Doculabs

In my recent engagements across a good cross section of health payers, I have the opportunity to hear a lot about how these organizations are thinking about using social media to further their business goals. And lately, I’ve been part of a number of conversations around how phone apps could provide a mechanism for health payers to engage their customers (current and potential) in ways not possible just a year or two ago.

I stumbled upon a great example of what a health payer app might look like on a recent episode of NBC’s The Biggest Loser, where they introduced a health and wellness app for Verizon smart phones. The app provides on-the-go nutritional advice (like recipes, calorie counters, and food swap suggestions) as well as exercise tips (like video workout routines and examples of proper technique) that allow fans to take the show’s approach to living a healthy lifestyle with them throughout the day.

I think this is a great model for health payers to consider as a way to meet some of the critical challenges they face today, as they look to transform their organizations for the health care reform changes coming in January 2014:

• Preventative care to keep people healthy (rather than curing them once they’re sick)
• Contributing to the overall health and wellness of  society (rather than profiting from its illness)
• Reducing health care costs or delivering more value for the same cost

And if health payers can find a way to move beyond generic apps like this one (which only send general information to users) to create apps that can target individuals based on information drawn from enterprise systems, they’ll be able to provide their insureds access to critical information and services…and things will get interesting very quickly in this space. Based on what I’ve seen percolating in the industry, I can imagine at least three broad areas where health payers might explore using more robust apps:

• Frequently needed patient information – like prescription and vaccination history, to make it easier for insureds to give providers (especially retail clinics) accurate information about their basic medical history (and to make it easier for these clinics to provide the right care).
• Mobile access to self-service functionality – particularly for rural populations, access to PCs and broadband internet connections make using self-service websites difficult or impossible. Wide usage of smart phones among this same population provides an opportunity to better serve the community and reduce administrative costs by driving call and postal mail volumes down.
• Utilization management/disease management – right now, targeting insureds for UM/DM and then making sure they get the follow up and information they need can be challenging and expensive for health payers via traditional delivery channels (phone, paper mail, and email). Using mobile devices to interact with insureds around UM/DM will not only lower administrative overhead, but ultimately make health payers’ UM/DM efforts more effective.

Organizations in the health care space are going through a fundamental shift today and are right to be concerned about how it will all wind up come January 2014. But this shift brings tremendous opportunities for them to transform the way they do business in response and reap the rewards that will accompany that transformation, both in terms of corporate profits as well as their contribution to the overall health and wellness of American society. And a big part of their transformation will require them to find new ways, such as the kinds of apps I’ve suggested here, to build relationships with their customers and the larger population.