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Getting Some Outside Help
February 1, 2008
The basics of all the emerging consumer-driven health plans are very similar. These lower-cost, high-deductible managed care plans are linked to health savings accounts that consumers use to pay their out-of-pocket expenses.
To differentiate themselves from the competition, payers launching these plans are investing in robust Web portals designed to make it easier for consumers to manage their accounts, find out information about symptoms they’re suffering and more.
Assurant, a New York-based payer that started offering consumer-driven plans with medical savings accounts back in the 1990s, knew it lacked the internal resources to acquire and manage all the necessary information technology needed for better HSA administration. So the company turned to outsourcers for help.
The payer hired DST Health Solutions, Birmingham, Ala., to head up its I.T. efforts. “We partnered with DST because we wanted to be different from other plans that offered HSAs,” says Carrol Jensen, Assurant’s director of planning and development.
Easy Access
Assurant wanted to enable its members to have better access to HSA information than they could obtain with competing plans, Jensen says. The insurer also wanted to provide its customers with easy access to information they could use to hold down their health care costs. Because consumers pay so much more out of their own pockets in consumer-driven health plans and need tools and information to manage their HSAs, many health insurers have concluded that they must develop new relationships with financial services companies.
“Health plans don’t know much about payment processing and financial transactions, and banks don’t understand claims and HIPAA transaction sets,” says Curt Palmer, senior vice president of consumer solutions for DST Health Solutions.
As it helps manage I.T. for Assurant’s consumer-driven health plan, DST is relying on First Data Corp., Greenwood Village, Colo., to provide the financial transaction systems and UMB Bank, Kansas City, Mo., to be the debit card issuer and the custodian of the HSAs. DST provides the Web services and integrates all the information from First Data and UMB into a single view on a Web portal called HSA Tools, Jensen says.
Assurant has marketed its consumer-driven health plan directly to individual consumers as well as small group employers in need of health insurance, Jensen says. So far, it has signed up more than 1 million members, and more than 70% of them have used the patient Web portal.
Now the company is planning to expand its services to smaller employers as well. As a result, Assurant will add functionality to its Web portal that enables employers to contribute directly into employees’ HSAs electronically.
Too many Web portals for consumer-driven health plans lack complete information, says Steve Lazarus, president and founder of Boundary Information Group, a Denver-based consulting firm.
“There’s a lot of activity around creating portals so consumers can look things up on the Web,” he says. “But I haven’t seen a lot of linkages that enable them to access the banking data.”
Payers launching these new plans also need to handle more transactions, especially HSA transactions and deductible updates, in real time, he argues. That’s because providers risk financial difficulties if they lack the necessary information on how much the patient is paying out of pocket, he says.
Assurant’s members can use the portal to check the status of claims after they have been processed. The site enables the customer to view the information, see what they owe and directly pay the provider for that claim, taking the money from their HSA account in real time with a few clicks of the mouse.
“It’s like looking at your online bank account,” Jensen says.
The funds are sent to the provider via a check along with the necessary information about the outstanding balance due.
Members also can use the patient portal to check their HSA balances, make deposits from other accounts and review debit card transactions.
They can also request to use their HSA for other expenses, Jensen says. For example, if a member purchases a prescription with cash instead of using the debit card, they can submit the expense for reimbursement from the HSA.
If a member’s HSA is running low on funds, they can transfer money from another account. Jensen says members can also set up the account to take funds directly from another bank account at predetermined times. The HSA information is also available from customer service representatives if a member calls in with questions. DST runs the call center for Assurant, Jensen says.
The site also enables members to compare prescription drug information, Jensen says. For example, if a patient is prescribed a drug to lower cholesterol, they can look it up and find out if there are cheaper alternatives.
Patients can also punch in different symptoms to find out information about possible conditions, Jensen says. The site will also help patients identify what questions they should ask physicians about different conditions as well as find a doctor. Assurant plans to eventually add information on what different procedures and visits will cost.
Some health insurers also offer portals that providers can use to make sure they’re charging patients the right self-pay amounts. Assurant doesn’t have plans to offer this functionality, Jensen says.
Learn more online
Visit healthdatamangement.com for more on consumer-driven health plans. * Taking Consumer-Driven Health to the Bank (search Donald Whitford) * Making a Better Connection (search Patrick Kennedy) (c) 2008 Health Data Management and SourceMedia, Inc. All Rights Reserved. http://www.cardforum.com http://www.sourcemedia.com
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