Member engagement was the watch word for health insurers in the fourth quarter, as we saw consumer-facing app launches or related moves from Humana, Anthem, Cigna, and UnitedHealthcare. The quarter also saw some big moves from CMS and some interesting developments in the realm of employee wellness. Check out our roundup of Q4 payer news below. If you want to take a look at the whole year, check out our roundups for Q1, Q2, and Q3.
Centers for Medicare and Medicaid Services news
The big news from CMS was support for both telemedicine and remote patient monitoring in the new physician fee schedule and Quality Payment Program update. CMS plans to increase access to Medicare telehealth services – especially in rural or underserved areas – by paying for more telemedicine consults and making it easier for providers to bill for them.
As for remote monitoring, a new reimbursable Improvement Activity is being added to the Centers for Medicare and Medicaid Services' Merit-based Incentive Payment System (MIPS), which encompasses using digital tools to monitor patients outside the hospital. It will encompass remote monitoring as well as reviewing and interpreting patient-generated health data, provided the physician uses clinically-endorsed tools that include an active feedback loop. That means the system has to return some kind of actionable information to the patient or care team.
Telemedicine reimbursements may be under some extra scrutiny as well, though. The U.S. Department of Health and Human Services’ Office of the Inspector General revealed this quarter that it will audit Medicaid payments for telemedicine and telehealth payments to ensure compliance with reimbursement requirements. The report is scheduled for 2019, given the breadth and scope of the project.
Early in the quarter, Anthem launched Engage, a new comprehensive digital health platform that grew out of the company's relationship with Castlight Health. Engage includes three main features: a single sign-on hub for all of a member's different benefits, an engagement and activation platform, and search tools for cost and quality comparison. The other benefit of the platform is that it pulls together all the different clinical and wellness tools Anthem offers, from telemedicine, to nurse calls, to fitness tracker-powered wellness programs.
That sort of comprehensive digital offering is something that a number of big payers have been adopting. At the Health 2.0 annual fall conference in October, both Cigna and UnitedHealthcare highlighted their engagement efforts.
Cigna’s latest attempt to support this vision is a patient-facing app called OneGuide, which is currently in use by 1.7 million of Cigna’s 15 million covered lives. OneGuide evolved out of a digital health pilot called Compass. UnitedHealthcare's executives spoke about the company's operations more broadly at the conference, but did hint toward future plans involving apps and sensors.
Later in the quarter, Cigna bolstered those efforts in a big way with the acquisition of digital health software-as-a-service company Brighter. Cigna will use the technology and team to develop future member-facing mobile and desktop tools, as well as continuing to run Brighter as a tool for the startup's existing customers.
UnitedHealthcare, Humana, and WellCare Health Plans all launched more specialized apps during the quarter as well.
UnitedHealthcare in November launched a new maternity health app, The UnitedHealthcare Healthy Pregnancy, which will provide patients with 24-7 nurse support during pregnancy and after delivery. The company hopes to provide expectant and new parents additional access to prenatal and post-natal care and also to reduce healthcare costs.
Humana launched two apps during the quarter. RXMentor, which is designed to help patients manage their medications, lets patients keep an up-to-date list of prescription medications, supplements, and over-the-counter items in one place. It will also give clinicians insight into what drugs their patients are taking. In a pilot study, the tool helped patients managing multiple health conditions and taking three or four medications simplify their daily routines. Crestwood, Kentucky-based Revon Systems' mobile self-triage platform, the Revon Smart Symptom Tracker, which Humana began piloting in late October with COPD patients. The app asks users simple questions about their symptoms and biometrics and takes in data from a pulse oximeter and thermometer provided to pilot participants. This data is fed to five independent algorithms that have been trained to mimic the triage decisions of board-certified pulmonologists, whose consensus is then returned to the user.
Humana also launched an innovation challenge this quarter to promote apps that would help individuals view and interpret their electronic health record data.
Finally, WellCare Health Plans’ South Carolina subsidiary is now offering the MyWellCare app to Medicaid members within the state. The free app allows members to access their health plan benefits on iOS and Android devices, and can be used to find nearby providers, receive reminders on flu shots or other preventive health screenings, and can send member identification information electronically to providers. The app is also available in Spanish.
WellCare also launched an app in Missouri. Local subsidiary Missouri Care’s mobile app will allow patients to find a doctor or dentist, locate nearby urgent care centers or hospitals, access wellness services, display their Missouri Care Member ID card or send it to provider, and receive member updates. The app is free and can be used on iOS or Android phones.
Health plan partnerships
Several private health plans partnered with others to offer new services to members.
Cigna-HealthSpring tapped ride-hailing service Lyft’s transportation network to assist its customers traveling to and from their doctors or pharmacies. The service — which has already provided 14,500 rides since being introduced in May — will now provide non-emergency medical transportation in seven states and the District of Columbia.
All five of Amerigroup’s Medicare Advantage Plans in Texas will be offering its members free telemedicine consultations throughout 2018 through LiveHealth Online’s web and app-based service. The service connects members with board-certified doctors and licensed therapists 24-7, and supports easy prescription through members’ local pharmacies.
The quarter also saw a handful of interesting partnerships between insurers and wearables makers around the employee wellness space.
For instance, life insurer John Hancock is offering Apple Watches to members who sign up for its Vitality wellness plan and pay a $25 activation fee, according to a report that broke this quarter. If members meet their exercise goals for two years, they can keep the device without paying any more. If not, they’ll be on the hook for the $299 device, which they can pay off in installments. John Hancock has been piloting the program for a few years.
UnitedHealthcare's Qualcomm Life-powered Motion program, which collects activity data which it reports back to insurance providers, usually giving the wearer monetary incentives to exercise, added new connected devices to the platform. While previously employees in Motion had to use Fitbits, they can now use Samsung and Garmin trackers as well.
Finally, international real estate franchise Keller Williams announced that it will be incorporating Fitbit wearables into its employee national US wellness program. This will allow more than 157,000 of Keller Williams’ employees to purchase the devices at a special pricing and participate in organized fitness challenges.