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Posts Tagged ‘United Health Group’

CR_brandWebNovember saw the acquisition of yet another HIE vendor by a payer (Humana). An in-depth analysis of this acquisition and its implications was provided to Chilmark Advisory Service (CAS) clients at the end of November. Following are abstracts of the three research notes in our latest Monthly Update.

Humana Leaps Into the HIE Market
The health insurance industry is undergoing massive upheaval. Payers don’t need a crystal ball to see that in the near future, providers will sell services directly to employers, and that insurers need to get creative in order to stay competitive. With its acquisition of HIE vendor, Certify Data Systems, Humana joined two other payers in the HIE market: Aetna and UnitedHealth Group. Yet Humana’s strategy sets it apart from the other payers. On a single day in November, Humana announced not one but three acquisitions: Certify plus two Florida-based managed care service organizations. Humana has clearly articulated its plan to become the preferred Integrated Delivery Provider to Medicare Advantage members and dual eligibles. By adding Certify’s strong HIE capabilities to its bag of tricks, along with the ability to deliver primary care directly to a large Medicare population, Humana has positioned itself to do just that.

Taking Population Health from Claims to Clinical
As you know from past updates, the burgeoning field of healthcare analytics is a top priority here at Chilmark Research. This month, we take a look at population health management and current efforts to adapt existing claims-based risk management to clinical settings. Population health and risk management have long been the purview of health insurers and public health departments. Yet as providers take on more risk, they will need to identify populations and sub-populations that could benefit from preventive health – and ultimately cost less in healthcare services. THis research note takes a look at some of the traditional, claims-based analytics vendors and their intentions to move into analysis of real-time clinical data sets.

From Med Lists to Meds Reconciliation to Meds Adherence
Ask any home-care provider, and you’ll hear stories of medicine cabinets chock full of old, unused medications. Chronic disease and frequent hospitalizations compound the problem, because patients end up with medications from before and after each hospital stay. It’s no wonder that medication maladherence is recognized as the most important driver of preventable readmissions. But understanding the problem is much different than finding a solution. Chilmark Research reports on the current fractured state of medication adherence, and argues that without deep provider engagement and interoperability across systems, true medication adherence programs will remain a pipe dream.

Each month, subscribers to the Chilmark Advisory Services (CAS) receive an update of our research on the most transformative trends in the healthcare IT sector. Exclusive to CAS subscribers, monthly updates are part of the continuous feed of information and analysis we generate to keep subscribers on top of the rapid-fire changes in this market. Below is a summary of what we covered in the latest update, which was distributed in November.

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optum1Seemingly on a roll, OptumHealth, the consumer facing health and wellness division of United Health Group (UHG), the nation’s largest health insurer, announced yesterday that it will support health record portability by allowing members to export their Optum PHR data to HealthVault.  Basically, what this means is that any user of the Optum PHR (formerly know as Health AtoZ which is free to any and all, not just UHG members – it is ad supported) will be able to move their health data out of the Optum PHR and into HealthVault, with HealthVault serving as a long-term, independent data repository that is controlled by the consumer.  This action follows on the footsteps of a similar announcement by Aetna in October.

While the press release states that this is being offered to all 25M+ members of UHG, it raises all sorts of questions.  A few which we hope to have answers for next week when we speak to Optum are:

  • Just how many UHG members are actively using the OptumHealth PHR today?
  • Exactly what types of data will be portable?  Is it everything that resides in a member’s PHR (e.g., claims, maybe PBM, HRA data) or some subset thereof?
  • When will this be made available, is it live today or will it be phased in?
  • What is the business case for making this happen?  Is this something that employers are asking for or are there other justifications?
  • Will you be making similar announcements in support of Google Health and Dossia (Dossia is a bit of a no-brainer)?
  • How will data flow between the two systems (publish/subscribe model – RSS, Atom, etc.) and what will be the data standard used?
  • How will you be positioning and advertising this capability to Optum PHR members?

We’ll put up a more in-depth post next week, provided OptumHealth is forthcoming with answering our questions.

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Being the nation’s largest heatlhcare insurer, it was only a matter of time before United Health Group (UNH) jumped into the fray of providing a consumer-centric healthcare website, which they announced this morning, myOptumHealth.com.  This follows similar moves by competitors CIGNA (finally coming on-board), Wellpoint (who seems to be adrift) and Aetna, (leader fo the pack) who introduced their SmartSource solution earlier this year and announced in October that they would allow members to export their claims data to HealthVault.

