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Payer tech isn't sexy, but it's on its way


Editor's Corner

Brian Eastwood, Senior EditorFor anyone with even a passing interest in technology, the annual Consumer Electronics Show (CES) is a landlubber's version of The Little Mermaid's collection. There are gadgets and gizmos aplenty. There are whozits and whatzits galore. You want thingamabobs? Forget 20. There are 20,000.

Amid the odd collection of devices, though, CES denizens increasingly find a growing collection of health and wellness tools. In a recent column, FierceHealthIT senior editor Dan Bowman described several health innovations at CES 2015. It's an impressive list, from smart bandages to waistline monitors to sensors that can examine your genes for signs of potential diseases.

An impressive list, yes--but something's missing. Where's the tech for improving the consumer-payer relationship?

Yes, there's plenty of wearable tech to tell insurance companies how far John walked today, how much sleep Jane got last night or how many pounds Steve has lost in the last six months. However, as I said a few weeks ago, the health insurance industry faces a long and bumpy road to digitization. Such technology is currently the exception, not the rule.

Most consumers deal with insurers through the mail or in telephone conversations after a long wait and many menu options, not in the 21st century ways they interact with just about every other industry. (To be fair, all of healthcare, not just the payer market, faces this problem.) Yes, physician lists are online, but many are out of date or flat-out incorrect, especially for Medicare Advantage.

But a new online pricing tool from Blue Cross Blue Shield of North Carolina shows some promise. The tool lets anyone--not just BCBSNC members--compare in-networks costs for procedures such as knee replacements.

The typical consumer doesn't know how much medical care costs. The typical consumer doesn't care, either, as long as treatments are covered by insurance. Out of sight, as the saying goes, out of mind.

Showing consumers exactly what a surgery will cost at Hospital A vs. Hospital B could turn the healthcare industry on its head. Numbers that would otherwise take much sweat equity to track down are now available in mere moments, empowering consumers to make more informed decisions about the care they do or do not receive.

The tool's importance stretches beyond price transparency, though. It shows that big-time insurers can, in fact, innovate beyond the wristband, pedometer or smartphone app.

More importantly, it shows that the barrier to entry remains incredibly low. For how many years have we been comparing prices for just about everything else we pay for? For how many years have the phones in our pockets, or the watches on our wrists, been processing more computations than the behemoth computers past generations used?

It's easy to blame insurers for failing to innovate. If necessity is the mother of invention, and if most payers expect another profitable year, then clearly it's not necessary for them to invent much of anything.

At the same time, health IT isn't improving care coordination on the provider side, while consumers continue to abandon devices, wearable or otherwise, when they become bored. (A former colleague had an overflowing "Drawer of Misfit Tech Toys" at his desk.) Insurers deserve some blame, yes--but they can also be forgiven for not wanting to invest time and money into something that might not work.

All in all, it makes sense that we saw so little tech catering to the health payer consumer at CES 2015. The tech that both insurers and the insured need isn't sexy. It's not going to garner celebrity endorsements or mile-long lines at the Las Vegas Convention Center.

But that tech is in the works. BCBSNC is among first large payers to debut a price transparency tool, and it won't be the last. Oscar Health is giving members free fitness trackers and rewarding healthy behavior, and others payers will no doubt follow suit.

These tools won't find a place among the myriad thingamabobs in Ariel's collection, but they will soon be a part of our world. --Brian (@Brian_Eastwood and @HealthPayer)

Related Articles:
CES 2015: What health innovations caught your eye?
Why HIT doesn't ensure better care coordination
Health insurance will go digital, eventually
Oscar Health to give members free, wearable fitness tracker
Study: Medicare Advantage networks include many docs that aren't available