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Innovations at WellPoint

WellPoint is committed to delivering the best combination of health, care and value in the industry, and to finding new and improved ways to provide real-world solutions that simplify health care processes and improve health care quality. 

IBM Watson 

WellPoint and IBM have announced an agreement to create the first commercial applications that utilize IBM Watson technology to help improve the delivery of quality, evidence-based health care. IBM Watson has the ability to analyze the meaning and context of natural language, and rapidly process information to find precise responses to questions.

In recent years, few areas have advanced as rapidly as health care. For physicians, incorporating hundreds of thousands of articles into practice and applying them to patient care is a significant challenge. IBM Watson can sift through an equivalent of about 1 million books or roughly 200 million pages of data, and analyze this information to provide precise responses in less than three seconds. This capability is expected to enable physicians to engage IBM Watson to coordinate medical data programmed into Watson with specific patient factors, to help medical professionals identify the most likely treatment options and perhaps refine diagnoses in complex cases.

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Plain Language

There is no rule that health care has to be confusing.  Yet all too often, instructions and paperwork are issued using language that complicates rather than clarifies.  According to the National Assessment of Adult Literacy, 50 percent of American adults (93 million people) have trouble understanding and using health information, and 2 out of three people don’t understand their health insurance coverage.  The result of this confusion is that Americans make uninformed health care decisions, get fewer preventive screenings and have higher health care costs.

To address this problem, WellPoint created its Plain Language program – a commitment to communicate clearly, not only with members, but also with employers, brokers and within the company itself.

Clear communication requires an ongoing commitment, but the principles guiding the Plain Language program have achieved some early successes.  Specifically, WellPoint affiliated health plans have developed MyHealth Note – an explanation of health benefits that uses everyday words rather than legalese.  Since MyHealth note was created in 2009, it has resulted in 50 percent fewer member complaints, a 13 percent increase in people who rated MyHealth Note as “a trusted resource,” and a 12 percent increase in people who said the tool helped improve their overall health.

Availity

Simplification is at the heart of innovation.  In health care that means streamlining administrative processes so doctors can focus on providing care rather than filling out paperwork.  To accomplish this, WellPoint selected Availity, LLC as a strategic part of its suite of online provider solutions.

Availity offers a secure multi-plan portal at no charge to doctors and other providers to improve efficiencies in the healthcare system by simplifying many aspects of health plan administration – an important step toward advancing affordable patient care. Now, instead of having to access different reimbursement systems for each insurer, providers can use the Availity multi-plan portal and have access to a common claims interface for all participating health plans.  Availity’s "one-stop-shop" approach benefits patients, providers and health plans by streamlining the health care administration process and providing a consistent user experience.

WellPoint is proud to join current Availity owners, Blue Cross and Blue Shield of Florida, Inc., Health Care Service Corporation, and Humana Inc., in making an investment in Availity’s industry-leading multi-plan platform.

Integrated Health Network

Improving the nation’s health care delivery system requires everyone to put their heads together.  That’s why HealthCore, WellPoint’s outcomes research subsidiary, has convened a collaborative research community of more than 3,500 physicians and other providers actively engaged in conducting and reviewing research, sharing clinical data and putting HealthCore’s research findings into practice.

The Integrated Research Network (IRN) helps HealthCore research be implemented in real-world settings and can be used to improve patient care. The IRN combines claims and clinical data, and then draws on the experience of doctors, pharmacists, clinical researchers and other practitioners to help interpret the research and develop insight for decision makers to make better informed decisions.

IRN physicians and practitioners who agree to be involved in a particular study can work with the IRN on an ongoing basis as subject matter experts, advising on the type of data to be collected, recording clinical information by participating in studies and then in interpreting and publishing the results.

By integrating data with medical practitioners’ experience, the IRN is making health care research more relevant by helping to answer challenging medical questions that can be used in everyday clinical practice.

Care Comparison

Walk into a retail store and you’ll find prices attached to every product, but walk into a hospital or clinic and it is unlikely you’ll find prices on anything.  To help individuals better estimate their health care costs, WellPoint’s affiliated health plans developed Care Comparison. 

Care Comparison is a first-to-market, innovative comparison tool that discloses real price ranges for 102 specific health care procedures and services. All costs are expressed as a “bundle of care,” meaning all facility-specific charges that are typically a standard part of a procedure or treatment including inpatient, outpatient, and diagnostic tests such as radiology are included in the cost ranges displayed in the tool. Care Comparison also includes facility-specific measures of quality obtained from state, federal and private sources, including measures such as procedure volumes, mortality and complication rates, average length of stay, and compliance with patient safety standards.  The Care Comparison tool is designed to provide consumers with an easy-to-use cost and quality comparison to promote informed decision making.

Care Comparison has been implemented in all 14 of WellPoint’s affiliated health plans, and was adopted as a national cost transparency solution for all Blue Plans nationwide*, serving approximately 100 Million members.

*Except Mississippi at this time.

Zagat Survey Tool

Word of mouth has long been the way many people select their doctor.  Now, WellPoint is taking that process into the digital age by teaming up with the respected rating company, Zagat, to provide the Zagat Health Survey.  The online tool enables members to provide feedback on their experience with their physicians based on a set of distinct criteria, creating a trusted resource to support informed member decision making. The criteria are designed to reflect a consumer’s experience with a physician and not the quality of care received, and members can use a comments section to explain their ratings.

For each network physician, the online entry displays contact information, ratings on a 30-point scale for each of four categories (trust, communication, availability and environment) and the percentage of members who recommend that physician. The most recent comments are displayed first and members have the option to rate the usefulness of comments and report suspicious comments. Members can complete the Zagat Health Survey by logging on to the secure member portal on the Anthem website.

Virtual Enrollment Center

Providing employees with comprehensive, consistent information during open enrollment can be challenging for many companies. To help businesses reach their employees more easily, WellPoint offers a virtual open enrollment center.

The virtual open enrollment center offers WellPoint customers a valuable tool to engage employees. The site is personalized with the company’s logo and custom video message, and offers an easy to use, interactive 3-D environment. Users can access interactive benefits information from any computer 24/7.  Employees can easily find benefit plan summaries, enrollment materials, and links to other related information such as health plan details, provider lists, prescription information and available health programs. 

The virtual open enrollment center is also a valuable resource for human resource departments to easily maintain and publish content. The tool gives them the ability to efficiently reach employees, increase visibility within the organization, track the number of visitors and monitor site usage.

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