With the growing adoption of and dependence on mobile technology for everyday tasks, health plans must quickly embrace and invest in capabilities that effectively address the needs of their members.

Health Plan Mobile

Apps: The Future of

Member Engagement

November 2015

1

Authors

Marc Huey

Consultant

march@elevarco.com

Roberto Olivares

Consultant

robertoo@elevarco.com

Casey Le Jeune

Officer

caseyl@elevarco.com

About Elevar

Elevar is an innovation advisory firm and enterprise-startup

connector. We work with senior executives of large organizations to

address their most challenging problems and leverage deep ties with

innovative startups to offer a unique platform that solves real pain

points in the industry. Our unique Elevar Labs™ builds partnerships

between companies and top startups, creating solutions aligned to

specific needs.

For enterprise and consulting clients, Elevar provides a customized,

end-to-end digital innovation program - from ideation to

execution. Through Elevar Consulting, we work with high-level

executives of large healthcare organizations to address their most

challenging problems and specialize in digital strategy, IT

transformations, healthcare payments and payer-provider

collaborations.

At Elevar, we connect today’s leading enterprises

with tomorrow’s innovations.

Contact Us

info@elevarco.com

www.elevarco.com

Health Plan Mobile Apps: The Future of Member Engagement |

SHIFTING MOBILE EXPECTATIONS

With the increasing prevalence of smartphones, individuals are empowered to perform more sophisticated

tasks while on the go. As the airline and banking industries are enabling consumers to perform more robust

activities through a mobile device, such as real-time money transfers and checking in for a flight, consumers

are looking to healthcare to provide a similar personalized end-to-end

mobile experience. The healthcare industry is beginning to make strides in

leveraging mobile technology with increasingly sophisticated tools, such as

remote patient monitoring, integrated fitness wearables, and care

coordination tools. Progressive health insurance companies are starting to

offer their members quick and accurate access to personal healthcare

information via a mobile app. However, most health plans have been slow

to adopt mobile technology innovation. For health plans looking to more

quickly offer mobile capabilities to their members, we provide a closer look

at which capabilities health plans are currently offering in their mobile app,

how customers are responding, and where health plans should direct

future investments in order to provide an end-to-end mobile experience

that meets and exceeds their customer’s expectations.

SMARTPHONE PENETRATION In 2014, smartphones accounted for 76% of all mobile phones in the US with Android and Apple operating

systems dominating the market (see Exhibit A). Previously, mobile apps were geared toward hobbies and

personal interests amongst the younger population. Today, mobile apps are becoming a fundamental part of

daily life, with Americans spending on average 3 hours a day on their smartphones in 2013 compared to 1.5

hours in 2011 (according to Nielson). Although individuals under 35 still have the highest penetration of

smartphones, the largest growth in smartphone use last year came from people aged 55 and over, growing

over 100% from 2012 to 2014 (see Exhibit B). Given this increase in smartphone adoption, the ability for

health plans to deliver robust mobile capabilities is becoming more important than ever not only for

technology dependent generations, such as millennials, but also for increasingly tech-savvy members of the

baby boomers and caregivers of the aging population.

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Exhibit A: Smartphone Penetration by Platform (2014)2 Exhibit B: Smartphone Penetration by Age (2014)3

Almost 64% of all time spent on

smart phones is spent

exclusively on mobile apps.1

CUSTOMER SATISFACTION OF HEALTH PLAN MOBILE APPS In 2015, Elevar analyzed 24 health plan mobile apps

in order to develop an understanding of the most

prevalent mobile capabilities within the market.

We structured our analysis to review three large

categories of health plans: BlueCross BlueShield

(BCBS) Plan apps, Regional Plan apps, and National

Plan apps (see Exhibit C). We used “App Store

(iOS)” and “Google Play Store (Android)” star

ratings (1 – low; 5 – high) as a proxy for customer

satisfaction. According to our research, Android

health plan apps have a higher average user rating

compared to those health plan apps on iPhone

(iOS). Additionally, Regional plan apps account for a

majority of the new health apps launched between

2014 and 2015. When comparing the average score

for each of the three groupings, BCBS, National and

Regional plans all fall within a narrow range (3.0 to

3.2). However, closer examination of individual

apps within the three groupings highlight large

differences. The highest scoring app for BCBS plans,

Nationals and Regionals was Highmark (4.5), iTriage

(4.5) and Kaiser Permanente (4.0), respectively.

