Look up the headquarters or regional offices of most large and mid-size insurance companies on Google Earth and what are you likely to find? Sprawling, well-manicured campuses with several multi-story buildings that house thousands of employees, acres of call centers and a labyrinth of massive file rooms archiving mountains of incoming paper documents.
Despite all of the advances in technology over the advent of the information age during the past three decades, many large insurance companies are still conducting aspects of their business the way they did in the 1950s. Sure, laptops have replaced typewriters, call centers are managed with slick applications and other individual technologies have been introduced. But the processes – from the way they onboard members to the way they take in and adjudicate claims to the way interact with providers and members – remain largely unchanged. All those buildings and all those employees are essential because their businesses still rely primarily on armies of workers performing manual tasks.
That may be the past and the present. But it is not the future. Instead, the insurance company of tomorrow will live largely in cyberspace. Those armies of employees will be gradually replaced by further automation, driven by new technologies that increase efficiency, lower costs and deliver superior customer service.
It’s a transition that must be made. The Affordable Care Act (ACA) has introduced the first of many changes to come to the health benefits landscape – not the least of which is making an additional 30 million Americans eligible for health benefits. While a positive for the nation’s health, as enrollment expands it will place significant pressure on outdated, manual health benefits administration processes. We are seeing this occur already, especially around customer service. Health payers that cannot service members with the speed and accuracy those members expect will have difficulty retaining them.
Expanding access to care at an affordable cost is a daunting challenge that cannot be met by taking a single step or simply adding a fancy new web portal. It requires a concentrated effort to take advantage of new approaches and technologies. In addition, health payers must learn to think differently. Rather than throwing bodies at problems, as they have in the past, they need to take a long, hard look at where they can use automation and which areas absolutely require human intervention.