Now, for those of you who may be thinking “jeez Oldham, this sounds like another ‘cut and paste partnership press release’….or it’s probably just allowing a carrier to ‘check the box’ on an upcoming consultant RFP”.....to that I would say, pump the brakes. In this instance, these two massive industries joining forces is something much, much more:
1) Guardian is an investor in Spring Health - and as opposed to my cousin “the Oracle of Odessa” Jimmy, who calls himself an investor while feverishly buying Doge on the Robinhood app during 24 second NBA timeouts, when insurance carriers invest in digital health companies, they are not simply toying around on an investment app…. insurance companies are looking at digital health to improve the lives of their customers, differentiate carriers in a tough, competitive market such as STD and LTD business and to grow their investment.
The convergence of digital health and disability insurance is just beginning. So, if you are asking ”why would disability carriers want to partner with digital health companies”? Well, in the last few years, disability carriers have taken notice of health plans and PBMs. These companies have provided disability carriers with numerous examples demonstrating how digital health has transformed their business, improved their customer satisfaction, and grown their bottom line.
1) Cost and Convenience - Most of us are aware of the significant adoption of health plans and PBMs incorporating various forms of digital health or digital pharmaceuticals to complement their products and formularies. And this isn’t just a “phase”. Heck, the majority of health plans and major PBMs have established investment teams solely to monitor and invest in the digital health and digital pharmaceutical market. Health plans are leaning forward in embracing the latest forms of population health,delivering an enhanced customer experience and obtaining a return on their investment. Covid certainly grew digital health adoption, but digital health is not going away. Numerous studies reflect that the convenience, cost and comparable clinical outcomes delivered by digital health companies is meaningful. Further, the rising costs of healthcare has been an employee concern for years - Americans are eager for alternatives to obtain care in a cheaper and convenient (e.g. not requiring to leave work for every doctor’s appointment) manner. Health plans embracing digital health programs address these market concerns.
2) New Employer Contracting Efficiency: Digital health companies specializing in products such as telehealth, behavioral health, cardiovascular disease, digital chronic condition management, musculoskeletal, infertility, and others have done well in selling directly to employers/via their consultants/brokers; however, digital health companies reach the ludicrous-sphere of growth when partnering with health plans or PBMs to distribute their products. An employer adding a digital product to its health plan or PBM through the convenience of a one page order form is efficient and helpful for everyone - plans/PBMs expand care faster, employers significantly reduce the typical, internal contractual friction-filled approval process by adding new digital services within the framework of existing agreements and last but not least, employees get their hands on digital products quicker. The adoption of digital health has also sparked the creation of virtual health first plans and hybrid (digital and brick and mortar care) plans. Disability carriers are not naive to the ways in which digital health has improved health plan performance, increased member-level customer service and clinical outcomes….and its applicability to their disability world as well.
3) Digital First Customer Service - We live in a business world of increased service expectations, real time feedback to customers, personalized guidance and data driven decision making. Traditional health plans and PBMs were not initially created to provide responsive, digital first, feedback. As Geoffrey Moore pointed out 20+ years ago, new, disruptive technology customer adoption requires an industry (such as healthcare) to make a choice - to either try to “build” the new technology themselves or become an early adopter in “buying” new technology advancements in their industry. Kudos to health plans and PBMs for “buying” - forming partnerships and investing in digital health companies. Traditional/historical means of providing customer service - via 800 #s, paper claim forms, faxes and/or email doesn’t provide the immediacy that consumers expect in a digital marketplace. Digital health offers a multitude of personalized, real time, feedback to the consumer, empowering patients to manage her/his health. Disability carriers are taking notice.
Come Together - how does combining digital health and disability help employees, employers and carriers?
1) Getting “in front” of a disability - as with other forms of insurance, it’s incredibly difficult for a carrier to provide value, create a relationship and gain trust with its constituents in advance of a claim-related event occurring…such as an injury, illness, accident, etc. Oftentimes, an employee may pay premium for years before utilizing an ancillary benefit. Yet with the combination of, for example, a behavioral health company and a disability carrier joining forces, there is an opportunity for employees to utilize behavioral health digital products prior to a mental and nervous illness disability claim. Taking this a step further, “pre-disability claim behavioral health engagement” could ultimately lead to reducing a claim’s duration or perhaps even avoiding a disability claim altogether. Further, for the employee, she/he finally begins a relationship with a carrier in advance of a claim, as digital health provides personalized service and trust. This kind of pre-claim engagement never existed before digital health and disability carriers joined forces.
