How Health Insurers Are Advancing Health Tech

How Health Insurers are Advancing Health Tech
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Wearables are now playing an important role in encouraging people to stick to their fitness goals. Many insurers are starting to recognize the potential that wearable devices have in keeping people healthy. Health insurers are joining forces with health tech companies and rewarding customers for wearing digital health devices and sharing their biometric data. This integrated approach is giving more people access to health technology.

It could also support the national effort to address improving the sedentary lifestyle of many Americans—one of the main risk factors for various chronic diseases.

Public-private partnerships and involvement of different stakeholders have been encouraged in the fight against chronic diseases. As health insurers partner with health tech companies, more users hopefully will gain access to the latest in digital health. Simultaneously, new wearable devices are being developed that could meet the demands and challenges users face in their everyday lives.

Using Wearables Can Result in Dramatic Health-Care Savings

Self-management health programs are increasingly being promoted as a preventative strategy. Studies show that learning and practicing self-management can be tremendously beneficial. This type of active engagement is particularly applicable to patients with chronic conditions—for example, diabetes, arthritis and cardiovascular diseases—who need to follow certain lifestyle routines and health regimes to stay out of the hospital.

A study led by SanghNam Ahn, assistant professor at the University of Memphis, showed that a well-implemented self-management program can bring a host of benefits, including increasing health outcomes and lowering health costs. Ahn calculated that self-management could bring a significant reduction in ER visits and hospital admissions, resulting in $364 net savings per person annually.

On a national level, implementing self-management could mean saving up to $3.3 billion per year.

Self-monitoring has been recognized as an important pillar of self-management. For instance, activity trackers have been studied as a valid tool that could help manage health risk factors such as inactivity. Sales of activity trackers keep increasing, making them one of the top-rated trends in digital health. Parks Associates, a connected health research firm, estimates that by 2019, more than 82 million fitness trackers will be sold globally, even when factoring in the likelihood that lower-cost physical activity trackers will likely become more commonplace in the coming years.

This downward pressure on wearable pricing is great news for consumers—lower prices means digital self-monitoring will be more accessible to people from all walks of life. At the same time, research is confirming the value of low-cost fitness trackers in disease prevention. For instance, Jochen Meyer of OFFIS Institute for Information Technology and Andreas Hein of Carl von Ossietzky University in Oldenburg, Germany, used the Fitbit Ultra and Garmin Forerunner 110 in their study of healthy participants. They showed that when physical activity trackers are used in natural settings and on an ongoing basis, they could help prevent cardiovascular disease, one of the leading causes of death in the world.

Letting Your Insurer Know How Active You Are

Employees used to be offered incentives for completing a health risk assessment survey or undertaking biometric screening. Consumer wearable devices now promise a more efficient way of stimulating people to commit to a healthier lifestyle. Many experts argue that digital health devices can contribute to behavioral change. Furthermore, these devices remove several of the limitations of self-reporting. Hence, many health insurers in the United States started showing interest in them. They now reward those who reach their activity goals as documented by their digital health devices.

Fitbit and Jawbone have been two of the most dominant players in the wearable market. Other vendors of popular tracking devices include Apple, Samsung, Garmin, Microsoft, Withings and Polar. Many of them have been working closely with health insurers, allowing them to reach new segments of the U.S. population.

A large-scale, Los Angeles-based study that included almost 84,000 participants showed that people are not very eager to share data with their health providers. When encouraged to sync their personal fitness trackers with electronic health records (EHR), only 0.8 percent complied. The study also found that those with health risks were the least likely to share their data. Healthy, young men were most likely to participate. Authors of the study, led by assistant professor Joshua Pevnick of the Cedars-Sinai Medical Center, concluded that extrinsic motivators, such as incentives, might therefore be required to promote better data sharing among Americans. The finding could be interpreted as another argument for insurers to use marketing incentives to promote data sharing.

Health Technology Players Partnering With Insurers

In 2015, John Hancock was the first to offer its policyholders discounts on their life insurance if they agreed to wear a Fitbit wristband, which was provided to the user for free. Users can earn points by partaking in physical activity. Other health insurances soon followed its lead. In 2016, Aetna became the first major health-care company that offered their customers Apple Watches at significantly reduced prices. In addition, Aetna employees received the watches for free if they enrolled in their wellness program.

