digital health insurance

Spring brings two painful ordeals. One is doing my taxes, where software can at least help ease the agony.  The other is choosing a health insurance plan, from a provider that seems never to have heard of the “digital” revolution.

Among the many loose definitions I’ve seen of the “D” word in my work with clients are:

  • Putting the customer first
  • Making products and services easy, and even delightful, to buy and use.
  • Customizing products and services, using Big Data to understand and even anticipate each customer’s needs.
  • Being mobile-first, or at least mobile friendly.

So 1980s

Compared to this lofty vision, what do I get from my insurer every year? A thick wad of paper (not even an email notification it’s coming) full of dense charts, impenetrable jargon, and confusing pricing options. The only “personalization” is their recommendation of a replacement of my current plan, which is being discontinued.) The new plan is close to 20% pricier than my current plan, and is about the level of a modest mortgage. But there’s no guidance on what I’m getting for the extra money or how this compares to my current plan. There are several pages of “mapping” diagrams to compare the insurer’s former and current plans, but it’s a year since I’ve signed up and neither my insurance card nor my bill have the name of the specific plan I’m now enrolled in.

And despite the fact I have, for at least 15 years, purchased only individual plans, the insurer makes me sift through four pricing levels for each of their new plans: for an individual, a spouse, a child and a family. It’s just another level of confusion about a decision (“How sick or injured will I be in the next year?”) that I’m not very qualified to make.

It’s also not very insightful or customized, in an era when Netflix can track which Doc Martin re-run I last binge-watched, and Amazon recommends stuff for me to buy based not only on my purchases, but my browsing history, and the purchase and browsing history of millions of others.

This seems like a process, and an industry, ripe for takeover by someone that could harness Big Data, real-time customization and a friendly user interface to make health insurance comprehensible and truly customized. (Note to health care CEOs: I, and a lot of other folks, would probably pay a modest premium just for the peace of mind of knowing what we’re buying. Just think, also, what simplifying the process would do for your back-office administrative and customer service reps.

So what would a “digital” health insurance purchase process look like?

Personal, Customized, Easy

  • Make online the default, and easiest to use, channel for information about plans and the process of choosing one.
  • Provide instant chat with a rep who can view my account and medical history without endless authentication and approval processes.
  • Use Big Data analysis of individual purchase behavior and health, as well as of others in their cohort, to recommend a plan on each customer’s historic health care consumption and scenarios (low, medium and high probability) of care needed in the next year.
  • To make it even more customized and interactive, provide cost estimates reflecting the customer’s most recent activity. (“Based on our experience with patients with your age and symptoms, there’s a 20% chance that shoulder pain you saw us about last week will require surgery rather than ice and Tylenol. If so, here’s the projected out-of-pocket cost under each of our three recommended plans.)
  • Tailor benefits to each customer’s needs and histories. Don’t tout your smoking cessation programs if you know I haven’t smoked in 30 years, or offer me a low-cost health club membership if you just gave me a discount for installing a home gym.
  • Speaking of home gyms, why not give me a one-click option to link my smartphone pedometer to your fitness-tracking program and give me a monthly discount on my premium based on my exercise level?

In industry after industry, disruptors are blowing away old-school competitors by providing easier to use products and services that save customers money. As a totally disgruntled (can you tell?)  health insurance customer, I’m ripe for being disrupted right out of my current provider.

Any contenders out there?

Author: Bob Scheier
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I'm a veteran IT trade press reporter and editor with a passion for clear writing that explains how technology can help businesses. To learn more about my content marketing services, email or call me at 508 725-7258.

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