mHealth for Healthcare Payers: 5 Key Applications focused on Member Interactions

In one of my earlier blogs on SearchHealthIT titled “mHealth for Healthcare Payers: 5 Key Focus Areas for Mobile Applications”, I had listed applications for member interactions as one of the hottest areas that provide more value add to the payer organization. There is more focus on the member interactions due to the advancement of mobile technology and the affordability of high tech mobile devices. These technologies provide users with new capabilities such as GPS, voice recognition and a host of privacy features to protect individual data. This coupled with the federal mandate to enforce the individual healthcare mandate by 2014 provides payers with one of the biggest opportunities in a lifetime. Those that adopt these early trends will be in a good position to be the future market leaders while others will struggle to succeed.

The following five applications are very critical in reducing the gap between the payer and the members and also ensure the interaction to be a pleasant experience.

  1. Campaign Management. This application will open new doors to get the message out to the member community, though we have still not seen many payers take advantage in this area. Applications that can enable payers to run campaigns across different social networking sites will enable the marketing department to have far more reach than other forms of marketing. Also, the GEN-Y population is very active on the social media sites like Facebook, Twitter etc. and can play an influential and profitable role.
  2. Online Enrollment. Creating a mobile application for member enrollment is one of the basic apps that have gained more traction with the users. These applications along with the camera and scanner features provide the capability to reduce the cycle time taken from online form submission to enrollment to the final issue of ID cards from many days to just a few days. Also immediate confirmation of acceptance of policy along with temporary policy no can be sent to the member via email.
  3. Benefits/Policy comparison tool. This is a new tool that would help policy shoppers decide on the right policy for their family. As the Health Information Exchange (HIE) market grows we could see the application evolve into comparing policies across multiple payers more meaningful and easier to understand for ordinary people.
  4. Member Personal Account. Customers these days are very informed and are always looking for information on the latest procedures available to treat their conditions. By providing information not only on internal procedures available but also providing links to other external websites, the application will enable customers to access all of the required information on a single web page. For example, alerts on claims submissions and payments can be a very useful feature to have.
  5. Health Management. This is one of the most beneficial applications as seen by the consumers. Payers can definitely use this application to track member health and provide regular updates on advancement in procedures and medications. Also prevention is a more attractive option than cure; consumers can use this application to provide useful information on diet and exercise.

The market has been flooded with applications, but adaption in the healthcare sector is still in its early stages due to the reluctance of the payers to change quickly and adapt to the rapidly evolving market dynamics.

Baskar Mohan

Director - Healthcare Practice, Virtusa. Baskar has more than 18 years of professional IT experience with over 13 years of US project experience. He has worked in the Healthcare industry for the past 11 years both on the payer and the provider systems. He has extensive knowledge of the Blues and has worked with them in many corporate initiatives including the HIPAA 4010A1 conversion, SSNE and the NPI project. On the payer side, Baskar has worked on EDI and core claims systems. During his tenure at BCBSMI, Baskar has worked in EDI, Membership & Billing, Facility, Professional, Dental, FEP & NASCO to name a few. Baskar has also very good exposure to the government run Medicare & Medicaid programs and has worked for the Dept of Health Services, Sacramento, California. He also has executed a number of projects in healthcare related to BPM. Baskar is very knowledgeable of the Pega platform and in specific the Healthcare payer framework, Insurance Industry framework & CPM. More recently he has executed projects related Governance, Risk and Compliance using Pega for providers very specific to CoBIT & HIPAA. As a Chief Architect, Baskar is responsible for designing solutions for 5010 & ICD10 solutions. He has created go to market solutions to help customers transition to 5010 & ICD10. As a Program Manager, he is responsible for delivery & execution of all projects both onsite & offshore and currently manages a team of resources. As a Client Services Director, Baskar is responsible for revenues for healthcare book of business, assist the sales team with pre-sales, account radiation and client management. Baskar has experience working with global clients across, USA, UK, France & Netherlands.

More Posts