While employers deal with ACA reporting requirements and communication campaigns that explain the public health insurance exchanges, some have turned to health care technology startups in hopes of elevating the open-enrollment experience for their employees.
Two such players have emerged over the past two years to lend a helping hand. They include Gravie and Stride Health, whose slightly different business models are designed to make this annual rite of passage more consumer-friendly.
Between the ACA and macroeconomic factors, many small and midsize companies that lack the purchasing power of large corporations have finally reached a point where they dont necessarily want to be in the business of health insurance, observes Abir Sen, Gravie CEO and co-founder. Theyd rather just get out, if they could, while making sure that their employees are well taken care of.
That means steering employees to the individual market, offering assistance with purchasing decisions and navigating their way through the process. It also may involve a higher salary to make up for the change in coverage.
Theres confusion surrounding most transactions in a doctors office or at the pharmacy, as well as how to wisely invest health savings account dollars, according to Stride Health CEO Noah Lang. But he says the time is right to bring personalized intelligent transactions to health care, since the technology is now well-refined and the data is well-constructed and machine readable under the Affordable Care Act.
What we do for employers is power the plan decisions for their 1099s, Lang explains, noting that his firms biggest partner in this space is Uber, a popular alternative taxi service with the nations largest freelance workforce. We work with them to make sure that all of those drivers, who are independent contractors, get covered, dont get fined by the government, can do it efficiently and quickly, and it fits right into their system that they use to manage their workday. The potential for similar opportunities is tremendous. He notes that as many as 40% of the U.S. workforce is projected to be independent contractors by the end of the decade.
Theres no shortage of activity in the health care tech arena, but theres also a lot of hype, observes Robert Booz, a health care analyst with technology consultant Gartner. He says new applications being rolled out have already been brought to market by companies such as eHealthInsurance or even payers such as Oscar Health.
His larger point is that new entrants to the market arent shaking it up with stunning solutions that deliver greater value as much as theyre simply augmenting whats currently in place. Theyre bringing greater notoriety to the need for better tools, he adds.
Booz describes Stride Health, Gravie and others as product configurators that enable consumers to customize coverage that suits their specific needs, including price points. As employers move toward more defined contribution benefits in health care, its important for them to help employees make informed decisions, which these kinds of products do, he says.
The HIX marketplace is still a largely conceptual experiment that entrepreneurs are trying to improve upon with practical tools to help elevate the consumer experience, says John Sarich, a harsh critic of the public exchanges who is vice president of strategy at VUE Software, an insurance automation company.
What youre seeing is some smaller technology companies kind of playing around the edges identify areas where technology, workflow, business process, data management and those types of things that are becoming useful and important, he says.
One handy tool Gravie offers is an iPhone app called Is this covered? to help answer coverage questions or find a network doctor. It provides enough meaningful insight into how people shop for their health insurance to actually help improve the functionality from one year to the next.
Sen, whose industry track record includes stints with Bloom Health Corporation, RedBrick Health Corporation and Definity Health, estimates that about 20% to 30% of his members qualify for HIX subsidies, while the rest buy plans from the private market.
Apart from asking for an individuals age, income and other demographic factors, Stride Health probes which doctors they prefer, as well as aggregates the prescription drugs they take and their health conditions to protect their privacy.
We prove out the value of the engine by building that forecast with them to figure out their medical consumptions for the year and pump that through every single plan available to build a true cost of coverage forecast, explains Lang, who previously built another Silicon Valley startup called Reputation.com to monitor, manage and secure personal information online.
Bruce Shutan is a Los Angeles-based freelance writer.
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