What is the difference between a man who is diabetic, married, travels frequently and has a dog, with his diabetic male friend, who is divorced, doesn't travel much, and has no pets? The answer is $16,000 per year in health care costs.
This finding is a result of advanced analytics performed by Carrot Health. The Minneapolis-based startup has built a big data model that uses more than 70 data sources with 5,000 variables calibrated on 3.4 million individuals to predict an individual's health care use. This model is being used by health systems to help them identify individuals who can benefit from case management and lifestyle counseling.
Carrot Health's model is an example of powerful tools now entering the health care system to support a move toward a broader engagement of individuals in their own lifestyle and health — particularly outside of the traditional health care system.
This transition was evident at the 11th annual Executive Conference on the Future of Health Care held recently at the Opus College of Business at the University of St. Thomas. Organizations are now finding opportunities to reinvent the health care system that most of us have experienced throughout our lives, including clinics, hospitals, drugs, medical technology and health plans. Presentations at the conference highlighted a new pathway for the evolution of the system which will still contain these traditional components but also will be broadened with new tools, processes and organizations to engage consumers in all aspects of their lives.
Entrepreneurs and innovation centers in big systems are creating new structures to either break or circumvent some of the old paradigms. For example, conference speaker Jean Wright, vice president and chief innovation officer of Atrium Health in North Carolina, shared how her organization used human-centered design principles to reconceptualize the structure of its operations.
Atrium Health created a subscription model of primary care, Proactive Health, that is designed to complement today's lifestyles. It includes an online care platform for care delivery and education, an interactive chat engine to share health information to drive a personalized action plan, health coaching with lifestyle planning, collaborative data sharing with the health care team, connections to apps and wearable devices and mindfulness training, healthy cooking demonstrations and more. At $25 per month in addition to traditional health insurance costs, this model aligns nicely with other consumer subscription models such as Netflix and Spotify.
Another innovation of this consumer-centric trend is Bind, a new concept in health insurance that provides core insurance coverage with the ability to add benefits as needed at any time. The core benefits include preventive care, emergency care, chronic care and pharmacy; the enrollee can add specialty coverage when they need it (e.g., obstetrics, certain orthopedic procedures). Bind also provides users with transparent pricing. Using machine learning and pattern science, they also provide the consumer with the most direct and cost-effective pathways to wellness. Bind's analytics and care recommendations have yielded lower premiums because of the removal of extraneous coverage. Bind is a leading example of a health care product that can be customized by the consumer to meet their needs.
Although the core elements of the health care system will remain into the future, innovators such as Carrot Health, Atrium Health and Bind are using emerging digital tools to create structures and organizations focused on the individual's needs and desires to maintain their health.
The companies are also using these emerging technologies to emulate industry leaders in consumer services, such as Amazon. For example, Carrot Health can determine your health status through analysis of large consumer data sets (Amazon knows which books you like); Atrium is crafting services that are convenient and accessible to you (Amazon has same-day delivery); and Bind lets you create a health insurance package that meets your specific needs (Spotify lets you customize playlists).
The health care consumer of today can look to the future where they will have many new technologies that are easy to use, effective in maintaining their health and convenient in accessing needed clinical health care services. And — they probably will have a dog too.
Daniel McLaughlin and Joseph White are on faculty at the University of St. Thomas Opus College of Business.
