Anthem poised to rollout data-rich digital health benefit platform

Register now

Starting January 1, an estimated 25 large national clients of insurance giant Anthem will have access to a new mobile benefits platform that will gather employees’ data to make the best recommendations for accessing care while saving costs for services and prescriptions.

Called Engage, the digital health program built by mobile health technology provider Castlight Health will collate data from Anthem’s clinical and wellness sources. This real-time data will include an employee’s healthcare, wellness and benefits information along with his or her use of Fitbits and other wearable devices to help them make smarter healthcare choices.

Employees can search for medical, pharmacy and dental services, and then compare the care options available to them, and understand their expected out-of-pocket costs for each option in real time. According to Jonna Kurucz, staff vice president for Anthem, this information weighs the overall cost of the service and the worker’s benefit plan to provide a personalized out-of-pocket cost estimate.

“When the employee is seeking information about care decisions, they’re provided with a personalized, curated search result. This result provides information on the relevant programs for the employee — such as telehealth or an onsite clinic offered by their employer — as well as information on the providers,” says Kurucz. “Providers that are designated as high quality and lower cost, such as Blue Distinction Centers, will default to the top of search results.”

“Anthem wanted to help their members navigate the healthcare system and that is specifically done by creating a personalized experience using data from the employer health plan, benefits program and clinical claims as well as information from Anthem’s Connected Health and Wellness apps,” says John Doyle, CEO of Castlight.

According to Kurucz, Engage can help employees become more literate healthcare consumers.

“The vast majority of our national customers are headed down a consumer-directed path but what they're finding is not all members are really thinking with their pocketbook — or with the employer’s pocketbook, frankly,” says Kurucz.

She adds, “Being able to present the most cost-effective, high-quality and cost-effective providers whenever a member is searching for a primary care physician, urgent care facility or a specialist is also of value to employers.”

As part of Engage’s care guidance features, employees have the opportunity to understand their expected out-of-pocket costs for medical, pharmacy and dental services, says Doyle. “This information takes into account the overall cost of the service and the member’s specific benefit design to provide a personalized out-of-pocket cost estimate.”

Direct approach
According to Castlight, more employers are asking for mobile solutions that offer data for smarter healthcare consumer choices. In the past, employers took a passive approach to hint at the best possible care choices and hope that employees made a smart choice, says Doyle.

“But what employers have seen [is] that approach just doesn't work. We're seeing a desire for delivering a personalized experience that curates the available resources and is much more direct about guiding employees to a right resource at the right time,” he says, adding that this approach “ends up being more cost efficient for employers and hopefully better for employees, as well.”

Castlight began work on the Engage platform in late 2016 and worked with the insurer on the platform’s array tools and multiple data sources. Anthem says it chose Castlight to design the platform because of the technology firm’s mobile expertise.

There are several critical steps employers need to take when moving human resource applications to a hosted environment.
1 Min Read

“Castlight had some of the technology already, however it wasn't integrated into our clinical or critical underpinnings,” says Kurucz.

The Engage platform was designed as a “mobile first” solution — meaning that it was the smartphone and tablet version of the program were designed first and a web-based solution for laptops and desktop PCs designed afterward.

“There is a web app available as well but we think mobile is the way of the future. All of the architecture we are devising now is mobile first. The mobile interface is the first interface that we are designing for,” says Kurucz.

Small- to medium-sized businesses in the Anthem network will have access to a streamlined version of the Engage platform later in 2018. Updates to Engage based on employer suggestions will be added on a monthly basis.

Engage is being offered to Anthem’s national accounts business segment, and to large group clients of Anthem Blue Cross in California and Anthem Blue Cross Blue Shield in Colorado. Roughly one million employees of 25 Anthem clients will be live on the Engage platform on January 1.

For reprint and licensing requests for this article, click here.
Technology Mobile technology HR Technology Employee benefits Workforce management Dental insurance