But there is an important twist with the UNH announcement.  This is a straight consumer play and will go in direct competition to existing players such as WebMD, Yahoo Health, and Waterfront Media (who recently merged with the now defunct RevolutionHealth). This is a big departure from its traditional competitors, other health insurers, whose initiatives have focused strictly on their existing members (the right-hand side of the slide below).

optum

Looking more closely though the basic myOptumHealth is not all that new, nor is the business model as this is as much a rebranding of their consumer-facing PHR which they acquired a couple of years back, Health AtoZ.  The HealthAtoZ PHR is a pretty decent solution that received high ratings in a number of categories in the iPHR Market Report that Chilmark Research published earlier this year.

It is also clear, however, that the OptumHealth Group at UNH have significantly built upon HealthAtoZ via a number of partnerships which are as follows:

  • A.D.A.M. – Providing interactive health slide shows.
  • HealthDay News – a daily health news service that a consumer may subscribe to.  Does not appear to support customization.
  • Healthline – Health-related search engine.
  • Healthology – Providing some 600 health streaming videos. Note that iVillage, the company that acquired Healthology for $17.5M, has taken steps in 2008 to trim costs that has lead to little “new” content. Tried one of the videos, not a user-friendly experience. Not the best partner to choose, but I bet the price was right.
  • Healthwise – Health content in Spanish for Hispanic population.  Healthwise is quite pervasive as a partner for health content on a number of health insurer sites.
  • Multum – Medication information including interaction checker, alerts and approvals. Multum is a Cerner product.

The site also has a doctor finder that uses the Igenix solution, a company UNH acquired several years ago.  Did a quick search on the finder, pretty poor as it was slow, provided few specialties to choose from and gave only the most basic info on a given physician.

In 2009, OptumHealth plans to roll-out specific health/disease-centric communitites similar to the one they launched earlier this year, my CancerHub.  Based on a cursory review of myCancerHub, other sites such as MedHelp and PatientsLikeMe need not worry as myCancerHub discussions are ancient (most recent posting, 3 months ago!).

Note, that in addition to this announcement, we have received information that UNH, through its OptumHealth Group is working with all three personal health platform (PHP) plays, Dossia, Google Health and HealthVault in support of portability for claims data.

Wrap-up

Interesting and novel push by UNH into the direct to consumer (D2C) market.  Yes, consumerism is coming into healthcare with consumers increasingly looking to the Web for information that helps them manage their health and/or the health of loved ones.  It is good to see a health insurer openly acknowledge this trend and move in a direction to not only assist their members, but support the broader market as well.

It is also apparent that WebMD and others are not the only ones seeing some healthy advertising revenue opportunities in the health & wellness sector. Yet, beyond this obvious revenue source, UNH will be able to leverage myOptumHealth for effective cross-promotion of other UNH services such as health coaching, vision & dental insurance, life insurance, and health-related financial services.

As with all these sites though (myCancerHub is a clear example), the big question remains: If you build it, will they come?  It takes far more than a press release and a collection of partners to gain traction in what is becoming a crowded market.  It will take some pretty hefty marketing spend. That doesn’t mean you have to advertise during the SuperBowl, but it will require investment and it is unclear just how much OptumHealth is willing to invest. Based on partners chosen and features out of the box, looks like they are not investing at the level they will need to to become a serious player in the D2C healthcare market..

It also remains to be seen how consumers will respond to a site sponsored by a health plan.  Sure, they may go there to collect basic health & wellness information, but will they use a health plan’s PHR if they are not a member?  First, it is exceedingly rare that a consumer is willing to populate any PHR on their own, let alone one from an insurer, as it raises all sorts of fears of future denial of claims.  Secondly, will consumers trust OptumHealth with this data?  Looking at myOptumHealth’s privacy and security statement (in the PHR section), while clear and straight-forward, it says nothing about how such data might be used.  In other words, there is no clear statement saying: No we will never use your data without your expressed consent. That definitely puts the brakes on for us.

Grade:

A: for initiative and risk taking

C-: for execution

F: for privacy policy (or lack thereof)

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