Responding to employer customers' concerns about rising costs, and their employees' wishes for greater involvement in managing their health benefits, Humana (Louisville, $4.4 billion total assets) has rolled out SmartSuite, a product that combines health plan design and Internet technology to give employers and employee members the ability to exercise healthcare plan options.
"There was significant concern about double-digit cost percentage increases from both the traditional managed care HMO side, as well as the PPO side, questioning what might be the next alternative," says Marsden Kucera, vice president, information technology, Humana. "We've also heard from employee members that they want choice again. Payroll deductions continue to increase, and as you pay more, you want to become more involved."
The SmartSuite solution incorporates six plan designs under four separate plan bundles. Employers choose one of the four bundles, and employees can select what suits their needs best from among the six plan offerings within the bundle chosen by the employer.
The tool simultaneously leverages plan design and technology-based delivery methods to put employees in a position to control costs based upon self-interest, according to Kucera. "By making the true cost of care more transparent to the members, they are able to make informed decisions," she says.
Members whose employers use SmartSuite interact via Web browser with the solution's Health Plan Wizard, which asks enrollees questions about their healthcare and budget needs and ranks the available plan designs based on the employees' responses. Side-by-side comparisons of each plan gives employees further information in order to discriminate among the plans.
In crafting the solution, Humana acted on CIO Bruce Goodman's maxim of "partner before buy, buy before build," Kucera notes. "We found partners that excelled in certain components we needed for SmartSuite and partnered with those companies and brought it all together," she says. Humana worked with San Jose, CA-based Selectica to provide the online questionnaire function, which the insurer then customized, Kucera says. Responses from the Wizard are integrated into enrollment capabilities using ProAct (Boston) technology, she adds.
Humana tested SmartSuite first in-house for its own employees before piloting successfully with an external company, according to Kucera. From what Humana learned from the experience, "we made some changes and enhancements to the plan and are now offering it on a broad basis for employers across all our markets," she says. Since then, the market's hunger for a way to deal with rising healthcare costs has led to a high level of interest in the solution, according to Kucera. "Any time you have employers proactively contact you when it's not during a traditional request-for-proposal process, you're having an impact," she says.
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