A smartphone app that launches this week from the health insurance company Aetna helps users monitor their own health-tracking data. As costs spiral upward, health-care companies could eventually turn to such apps as a way to encourage healthy behavior.
At MIT Technology Review’s Mobile Summit in San Francisco last week, Martha Wofford, consumer platform vice president at Aetna, said the company would launch an app called CarePass to serve as a portal for an individual’s health-related activity and, if he allows it, his medical records, too.
Through CarePass, a person could enter a health goal—say, fitting into his jeans next month—and get personalized suggestions for how to go about achieving it. CarePass can integrate data from wearable tracking devices like Fitbit or Jawbone’s UP, as well as apps like MapMyRun; it can take into account doctor visits, prescriptions, and blood pressure or cholesterol records. It will also point users to trustworthy symptom and diagnosis information through iTriage, software that Aetna acquired last year.
A few other health-care providers, such as Kaiser Permanente, are getting into this area, but Aetna appears to be pushing forward more quickly than most. CarePass, for example, will include APIs so that patients can give access to their data to third parties, including doctors or other software developers, Wofford says.
Nearly 50,000 health-related mobile apps are already out there, letting people collect data about their well-being and interact with doctors and pharmacies from their mobile devices.
With the entire U.S. health-care system under pressure to reduce costs, insurance companies could start creating financial incentives for people to voluntarily share this data and improve their health and fitness.
President Obama’s Affordable Care Act, Wofford says, allows insurers to increase so-called “wellness incentives” to up to 30 percent of a premium, up from 20 percent before. This would allow employer health plans to create bigger “carrots” for their employees to go to the gym or use a Fitbit. Under U.S. law, incentives have to be based on behaviors—say, joining a gym—rather than outcomes, such as losing 10 pounds versus two pounds, Wofford says. The same rules do not apply in Europe.
CarePass will be offered to individuals at first, but Aetna plans to launch a portal for employers, too. There they will receive anonymous and aggregated data about the overall health trends of their employees, Wofford says.
As health-care costs increase for employers as well, they are likely to become more aggressive in looking for ways to reduce costs.
“I think it will be led by employers,” says Wofford. “We see some more aggressive employers like Safeway, where they are driving outcomes by swabbing the cheeks of employees to see whether they are smoking or not.” U.S. law says that smokers can be charged higher premiums.
More data is not enough to improve health outcomes, however. And the data can be difficult to make use of. Zeo, a company that made a sleep-tracking device, and which was a pioneer in this area, recently went out business because people found its data too complicated to understand, Wofford says. “If we make it convenient enough, the question is whether we can actually drive behavior change,” she says.
"Under U.S. law, incentives have to be based on behaviors—say, joining a gym—rather than outcomes, such as losing 10 pounds versus two pounds, Wofford says."
This is (mostly) incorrect. Under both the current and new wellness regulations (which go into effect alongside the ACA), wellness incentives CAN be tied to outcomes. An employer can have an outcome-based wellness program that requires participating employees to achieve a certain health status (e.g., a waist measurement equal to or less than half of their height in inches).
The caveat is that alternative standards must be made available for those who don't meet the primary standard. In the example I gave of waist measurements, such an alternative would be to take part in a diet/exercise program and work to reduce that waist measurement by 2-3 inches over the course of the year.
The regulations also state that these alternative standards can be altered by the employee's personal physician, and that employers/health plan providers must accommodate those recommendations.