Health IT, Startups

SeeChange, in shift away from health plan to telemedicine and big data, inks deal with Doctor on Demand

As the Affordable Care Act took shape, bringing with it massive changes to the world […]

As the Affordable Care Act took shape, bringing with it massive changes to the world of health insurance, SeeChange Health saw both troubled waters and opportunities ahead.

Once a PPO health plan with a technology business, the San Francisco-based company shifted completely out of the health plan world and turned its attention to the then-burgeoning but now booming field of healthcare analytics, using its payer knowledge to quickly analyze a wide range of data.

Yesterday, it inked a deal to integrate Doctor on Demand, a telehealth startup also based in San Francisco that provides video visits with board-certified physician by way of smartphones, tablets or desktop computers. The service is geared toward employers, augmenting SeeChange’s data analytics that helps both employers and health plans better predict when patients might face risk for costly claims, or help steer the employee toward a more cost-effective provider.

Doctor on Demand will become part of SeeChange’s FlyWheel health improvement platform, a cloud-based, mobile service for consumers that combines various data sets together, including claims, lab, pharmacy, health and biometric data gleaned from wearable devices and self-reported patient data.

From that wide range of data, SeeChange CEO Martin Watson said the goal is to detect and predict chronic conditions, engage more healthful actions by intervening with preventive care, medication adherence efforts and personalized incentives.

“We’ve built this software engine that just consumes tons of data,” Watson said. “We’re mining that data to look at the clinical needs in the near term or the long term.”

The company also sees potential in the emerging private health exchanges, where employers and health plans will be looking for evidence-based options for the variety of health plan options. Conceivably, large employers could use analytics platform alongside a health plan, or a health plan could demonstrate better results to the employer.

“This is a huge change for the payer world,” Watson said. “Now you’re in a world of ‘How do I engage with consumers and how do I help them go to the right provider? I think it will be interesting to see the evolution of those exchanges. Over time, I think they’ll become a site for members to really look at data and see what works.”

And the move into telehealth with Doctors on Demand will further the idea of “getting people to use a great system for low-acuity care,” Watson said.

SeeChange cited a Towers Watson report that predicts telemedicine has the potential to save more than $6 billion in healthcare spending for employers.. In a survey of 1,000 U.S. employers, 37 percent said they expect to offer employees telemedicine consultations by next year as a low-cost alternative to emergency room or physician office visits for non-emergency health issues.

“Telemedicine has the potential to do much more than bring convenience and predictable prices for medical services,” Watson said. “It can help transform us into a wellness culture by delivering preventive screenings, remote monitoring and ongoing management for chronic care patients.”

SeeChange also recently announced a partnership with Family Health Hawaii, a health insurance provider with more than 8,000 members that will similarly use its data analytics for preventive and wellness efforts and engagement.

To that end, SeeChange published a white paper that showed hospital utilization decreased downward between 10 and 20 percent, including bed days and ER visits, over a one-year period. Over three years, hospital readmission rates were down by 50 percent.

The study evaluated a sample of approximately 120,000 members across three employers over a three-year period starting in 2010. The three employers covered an array of industries incuding finance, car rental, and health insurance with a population size ranging from 15,000 to 100,000 members

By the end of 2012, all three employers completed their third year of the incentive program. Among members, nearly to 80 percent completed at least one action defined in the program, and approximately 42 percent completed more than 50 percent of all health actions in the program. In addition, about 12 percent of members completed all rewarded health actions based on age, gender and disease conditions by the end of the third plan year.

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