Other insurance companies, too, started offering different perks to their customers if they committed to tracking their physical activity. For example, UnitedHealthcare and Qualcomm partnered with Fitbit. This program encourages people to reach their fitness goals and in turn earn points. These points can be redeemed to a maximum of $1,500 in health-care credits. Many national health insurers, including Humana, Cigna and HCSC, now offer incentives that are linked to activity tracking and the sharing of your activity data with the insurer. Rewards are wide ranging and can come in different formats, ranging from Amazon gift cards to discounts on healthy food at Walmart.

Smaller insurance companies have been joining the fitness bandwagon too. One of the most notable has been Oscar Health Insurance, which partnered with Misfit. They offer their policyholders a free Misfit band that connects to Oscar’s app. To earn points, users need to reach certain walking goals, which can bring them up to $240 in rewards per year.

It has also been suggested that data from activity tracking could, in the future, be used to determine your insurance policy pricing. Those who try harder to stay healthy might be given lower rates. However, this could jeopardize the growing partnerships between fitness-tracking companies and payers. Based on collected data, those less active or unable to participate in a required fitness program could be denied coverage. Or, prices could be increased for certain customer groups. Companies could then refuse patients with pre-existing conditions. Data collected by a wearable device might even enable insurers to detect that a certain customer has a health condition and deny coverage for him or her. At present, however, these partnerships still bring many benefits and potentially positive outcomes for the end user, while the focus remains on rewards and not penalties.

Pairing Fitness Tracking With Health Data Can Bring New Insights

Some insurers are investing in wearable technology and are interested to see what other benefits digital devices can bring. Due to their simplicity and inexpensiveness, activity trackers get used in a growing number of clinical studies. Fitbit devices, for example, have been used in a range of studies: from evaluating patients’ fitness for chemotherapy to studying diabetes prevention among youth.

A research group led by professor Michael Snyder of Stanford University School of Medicine explored the use of wearable devices in monitoring changes in physiological functions—such as heart rate, skin temperature and oxygen level—and linking any changes to disease onset. Currently, it can take months before a health condition gets noticed. Timely diagnosis, however, could make the recovery process a lot shorter, easier and also cheaper. The long-term idea is that health apps can alert the user (or insurer) that something is not quite right before he or she notices any noticeable changes in their body’s function.

Snyder’s group found that by combining biosensor information with individual’s medical measurements taken over a long period of time, the wearable device could identify early signs of Lyme disease as well as detect inflammation. They were also able to distinguish between insulin-sensitive and insulin-resistant individuals, which could help diagnose diabetes. Progress has also been made in using personal trackers to diagnose the flu.

If insurance companies had access to patient data, they could provide incentives for early interventions. They could, for instance, detect changes in activity levels or the body’s vital functions that signaled a client was getting ill. Based on that, the insurance could promptly notify the user to suggest treatment before symptoms became fully blown and treatment becomes more expensive.

Those types of scenarios, however, will require more studies to ensure the accuracy of measurements as biosensors continue to proliferate. Also, better data protection needs to be established. Nonetheless, scientists are showing that continuous tracking of individuals’ activity and physiological characteristics could help analyze their health and guide better health-related decisions while lowering health-care costs. Therefore, the role of wearable devices will most likely become invaluable in the process of health maintenance and disease prevention. The progress in this area also suggests that further partnerships with health providers and payers will likely continue.

Sources

Ahn S, Basu R, Ory M, et al. The impact of chronic disease self-management programs: healthcare savings through a community-based intervention. BMC Public Health, 2013.;13: 1141. doi: 10.1186/1471-2458-13-1141.

Hickey A, Freedson P. Utility of Consumer Physical Activity Trackers as an Intervention Tool in Cardiovascular Disease Prevention and Treatment. Progress in Cardiovascular Diseases, 2016; 58:613-619

Li X, Dunn J, Snyder M, et al. Digital Health: Tracking Physiomes and Activity Using Wearable Biosensors Reveals Useful Health-Related Information. Plos Biology, 2017;15(1):1

Meyer J, Hein A. Live long and prosper: Potentials of low-cost consumer devices for the prevention of cardiovascular diseases. Journal of Medical Internet Research, 2013;15(8)

Pevnick J, Fuller G, Duncan R, Spiegel B. A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results. Plos ONE, 2016;11(11):1-5.

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