Will insurer apps reduce domestic US medical travel?


The new app, CareSpree, has been introduced in one US state, but will later reach the insurer’s full geographic territory.

Anthem’s plan to make an app available to people who don’t have its coverage is unusual, because most insurers’ digital tools are aimed at their own customers. CareSpree is testing in Indiana and will roll out across its 14 main states, including New York, California, Virginia and Georgia. Powered by artificial intelligence, the Anthem app can suggest potential diagnoses to consumers.

The app will incorporate technology from K Health Inc., a New York-based start-up. K Health uses a chat function powered by artificial intelligence to suggest potential diagnoses for consumers who enter symptoms and other Anthem’s app also ties in other features, including video doctor visits. For services including in-person doctor visits, magnetic-resonance-imaging scans and X-rays, the app lets users schedule appointments and pay a pre-negotiated price through their smartphones. In Indiana, Anthem has deals with 10 healthcare providers, including some large hospital systems.

For Anthem customers, the app will tie into their health history and benefits structure, letting them pay out-of-pocket charges via smartphone.

United Health Group, CVS Health/Aetna and Cigna are all competing to introduce offerings that they hope will smooth the fragmented experience of getting and paying for health care. Often, such tools can also serve to steer consumers’ decisions about their care in ways that reduce costs.

Humana is also testing a new plan that links patients to primary-care doctors whom they can see for regular video visits, using Doctor On Demand Inc. Patients get tools including blood-pressure cuffs at home. The doctors get patient health histories from Humana, and can track their care and coordinate follow-ups. Premiums for the digital-first plan are significantly lower than many competing products, Humana claims.

The UnitedHealth app Recover tells patients where they can go for various services tied to the surgery, such as imaging, and another app tells how much each will cost. Recover sets up text messaging with the surgeon’s office. After the operation, patients can use the app to take pictures of their surgical site that are analysed by the technology. If there are signs of a problem, the doctor’s office is automatically alerted. The provider knows what’s going on in real time. In a test with hip- and knee-replacement patients, the Recover app helped cut costs by 11% and reduced readmissions.

Insurers hope to save money by using digital services to promptly detect and respond to health problems that can result in costly emergency-room visits. They also want to use digital tools to steer customers to lower-cost care, including their preferred specialists, pharmacies and imaging centres. That would short-circuit hospital systems’ ability to refer patients to their own, often costlier offerings.

As US insurers increasingly combine healthcare and insurance, and if they follow Anthem's lead in offering direct to healthcare services for customers and non-customers, then this will cut out small agencies and online services offering appointments and reduce the need for hospitals to market to customers on domestic medical tourism.

The combination of insurance and healthcare is a global move by health insurers and not just happening in the USA. This takes decisions about where to be treated out of the hands of patients and drastically reduces the need and ability of hospitals to market to patients with health insurance.



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