Will Payers Lead Digital Health?

Scott Mace, for HealthLeaders Media , January 22, 2013

HealthLeaders Media: I went to South by Southwest last year, and Aetna was there giving a big talk and exhibiting. Are payers leading the charge here? What about the providers? Should Kaiser have a booth at CES next year?

Tuckson: I think that it's hard for delivery systems per se to be in this space, because they've got a lot on their plate now. The opportunity that at least we see is being a facilitator, an intermediary to help make all that happen for all the players. We are clearly seeing our role as, first of all because of our Optum company, very much involved in sharing the aggregated and analyzed data back with the delivery system for action by them. We also see our role as being helpful in developing and integrating the software necessary to make that data actionable and useable at the point of care delivery, so we have to help them in that regard. So we see our role as sort of enablers to getting all of that done.

Would I expect small practices or even fairly large medical groups to be here yet? It is very tough for them to make the health IT decisions, the capital investments in all of that world right now. I think what I would see our opportunity is to help make it easy for them as we go through this transition period. The other thing about it is that what you also see, at least for United, is that we are trying very hard to be product-agnostic. The delivery systems, especially the large integrated hospital and medical systems, have a harder time being flexible and fluid. They get locked into systems. We want to be the ones that help make it easy for you, depending on whatever system you use, to feel that the data flows, the engagement flows, the interoperability flows, and the coordinated care delivery flows, so that's probably the space that companies like ours can better occupy.

HealthLeaders Media: Is this the year we're going to see employers say, 'Hey, you do this, you wear this, you're going to get cheaper insurance'?

Tuckson: Absolutely. We're already seeing it now, and the curve has got to go up. I think it'll go up, because we're going to be able to have more data to be able to prove to employers that it works, and secondly, we're going to have to convince employers that for the tipping point to occur, it's going to take employer engagement in terms of being cajolers, leaders, cheerleaders, information disseminators, but then ultimately building incentives into the benefit package. We're doing it at our company. We're seeing, with our own employees, that the consumer-directed health plans are really taking off, showing great results.

But then, it's not good enough just to say, Okay, here is your consumer-directed health plan. You've got to give them two things. Number one, you've got to give them the opportunity to engage successfully in turning around those modifiable risk factors—thus the digital health revolution—and secondly, you've got to give them the health cost estimator, because you want them to be able to know how much is out of pocket when they make health choices. So granular data around costs and granular and actionable information around modifying preventable risk factors. Those are the two things that we get excited to bring forward, and hopefully that will all convince and get enough employers to get us to the tipping point.

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2 comments on "Will Payers Lead Digital Health?"

Janice McCallum (1/25/2013 at 11:34 AM)
Scott & David, I have to agree, esp. since I wrote on this topic nearly two years ago: http://www.healthcontentadvisors.com/blog/2011/5/31/look-to-payers-for-innovation-in-health-information.html

David Lee Scher, MD (1/23/2013 at 9:04 AM)
I wholeheartedly agree that payers are the key to digital health and specifically mobile health technologies. Please see: http://davidleescher.com/2012/12/02/why-payers-are-critical-to-mhealth-adoption/




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