The lowest scoring apps for the same groups were

HCSC (1.5), HealthNet (2.0) and Emblem (1.5).

3 Health Plan Mobile Apps: The Future of Member Engagement |

Exhibit C: Mobile ‘Store’ Ranking Scores

1 [low] to 5 [high] stars

HEALTH PLAN MOBILE APP FEATURES

Among the 24 health plan apps included in the analysis, we identified 30

separate features, which were organized into 3 overarching categories:

Access to Care — Access member information (e.g., digital member ID

cards) and locate healthcare (e.g., find a provider, facility, or pharmacy,

as well as view and schedule appointments)

Financial Capabilities — Access to member benefits, coverage, claims,

copay, and deductible information and the ability to make a premium

payment

Health and Wellness Tools — Access to Personal Health Records, inte-

grated health and wellness rewards, symptom lookup, social media inte-

gration, and other add-on engagement functionalities

Daily usage of

Health & Fitness apps

grew by 62% between

December 2013 and June 2014.

In comparison, overall daily

app usage grew 33% in

the same period.4

HEALTH PLAN MOBILE APP PERFORMANCE Based on our findings, mobile member ID cards, benefit information, and “find a provider” tools are core

features essential to even the most basic health plan apps. Financial tools such as copay information and

deductible tracking were also frequent features found in the majority of applications. The ability to reference

financial and benefit information at the point of care are particularly important for members on high

deductible health plans.

On average, National plan apps led in feature functionality while Regional plans generally lagged. National

plans are also ahead of the competition when it comes to helping members locate providers and facilities.

They also offered more advanced features involving prescriptions, such as prescription lookups, price

comparisons, and refills. Specifically, BCBS plans offered apps with the most capabilities around purchasing

healthcare, such as making a payment and shopping for coverage, while many Regional plan apps lacked

those features.

4 Health Plan Mobile Apps: The Future of Member Engagement |

iTriage — An End-to-End Mobile Health Experience Two ER doctors conceived the iTriage app, developed and owned by the population health organization Healthagen, in 2008. It focuses on, “empowering consumers to take control of their health5.” It has been downloaded more than 15 million times since its release, has scored a 4.5 out of 5.0 user review rating and is among the top 20 healthcare and fitness apps downloaded by Android and iPhone users. Healthcare giant, Aetna, saw the potential of Healthagen and iTriage to increase consumer engagement and acquired them at the end of 20116. iTriage gives users a variety of ways to manage their healthcare journey. Some of the unique stand-out features include a robust set of provider and facility finder tools with integrated appointment scheduling, access to personal health record information, medication and health and wellness look-up, and personalized push notifications. In conjunction with a strong set of functions, the iTriage app has a sleek and intuitive user interface. The application’s simple logic enables the user to intuitively navigate through the app and provides a complete end-to-end experience. For example, with the “symptom to provider process” a user can search symptoms either via an avatar or by a key word search. The app then provides results and information to address the symptoms, locates appropriate facilities and providers, and ends with an option to schedule an appointment. Lastly, iTriage pushes personalized reminders and information to users, providing a complete user experience. iTriage has developed and sustained a best-in-class app. The reason for the app’s success is not that it does one thing exceptionally well, but rather it provides a complete experience that is personalized, easy to navigate, and relevant to the user.

HEALTH PLAN MOBILE APP PERFORMANCE (continued) Exhibit D: Recent Investments in Mobile App Functionality

Health plans with an existing mobile app are continually adding new features and improvements in response

to customer feedback. By identifying which features health plans added in the last year, we can identify what

capabilities are top priorities (see Exhibit D). The vast majority of added features focused on core

functionality. Many of the add-on features such as games, ringtones, and other non-essential functionality

had either not been enhanced or had been removed altogether. The top four added capabilities by frequency

included:

Locate an Emergency Room — Locate an emergency room by current location, address, or zip code

Locate Provider by GPS Location — Find a nearby provider utilizing GPS based on your current location

Locate a Retail Clinic — Locate a retail clinic by current location, address, or zip code

Membership Information — Access basic member ID card and benefit information

WHERE HEALTH PLANS SHOULD INVEST For each of the 24 apps reviewed, we took the average star ratings across the “App Store (iOS)” and “Google

Play Store (Android)” and compared the top four apps (iTriage, BCBS of FL, Highmark PA, and Kaiser

Permanente) to the remaining 20 lower scoring apps.

