HUMANA: Laying Groundwork For ‘HMO of the Future’
Hoping to lower costs and improve medical decision-making, Humana Inc. is positioning itself to become a leader in the "digital health plan industry" -- and possibly the first health plan to operate fully through the Internet. The insurer plans to launch separate Internet sites for its different users, including plan members, physicians, employers and insurance brokers. Portions of the new sites, such as a service that allows members to search for information about the medical procedures covered under their plan, are being piloted and ultimately will be extended to larger groups of customers. Humana plans to put health risk assessment surveys online to identify high-risk customers and link them to case managers, and will create chat rooms for members to share their health experiences. To attract physician users, the company has partnered with companies that offer billing and claims processing, supply ordering and patient data transmission services, and in January, it penned a deal with Healtheon/WebMD, adding general consumer and professional content and the ability to offer online referrals and authorizations.
Some analysts argue that the transition to a Web-based strategy will not give Humana a competitive advantage or boost market share, but one observer calls the insurer's efforts "prudent," projecting that they will cut administrative costs at the very least. One analyst, noting that the Web will play a key role in most insurers' efforts to trim transaction costs, predicts it will take several years to assess whether Humana's Internet strategy secures the insurer an edge over rivals (Adams, Louisville Courier-Journal, 3/5).
The Boss in Beantown
Meanwhile, a similar idea comes from Texas billionaire and erstwhile presidential candidate H. Ross Perot, whose Perot Systems holds a 10-year, $700 million contract to supervise Harvard Pilgrim Health Care's claims and technology systems. Perot is negotiating a second deal that would enable the computer company to help transform the struggling insurer into a Web-based "HMO of the future." The Boston Globe reports that Harvard Pilgrim plans to unveil the first stage of the new Healthbank system, an online enrollment service for employers and employees, in April. In Boston there are "all these genius doctors practicing in all these elite hospitals. What better place to create a model for how medicine should be practiced in the 21st century?" Perot said. By the end of 2001, Perot envisions a platform through which providers, employers and members will be able to update patient accounts online and the HMO will wire payments directly to providers. Sources say Harvard Pilgrim and Perot Systems would split the estimated $20 million cost of the system, though an official with a state HMO association cautioned that the system must overcome challenges such as Internet privacy concerns (Kowalczyk, 3/8).