2) SDOH (Social Determinants of Health) and HPSA (Health Professional Shortage Area) - these are acronyms and challenges typically most associated with member limitations of access to health plan professionals. A good example of using digital health to address HPSA challenges is in this peer review paper. In it, Lark Health provides 4,000 health plan members living in an HPSA “desert” AI pre-diabetes management care via their smartphones. Incredible clinical improvements and engagement occurred, in an area of the country in which, without Lark, 95% of these 4,000 members wouldn’t have had access to “brick and mortar” care. Disability carriers and their customers battle similar access hurdles as health plans….it’s incredibly difficult to manage an STD or LTD claim in very rural areas with limited access to physicians. In partnering with digital health programs, whether it’s behavioral health, preventative care, musculoskeletal, diabetes management, etc, disability carriers would be able to provide care and monitor services for their customers in ways carriers only once dreamed of.
3) This ain’t your grandparents' disability carrier - Digital health products combined with a disability carrier will introduce a multitude of customer service related enhancements, such as remote patient monitoring, digital scales, blood pressure cuffs, wearables, etc. For those of us who have worked in the disability industry, either as an employer, a broker or on the carrier side of the fence, we are all aware of disability claims placed “on hold” due to a lack of updated medical data. We all get it, PCPs are inundated with paper, phone or email related activities. However, with these delays, there are employees in great need to receive the benefit in order to pay bills and feed their family. Digital health provides carriers with faster access to claimant data, rehabilitation updates, including confirmation of preventative care compliance of chronic conditions. Imagine a disability carrier managing a musculoskeletal claim (MSK claims are the second most popular short term disability type and number one in LTD), and to extend a disability benefit, the carrier needs to confirm the employee is maintaining her/his MSK rehabilitation plan. Incorporation of an MSK digital health plan, such as Hinge or Sword, can provide this information….in real time, to the carrier. Similar to “getting in front of a claim”, access to digital health and the corresponding data (with employee consent) will ultimately provide the disability industry with the chance to reduce disability duration. And do so in a way which is, most importantly, helpful to the claimant. This is a kind of Jetson’s-like experience for the disability carrier industry.
4) Customer Motivations have Changed: In our world of employers doing more with less, requiring an employer to complete more claim forms, make more calls to a carrier or send more emails to file or update a disability claim just won’t cut it. The adoption of digital health partners will allow disability carriers to become true extensions of a benefits team. Benefit teams are looking for ways to provide better service to their employees, and do so in a way in which growing headcount isn’t typically a viable option. Technology and digital health can reduce an employer's day-to-day management of benefits, while providing the level of care expected by their employees offered in other forms of consumer business. As an example of allowing tech to drive efficiency and improved customer service, two years ago, my car flooded in one of Charleston SC’s notorious summer flash floods. After completing my Shawshank Redemption hands up to the sky, in the rain reaction, I downloaded my car insurance’s app, took pictures of the car, answered questions (e.g. filed a claim) with an AI bot, uploaded the pictures to the app, spoke to a claim rep for less than 2 minutes, and received my car insurance benefit via direct deposit in five days. It was a break-through, educational customer insurance experience for me. With the adoption of digital health programs, disability carriers can ultimately reach this level of customer service in managing particular claims.
And this digital and disability collaboration is just the beginning. In addition to Guardian, other non-health carriers (Aflac, Allstate, New York Life, MetLife, etc) have also created venture teams, evaluating new forms of digital health (physical health and financial health). So as health care quickly blends into an omnichannel of brick and mortar care, digital health and home health, the VC firms of disability carriers are taking notice and will be ready to make a similar transition in their industries as well.
The marriage of disability carriers and digital health companies provide a unique opportunity to advance the disability industry, establish a new level of customer service, and create an experience which is more in alignment with consumer expectations. It’s a cool culmination of respective all stars in their unique fields, digital health and disability carriers, coming together to “handle with care” employee and employer needs in the digital world.
Beatles source: The Beatles in 1969 © PictureLux/eyevine
Traveling Wilburys source: https://www.travelingwilburys.com/photo-gallery-polaroid