We first assessed how robust each of the 30 capabilities were for the top four rated apps versus the

remaining lower scoring apps. We then plotted each capability on the ‘Mobile Capability Matrix’ in Exhibit E

to determine relative robustness. The placement of each capability on the matrix suggests whether to invest,

maintain, reevaluate, or deprioritize a particular capability. For example, if the top four health plan

applications have a capability that is very robust but is minimal among the remaining health plans (e.g.,

prescription info lookup), this indicates that most health plans should invest in building out this capability in

order to stay competitive with top rated health plan mobile apps.

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WHERE HEALTH PLANS SHOULD INVEST (continued) Exhibit E: Mobile Capability Matrix

6 Health Plan Mobile Apps: The Future of Member Engagement |

Invest Health plans should look to build or improve upon these capa-

bilities. They are differentiated from the mainstream since they

are more robust in the top rated apps and minimal or non-

existent in the remaining apps. Looking up medication infor-

mation about a prescription and quick access to customer ser-

vice ranked highest in this category followed by making a pay-

ment and accessing Personal Health Records.

Maintain These capabilities are robust across all health plans. These are

core capabilities most plans offer and features members expect

and therefore should be maintained to stay competitive. These

include access to personal benefit and financial information

including mobile member ID cards, copay/deductible details,

and locating healthcare providers. Other capabilities in this cat-

egory include tracking claims and health and wellness alerts.

Deprioritize These capabilities have minimal robustness across all health

plan apps and do not correlate with a high app ranking, sug-

gesting low utilization. These are ‘nice-to-haves’ such as social

media and health and wellness integration. Individuals may be

using another tool for these tasks, such as prescription refills,

appointment scheduling, and shopping for plans. These can be

deprioritized to a later release or offered by another channel.

Reevaluate These capabilities may not be necessary to immediately invest

in because top rated apps often do not include them. These

may be the ‘bells and whistles’ that are not currently utilized by

top performing apps and therefore not broadly expected by

users. While the lower scoring health plan apps offered “find a

provider” using geolocation, many top rated apps did not offer

this, thus potentially not contributing greatly to high ratings.

THE OPPORTUNITY Mobile is the future and mobile applications from health plans are

quickly becoming industry standard offerings. With the growing

adoption of and dependence on mobile technology for everyday tasks,

health plans must quickly embrace and invest in capabilities that

effectively address the needs of their members. In order to stand out

among the sea of mobile health applications currently in the

marketplace, receive top customer ratings and drive true adoption,

health plans should focus on maintaining the capabilities that customers

expect and on investing in what best-in-class health plans offer. Those

who leverage the power of mobile can bring advanced capabilities to

create a whole new category of powerful health plan mobile apps – with

the ultimate benefit of providing a better experience for their members.

_______

Sources:

1eMailMonday. The Ultimate Email Statistics Overview, 2015.

2Nielson: Mobile Millennials Report. 5 September 2014.

3ComScore Reports: January 2015 U.S. Smartphone Subscriber Market Share.

4The Realtime Report. Health and Fitness Apps See 62% Increase in Usage in Last Six Months, 24 June 2014.

5iTriage. Our Vision for the Future.

6Dolan, Brian. MobiHealthNews. Why Aetna acquired iTriage app maker Healthagen, 16 December 2011.

7 iTunes. iTriage – Health, Doctor, Symptoms and Healthcare Search.

8Murphy, Tom. Associated Press. Report: Health care apps available in US top 165,000, 17 September 2015.

7 Health Plan Mobile Apps: The Future of Member Engagement |

There are over

165,000 healthcare

apps available today, but

LESS THAN 40 of

those apps account for nearly

50% of all healthcare

app downloads.8