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Centralized data is enabling digital health innovation: A conversation with Vericred’s Michael Levin

Trying to find a compatible health plan for his family of six (one that covered […]

Trying to find a compatible health plan for his family of six (one that covered all of his family doctors) is what led Michael Levin to co-found Vericred, a New York-based healthcare data services company where he’s currently CEO. What he figured would be a 15-minute process on Healthcare.gov, the public health insurance marketplace, actually took him six hours on a Saturday. Levin had to work backward: He went to each carrier, found the corresponding doctor information, and copied the information into a spreadsheet on his computer. Eventually, he found the right plan to cover his family, one that included all of their family doctors in-network. Why the runaround? “There was no single place that stored all this provider network data,” says Levin. “And the need for this central data layer to enable innovation in digital health and insurance tech became very clear.”

That’s the niche being filled by Levin’s three-year-old startup. Its health insurance data platform combines three different types of data: benefit and rate data, provider-network data, and formulary data. “We have the single largest database of health insurance plan data in the U.S.,” says Levin. Its customers are tech companies — fellow startups — that need access to reliable health insurance data in order to create their own consumer-facing software products that can allow everyday people to search and enroll for healthcare more efficiently, find out about changes in provider networks, find combinations of prescription drugs that patients can afford, and more. “Think of an Amazon-like experience where you look for different products,” Levin says. “We have the data behind that: what each healthcare plan is, to whom it’s available, where it’s located, how much it costs.” In a call with MedCity News, Levin went on to explain more.

You say you have the largest database of health insurance data. Does that data come from carriers themselves? And how do you organize it all?

When we started three years ago, we went to different carriers and told them our vision. We couldn’t get the time of day from them – this has changed now – but three years ago we instead went to departments of insurance for each state for plan data. We built our database from lots of disparate sources. What we do with the data we collect is a couple of things. One is we put it into a structured format. Even when pulling from all these different departments of insurance, some of that data was structured; some of it was just scanned PDFs. So we extract the data and structure it. The second thing we do is normalize it. For any kind of benefit design, say a primary care physician, there might be 50 different ways to design that, but carriers describe it in 300 different ways. For instance: ‘25 dollars after deductible’ or ‘deductible, 25 dollars.’ So we’ve built algorithms to recognize all those different iterations and then present them the exact same way.

It sounds like that’s where Vericred’s customers see the benefit. They get the same data, regardless of whatever digital health product they’re creating.

Right. We don’t build anything that’s user-facing. We’re a pure-play data company. … By normalizing data, we enable our partners to create a consistent user experience. Our customers are tech companies that are transforming the way health insurance and employee benefits are searched for, quoted, enrolled, and ultimately used. Some platforms like Gusto and Zenefits are building new experiences around benefits and HR administration for health insurance in order to be one-stop shops for groups. Other platforms are building software-as-a-service apps for brokers. Think of anything under the digital health umbrella. We enable those types of applications.

Vericred recently rolled out provider-network notifications so everyday consumers don’t get blindsided by undisclosed changes in provider networks. Can you explain how that works?

What happens mid-year when a doctor leaves a network? How do you get notified? The industry as a whole has done a really bad job here. So we look to solve the data problem. What we built are these notifications. As we update our provider-network data on a cyclical basis, we look for changes. And our partners, our customers, can register. If there’s a change, we send them a web hook and they can do with it what they may. So this enabled the carriers themselves to build the kinds of notifications you’d like to see coming from a carrier — through text, email, or in-app notifications. Carriers can even generate a letter as a result of these notifications.

Your startup just raised a $5.5 million round of funding in May. What are you planning to do?

Increase the breadth and depth of our product offerings. We introduced a Medicare Advantage dataset, which was an important expansion for us. Later this year we’ll be extending to vision and dental plans and other ancillary benefits. So our partners can use that single integration point and bring in more data. And for our carrier partners, we become this distribution pipeline.

Getting back to carriers: Are they now providing data directly to Vericred?

Over the last nine months we’ve again gone back to carriers and made the same pitch, and now we’re getting traction. Roughly 50% of our plan data, in the small group space, is coming directly from carriers. What’s changed? Carriers recognize that digital platforms are gaining traction, whether for buying or selling insurance, and most of them realize that they’re not tech companies.

How do we even get everyday consumers to look at healthcare data? How do we get people who need to buy healthcare to shop for it using digital tools?

There is no one app, one user experience that’s going to be right for all. What you’re going to see is a spectrum of applications and means to engage individuals. On the shopping side, the Affordable Care Act and Healthcare.gov was kind of a seminal event. It brought for the first time, in a broad-based way, a marketplace to shop for insurance. So now this marketplace brings people digital tools. I think it’s happening. It’s not happening at the rate that anyone has liked or hoped or expect — that’s healthcare — but it is happening.

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