Health Carriers Tackle Privacy Challenges of Online Coaching Programs

Health insurance carriers have a vested interest in making sure their policyholders are taking the right steps to manage chronic conditions and stay in good shape, and they have a tradition of offering incentive programs and health coaching to customers to ensure that commitment. Now, with increased usage of member portals and consumer comfort level with the internet, carriers are taking these programs online.

Minnetonka, Minn.-based Medica will launch an online health coaching program at the beginning of 2011. This represents an expansion of an existing telephone-based program that incorporates Insignia Health's (Portland, Ore.) Patient Activation Measure. Policyholders who use the program, which is accessible through a tab on the company's existing member portal, will have the opportunity to earn gift cards to national retailers when they complete health and wellness activities. The carrier began working with Insignia in October 2009 on the telephonic program.

"There are times when people want to access this information off hours," says Leslie Frank, senior director of health improvement at Medica. "We'll have an online version of the [Patient Activation Measure] assessment, and individuals will be able to receive messages and information based on their interaction."

Medica will house data that comes from the program separately from its clinical and claims data, and makes a point to assure customers of that fact, Frank adds.

"We do get questions from our members about, for example, whether their employers see that data, and the answer is no, it's kept confidential," she says. "We've been dealing with that for several years."

That doesn't mean, however, that the carrier doesn't learn from the usage of the program. Medica has found that Insignia's program gives it a fuller view of how its customer base uses healthcare services.

"So much of healthcare happens outside the doctor's office, and people need to know what they're doing, what their symptoms are and how their actions affect their health," Frank explains. "This helps us understand the health of our population, where some of their challenges might be and where we can focus our coaches in reaching out to our membership to ultimately manage healthcare costs."

HealthMedia, an Ann Arbor, Mich.-based company that offers the CARE for Your Health online health coaching program to insurers, surveyed HighMark (Pittsburgh) policyholders who used the program over five years to see how it performed in terms of ROI. This required the vendor to tap into its database, which it does anonymously, according to Dr. Steve Schwartz, research director for HealthMedia.

"Each one of those question responses is a data point that we collect," Schwartz says. "When we want to demonstrate an ROI we have to work with the carrier to match their data up to our data, but we do keep it confidential and work within the HIPAA rules to match that to claims and utilization to measure those outcomes."

Ninety-three percent of Highmark members reported that they were better able to manage their conditions, leading to a $757 reduction in health care costs per year per person compared to non-participants, the companies claim. This took into account increased use of flu shots, Pap test and mammograms.

"The programs really convey that this is a plan that cares and it provides offerings that improve the lifestyle or quality of life for people — that goes beyonds dollars and cents," Schwartz asserts. "It also shows an impact on worker productivity, which carriers can re-sell to their marketplace."

However, a big part of that value proposition as far as end-users are concerned is the privacy aspect. That's why, Schwartz explains, carriers and vendors are slow to push health coaching into emerging technologies.

"Social media, for example, has a lot of potential, but we've been slow to dip our toe into there," he says. "It is powerful, but it is difficult to oversee and regulate."

Mobile applications are more likely to emerge first, he notes.. But companies are also interested in using the analytics the programs provide to improve them before expanding the platforms on which they're available.

"Right now we sell programs that are content specific: diabetes, weight loss, smoking cessation. What the future holds is really a smart system that integrates the content of all of those and does an even higher layer of personalization," Schwartz explains. "Then there's the leveraging of new technologies that allow messages, content and tools to be available to people where they are. The web is the hub and then there's outreach in a number of other areas."

Nathan Golia is senior editor of Insurance & Technology. He joined the publication in 2010 as associate editor and covers all aspects of the nexus between insurance and information technology, including mobility, distribution, core systems, customer interaction, and risk ... View Full Bio