Supporting a drive for a leadership position in consumer-directed healthcare-an industry trend whereby healthcare plan members are given more discretion and more financial responsibility in healthcare decision-making-Aetna (Hartford, $40 billion in assets) has expanded its suite of decision-support tools on its Navigator member self-service Web site, first launched in October 2000.
The enhancements parallel the carrier's marketing of Aetna HealthFund, which combines a traditional health plan with a fund benefit for pre-deductible coverage. The product originally appeared in the fall of 2001 as a self-insured plan. The fully insured version became effective Oct. 1, 2002.
The new features include a hospital comparison tool, providing users with access to evidence-based outcomes; Price-A-Drug, which provides information on prescription drugs and generic alternatives; Price-A-Medical Procedure, which gives information about physician fees; Evaluate Your Health Care Provider, a survey that enables members to provide feedback; and DocFind, an online directory thatprovides information on healthcare providers, in both English and Spanish, according to Aetna. "Technology will be instrumental in advancing consumer-directed healthcare, because the consumer is going to want timely and credible information to help them make decisions," says Aetna's Robin Downey, head of product development.
Greg LeGrow, Boston-based research manager of First Consulting, agrees that the Navigator's tools are essential to the success of consumer-directed plans, such as Aetna HealthFund. "If we put the healthcare decision-making responsibility in the hands of consumers without providing adequate support tools, consumer-driven healthcare is just not going to last," he says. "Consumers will revolt, and if that happens, perhaps only 10 to 15 percent of consumers will enroll in consumer-driven plans. If it's done correctly, we could see adoption as high as 40 percent in the next eight to 10 years."
According to LeGrow, Navigator's new features are competitive with the decision-support tools of aggressive non-traditional online marketers of consumer-directed health plans, such as Definity Health (St. Louis Park, MN) and Lumenous (Alexandria, VA). However, Aetna has an edge in having "an established network and contacts with providers, whereas the start-ups will have to build them."
Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio