast solutions, on-line and cell transactions, and quick access from their well being insurers as they get from their financial institution.

Partnering with dynamic tech corporations like Zipari helps us maintain tempo with these calls for. By shopping for the expertise from them reasonably than attempting to construct it ourselves, we are able to implement it sooner, at a decrease long-term value. And it may be configured to enhance—not exchange—our present workflows, together with the way in which we handle buyer interactions in Salesforce.

Engagement: One among our healthcare system’s best flaws lies in insurers’ incapacity to attach with and perceive their members, at every second they intersect with that system. Insurers like CareFirst could have the info and experience to information members by means of these interactions—to steer them towards the suppliers, selections, and actions that may give them the most effective well being outcomes on the lowest value. Most simply don’t have a technique to successfully and constantly talk the message. 

RELATED: Healthfirst accelerates launch of its member app resulting from COVID-19

Know-how platforms allow us to do exactly that. By pulling collectively our information—from legacy programs that don’t work together with each other—right into a single software, our new platform provides us the power to remain in contact with our prospects at common factors alongside their journey, creating a chance to considerably enhance the member expertise.

Systemic change: Because the tempo and diploma of healthcare change will increase dramatically, medical insurance leaders—traditionally resistant to alter and reluctant to relinquish their sovereignty within the healthcare world—can be pressured to change into extra agile. Partnering with outdoors expertise corporations can be a technique of doing so. 

Over time, these partnerships will start to remodel the complete system. As extra insurers implement expertise platforms, we’ll begin to see community results much like these created by Salesforce or Fb.

Zipari, as an example, makes use of its platform to create self-sustaining suggestions loops which can be always analyzing information from throughout their buyer base and utilizing that information to enhance the applying’s efficiency and ship insights again to these prospects. That suggestions loop solely will get extra highly effective as extra corporations come aboard.

Throughout the pandemic and within the years that comply with, medical insurance leaders can be judged on their capacity to enhance their prospects’ well being whereas gaining and sustaining their belief. Those that rise to the event can be rewarded with highly effective buyer loyalty and stronger manufacturers. Those that don’t will wrestle to draw and retain members in a post-COVID world.

This will depend on extra than simply expertise. It requires management. Healthcare leaders might want to have the braveness and humility to acknowledge the methods our present system’s shortcomings impression our social and financial order—after which search a approach ahead. In partnership with expertise corporations, CareFirst is simplifying the complicated, delivering tailor-made options and stepping ahead with new concepts.

I consider partnering with revolutionary expertise corporations is the way in which. I hope you’ll be part of me.

John David Kaercher is chief info officer and govt vp of data expertise and operations at CareFirst BlueCross BlueShield. He’s chargeable for a broad vary of strategic initiatives, technical and operational assist, and oversight and management features throughout the corporate. 


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