Imagine you could target the exact right health care plan for yourself. No, not via a “Back to the Future” situation. Not from an Ouija board. Not from a séance. Something more personal and private. Your healthcare data. That’s the goal of data-driven benefit selection. The approach is still in its infancy, but one ideal is that one day a tool could pull in health data from all employees anonymously. This includes Electronic Health Records (EHR), pharmacy records, possibly even health fitness trackers. In theory, artificial intelligence (aI) could analyze the data, benefits administrators can see that a large percentage of employees fit a certain health profile—maybe they spend long hours hunched over computers. Maybe they consume 4 Mountain Dews daily. Maybe they are prone to stress, which causes a common recurrence of back issues or chronic fatigue. They also all wear glasses. Eighty-two percent of them see doctors in a particular network or zip code. Also they prefer co-payments for doctor visits instead of high deductibles.

With all this data, the system can evaluate a number of different health care plan offerings, crunch the numbers, and figure out which is going to best suit your employees’ needs and align with the organization’s needs.

This system doesn’t exist currently, but we are moving in that direction.

Stop snooping on me but then again, if it saves money…

The idea is based on personalization. Companies use data they collect on customers’ behavior—what sites they surf, what content they linger on, and what purchases they make—to create personalized offerings the customers are more likely to buy. Theoretically benefits could be personalized in the same way, based on people’s actual behavior rather than their guesses as to which benefits plan would be best.

Right now there’s a rudimentary version of this in which an employee fills out information about their health and insurance choices and the app—sometimes with the aid of a human counselor—helps them choose the best plan. But there are hurdles.

For example, people may not fill the forms out accurately or may leave out things they’ve forgotten or would rather not share with a company they’re not familiar with. The most accurate source of data would be the Electronic Health Record, a digital equivalent of the “file” or record doctors and hospitals formerly kept on each patient. It includes everything from doctor visits to the results of x-rays and tests, medications prescribed, treatments and so forth. As of 2017, 85.9 percent of doctors and health care centers used EHRs instead of paper records. But many people wouldn’t want to grant access to that record.

Another problem is that benefits—even if restricted to healthcare—is much more complicated than choosing a new outfit or even a mortgage product.

I might be willing to put a price on my privacy.

The one thing that often inspires people to share personal information is the ability to save money. A tool developed to help Medicaid patients decide which prescription plan to use their prescription records from their EHRs. It saved them an average of $71 a month in prescription drug costs. Saving money might make people willing to share their personal data.

That’s what insurer John Hancock was counting on when it started incentivizing policy holders to give up their data in order to get a discount on premiums at the end of the year. The company has shifted all of its life insurance policies to Vitality Policies which require customers to start with a health review to determine how their health stacks up relative to your age. Then the company gives customers annual personalized vitality health goals and tips as well as a Fitbit, and an app to track their progress. Healthy behaviors, tracked by the company, give Vitality Points which translate into Status. The higher your status, the lower your premium the following year.

A study done by health care navigation platform firm Castlight Health and the nonprofit National Business Group on Health of 58 U.S. companies, most with more than 5,000 employees, showed that 84 percent believed personalization had the potential to match employees with the right health benefits. But 71 percent of these respondents aren’t using the tools, or are using them very little.

Technology in this arena will continue to evolve and we’ll stay on top of it. For help with how to choose the best plan with the tools we have now, contact us!