December 24, 2011

Blues Plans Pilot New Wellness Tool With Personalized Web Platform

As health care costs continue to rise, both health plans and employers are looking to wellness programs to slow the rate of increase. Although many insurers offer smoking-cessation programs or discount health club memberships, three Blues plans have teamed up with a company to use its Web-based platform, mobile apps, wireless-enabled biometric measurement devices and digital coaching to devise a more personalized wellness program for members.

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Independence Blue Cross, Blue Shield of California and Highmark Inc. are working with Boston-based Healthrageous, Inc. to launch pilots early next year that will use its technology either on their own employees or a certain segment of membership before offering the system to all members. Blue Shield of California is folding its program into the existing Wellvolution employee program that began three years ago, and Independence intends to begin its pilot program with employees in the first half in 2012, according to representatives from the insurers.

Using the Healthrageous technology, participants create a personalized account using a Web-based portal that includes both a demographic and health habit profile involving physical activity, diet, sleep and tobacco use. Through ongoing interactions, such as inputting weight and blood pressure readings, as well as exercise activity, Healthrageous’ “machine learning personalization profile” monitors participants’ progress and sends out alerts if they are on track for poor outcomes.

In addition, the system provides a digital coach providing daily health tips, health-related messages, biometric feedback (gathered by both wireless and connected devices), and even a social network tool — all available over the Web or via a mobile app — to keep participants engaged.

Healthrageous grew out of work being done at Boston-based Partners HealthCare’s Center for Connected Health, says Healthrageous Chief Technology Officer Doug McClure. He says the tool initially was used to remotely monitor patients with chronic heart failure, diabetes and hypertension, but developers soon discovered it could be expanded to population health management.

In an employer setting, “the platform can be used for management of disease conditions, self-management and wellness,” he tells The AIS Report. He adds that the platform can be tailored to a health plan or employer’s needs.

Healthrageous Vice President of Business Development Greg Zobel says the platform can be used with or without the aid of high-tech devices, such as a wireless glucometer or blood pressure machine, and that information can be entered in manually through the Web portal or app. But he tells The AIS Report that what sets the platform apart is its ability to learn about members and make personalized recommendations as members answer health questions and submit biometric readings.

IBC Uses Employees in Pilot
Independence’s Healthrageous pilot is slated to include about 500 associates from the company. IBC will place at several locations around IBC’s office in downtown Philadelphia kiosks that can measure blood pressure, pulse, weight and other biometric readings for a participant and instantly transmit that information to their personal profile. These employees also will be given pedometers to measure the number of steps walked each day.

“If you set a goal of losing 10 pounds, you would enroll yourself in the digital weight management program,” says Michael Yetter, director of eBusiness for the insurer. “If you forget to weigh yourself, [the platform] reminds you, as well as of your broader goals.”

But one of the ways Healthrageous can be used to encourage healthy behaviors is through use of “gamification,” he says. The term refers to the application of game theory concepts in products. In the case of wellness, Yetter tells The AIS Report that the Healthrageous platform can be set up to support what he calls team wellness challenges. An example of this might be to see which department can collectively log the highest number of steps in a day or week.

“There’s a social networking aspect within the platform that lets other teammates in the program give you kudos…for good results,” he adds.

Yetter envisions targeting Healthrageous to group-based customers to complement existing wellness programs. But first, the insurer will have to build a business case to demonstrate the value proposition to employers and employees, in terms of having more engaged, healthier employees, he notes.

BSC Starts a “Wellvolution”
Blue Shield of California plans to integrate Healthrageous internally through its Wellvolution employee wellness program, which has been around since 2008.

Under the Wellvolution program, employees can get a discount on health coverage by completing a wellness assessment, undergoing a biometric screening and meeting certain health goals or completing targeted wellness programs. The Healthrageous platform will focus on weight management and blood-pressure reductions, says Nazli Ghamarifard, Blue Shield’s senior program manager for Wellvolution.

For example, by “getting people to exercise and rewarding them to do so, we hope to begin to drive behavior change,” Angie Kalousek, Blue Shield’s senior program manager for wellness, tells The AIS Report. “Incorporating exercise into one’s lifestyle can mitigate and prevent many chronic conditions, which ultimately will lead to cost savings.”

Blue Shield will set up a Healthrageous kiosk in its office fitness centers.

Kalousek says the Healthrageous platform integrates biometric tools that enable participants to earn incentives, such as a “health day off,” by completing certain requirements. For example, a requirement might be to complete 1,200 minutes of physical activity over 12 weeks, and the participant would wear a wireless accelerometer to measure the activity and upload it to the platform to track progress.

Blue Shield reports that Wellvolution has already demonstrated improvements in employees’ health. For example, on an annual basis, BSC employees save $1.5 million on premiums and get 3,000 health days off due to their commitment to wellness. In addition, there has been a 22% decrease is smoking, a 22% increase in physical activity, and statistically significant reductions in cholesterol levels.

Beginning Jan. 1, Blue Shield will include the Healthrageous platform as part of its new Blue Groove program, a fully insured HMO and PPO replacement pilot for mid- to large-size employers in the Sacramento area. The program’s goal is to improve health care quality while reducing costs. It incorporates integrated provider/health plan relationships built on accountable care organizations, wellness engagement, value-based insurance design, and the patient-centered medical home (PCMH) model.

While Blue Groove encompasses more than Healthrageous, the goals for the program in its first five years include a first-year premium reduction of between 10% and 15%, a medical cost trend of 5% or lower in future years and improved quality of care.

In addition, members who participate in wellness programs and follow preventive care guidelines will be able to lower their out-of-pocket costs. “Blue Groove is designed to make it easier for members to personalize and achieve their health goals while meeting the needs of a wide cross-section of people,” the insurer says.

Although Highmark declines to comment since it is still in negotiations with Healthrageous, Zobel says that the Pittsburgh insurer will use the platform for diabetes management, including a wireless glucometer to measure blood sugar. The platform also will be integrated into one of its PCMHs to improve communication between providers and patients.

Posted by CraigKeefner at December 24, 2011 09:39 AM