posted by Alicia Caramenico
on September 20, 2017
What does it take to reimagine health care and health insurance through innovation and collaboration? To find out, we asked Oscar Health, a technology-based health plan that’s been disrupting the industry since 2013. With a focus on data, design, and personalized service, Oscar serves roughly 100,000 individual and small group members in New York, California, and Texas.
Dr. Alan Warren, Chief Technology Officer and SVP of Engineering for Oscar Health, shared some of his insights ahead of AHIP’s 2017 Consumer Experience and Digital Health Forum in Nashville.
Alan Warren: Some of the biggest hurdles the health care industry faces are outdated technology and technology lacking interoperability across providers, payers, and patients. As Oscar’s CTO, it’s my job to develop a strategy that directly addresses these issues. This entails working cross-departmentally with our risk, claims, network, and concierge teams to determine what components are needed to build scalable technologies that enable our provider partners and our members to simply and effectively manage their health care. On the operational end, I’m also in charge of pulling our engineering, product and design teams together into a cohesive and well-organized technology unit that works together to execute on these solutions.
Warren: While at Google, I started Google Health, a platform that gave people access to their personal health and wellness information including prescriptions, medical history, and medical records. This experience was ultimately a crash course in the complex integration challenges that exist in health care, and the importance of identifying and focusing on like-minded partners that embrace doing things differently. I think that Oscar has done a great job at identifying these types of partners, such as Cleveland Clinic, that allow us to create truly innovative products that will move the needle. Health care is not a problem that can be solved piecemeal!
Beyond health care, another lesson I learned at Google was how to scale an organization from 45 to 3,000 people. Key learnings here were that you have to be careful to manage the expansion in “surface area” and array of initiatives being tackled as you grow, as well as limiting the growth rate to what your organization can handle and still maintain its core culture and coherence.
Warren: Where to begin! The health care system is fragmented. Even a health insurer like Oscar Health, which is reimagining insurance with first-rate member engagement and technology, can’t follow and track every interaction its members have with the health care system. There are too many handoff points between patients, providers, payers, with no single stakeholder in the health care system accountable for patient health. The digitization of health care is fueling momentum for solutions that the simplify health care experience and hold providers and payers accountable for the health of the member.
Additionally, health insurance has not historically been a consumer-friendly product. When the Affordable Care Act passed and established individual insurance markets, it finally put some pressure on insurers to treat their members like end consumers. That created an opening for Oscar. We’re working to change the way individuals think about their health care by serving as a proactive guide for our members’ care.
Warren: At Oscar, we always start any development process by truly tuning into our members’ needs, pain points and friction. Only by putting our members’ real-life experiences at the forefront of our innovation process, can we actually build the right products to help our members manage care. We also mix in a healthy disregard for the status quo, and a willingness to question how health insurance has “traditionally” been done. Lastly, it’s only with a compassionate mindset that we can develop truly innovative solutions. It’s of the utmost importance for us to maintain a deep respect for the sensitivity of our members’ personal data, and respect the difficulties members experience while dealing with one’s (or one’s family’s) health issues.
Warren: At Oscar, we view tech as a means, not an end. As such, our two main priorities while building technology are connectivity and transparency. We’ve built various communication channels for our members, so that they have the opportunity to communicate with their concierge teams—comprised of three care guides and a nurse—in the way that works best for them, whether it’s by phone or secure messaging. Concierge teams are digitally enabled as well; they have every member’s plan and relevant health information at their fingertips so they can help members navigate complex conditions, medical emergencies, and everything in between.
We also digitally support all methods of care delivery, from on-demand telemedicine to direct appointment booking with doctors. Finally, we strongly advocate for our members by providing them with easily accessible health plan coverage details, anticipated costs and co-pays, and fully built-out provider profiles that include anything they’d want to know before seeing a doctor.
Warren: A killer app will not hearken the digital health care revolution. Everyone in the health care space should be thinking about innovation as a holistic blend of leading edge processing power and analytics, deep integrations with providers, a premier member support experience, and clean and simple user interfaces (that work for all demographics of users). A real 360-degree view of the industry and the actors involved is the key to innovation.