By Eric Wicklund, mHealth Intelligence | April 25, 2019
Health insurers are finding new ways to partner with mHealth companies to improve care management and coordination for their members.
This week Oscar Health, a digital health-based health plan launched in New York in 2012, announced a partnership with Cardiogram to give members expedited – and reimbursable – access to follow-up care when their mHealth wearable detects an undiagnosed health concern.
The new service allows Oscar’s members to download the Cardiogram mHealth app on their wearable – including the Apple Watch, Garmin or Google WearOS for Android devices. If the app, whose DeepHeart algorithm analyzes data through the wearable’s heart rate sensor to detect diabetes or atrial fibrillation, shows an elevated risk, the user will be given access to a free diagnostic test, either shipped to the home or offered in a nearby lab. If the test proves positive, the user will be directed to an in-network physician for care management.
The program is designed to help members who don’t realize they have a chronic health concern, and to get them into a care plan with their care provider before their health deteriorates.
“Many people with diabetes and with atrial fibrillation don’t even realize that they have it,” Harish Kilaru, Cardiogram’s Director of Business Development, said in a press release. “But we can help close this diagnosis gap using a device that may already be on their wrist.”
“By working with Cardiogram, we can get more patients to the treatments they need using devices they already own, delivering a fundamentally better type of health insurance today and preventing costly complications tomorrow,” added Nikita Singareddy, an operations and strategy analyst with Oscar, which covers some 250,000 people in nine states.
The connected health service not only improves access to care, but gives health plans an opportunity to reduce long-term costs associated with chronic care.
According to Kilaru, payers offering Medicare Advantage plans generally see $1,200 to $3,000 in annual risk adjustment costs associated with new diagnoses of diabetes or AFib.
“When combined with timely and accurate claims filing, wearable-based monitoring helps a payer accurately understand the health of its members and be appropriately compensated for their care,” he said in a recent blog.
The Cardiogram-Oscar Health partnership isn’t unique, as payers large and small are turning to mHealth devices and platforms to get a better handle on member health and wellness outside the doctor’s office or clinic. Kilaru noted that Apple and Aetna have teamed up to create an app on the Apple Watch for Aetna members, while UnitedHealthcare is subsidizing several mHealth wearables through its Motion program.
“However, more than offering devices, an effective wearable strategy targets multiple conditions and has a triage system that both contextualizes health information and guides members to the right care,” he noted. “Otherwise, a push notification could unnecessarily send someone to the ER.”
That’s why new programs are going beyond simply notifying a user that he or she has a health concern. They’re now directing that user to healthcare providers to confirm that assessment and coordinate long-term care for that condition. By creating a care management plan earlier, patient, provider and payer have an opportunity to reduce care costs and improve outcomes.
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