Industry Voices—How tech companies can help health insurance leaders meet the COVID-19 challenge

Back in February, I sat down to write a call to arms for health insurance technology leaders. The time had come, I believed, to stop investing in the legacy technologies that have long made interactions with health insurers such a dreadful experience for American consumers.

I had a rallying cry raring to go: Let’s stop trying to build systems and solutions ourselves and instead turn to external technology partners. Let’s reorient our IT teams around business and product outcomes. That, I thought, was how health insurers could not only improve their reputations with consumers but also make our members—healthier and our healthcare system more affordable.

A few weeks later, of course, the world changed. By late February, all my extended working hours were focused on supporting my team in helping 3.4 million CareFirst BlueCross BlueShield members and more than 5,000 colleagues grapple with a full-blown public health crisis.

Yet while the crisis forced me to set aside work on my manifesto, it didn’t weaken my conviction. If anything, it has shown me it’s more critical than ever for health insurers to shift away from technology tools built in-house and toward innovative solutions built by nimble technology companies. 

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The benefits of a technology partner for health insurers

When we partner with technology providers who understand health insurance, we can move quickly to build solutions that help our members understand their benefits and direct them to take actions that will improve their health at the lowest available cost.

Last year, we invested in a new technology platform created by a company called Zipari. It provides a new customer portal, call-center technology with a single user-friendly interface for customer reps, and a wealth of other tools that give us a holistic view of our members and a new suite of tools for coordinating and optimizing our communication with them.

Building that technology ourselves would have taken years; Zipari’s was available out of the box. Customizing it and implementing it for our business cost millions of dollars less and will get done exponentially faster than if we’d tried to build such a platform ourselves.

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Partnerships like this have three critical benefits for health insurers:

Acceleration: COVID-19 will only accelerate the industry’s transition toward a consumer-driven, technology-powered future. Consumers will demand the same immediate answers, online and mobile transactions, and easy access from their health insurers as they get from their bank.

Partnering with dynamic tech companies like Zipari helps us keep pace with those demands. By buying the technology from them rather than trying to build it ourselves, we can implement it faster, at a lower long-term cost. And it can be configured to improve—not replace—our existing workflows, including the way we manage customer interactions in Salesforce.

Engagement: One of our healthcare system’s greatest flaws lies in insurers’ inability to connect with and understand their members, at each and every moment they intersect with that system. Insurers like CareFirst may have the data and expertise to guide members through those interactions—to steer them toward the providers, decisions, and actions that will give them the best health outcomes at the lowest cost. Most just don’t have a way to effectively and consistently communicate the message. 

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Technology platforms enable us to do just that. By pulling together our data—from legacy systems that don’t interact with one another—into a single application, our new platform gives us the ability to stay in touch with our customers at regular points along their journey, creating an opportunity to significantly improve the member experience.

Systemic change: As the pace and degree of healthcare change increases dramatically, health insurance leaders—historically resistant to change and reluctant to relinquish their sovereignty in the healthcare world—will be forced to become more agile. Partnering with outside technology companies will be one way of doing so. 

Over time, these partnerships will begin to transform the entire system. As more insurers implement technology platforms, we’ll start to see network effects similar to those created by Salesforce or Facebook.

Zipari, for instance, uses its platform to create self-sustaining feedback loops that are constantly analyzing data from across their customer base and using that data to improve the application’s performance and deliver insights back to those customers. That feedback loop only gets more powerful as more companies come aboard.

During the pandemic and in the years that follow, health insurance leaders will be judged on their ability to improve their customers’ health while gaining and maintaining their trust. Those who rise to the occasion will be rewarded with powerful customer loyalty and stronger brands. Those who do not will struggle to attract and retain members in a post-COVID world.

This depends on more than just technology. It requires leadership. Healthcare leaders will need to have the courage and humility to acknowledge the ways our existing system’s shortcomings impact our social and economic order—and then seek a way forward. In partnership with technology companies, CareFirst is simplifying the complex, delivering tailored solutions and stepping forward with new ideas.

I believe partnering with innovative technology companies is the way. I hope you’ll join me.

John David Kaercher is chief information officer and executive vice president of information technology and operations at CareFirst BlueCross BlueShield. He is responsible for a broad range of strategic initiatives, technical and operational support, and oversight and control functions across the company.