Internet Powers
Healthcare
Self-Service

The Internet has changed the way in which we conduct business, gain information and communicate. Nowhere is this more evident than in healthcare, which is the second- leading search category on the Web today.

As consumers have embraced the Web to gain healthcare information, the industry has taken notice. Employers and health plans are turning to this medium in large numbers to offer self-service tools that empower individuals to take more control of their own healthcare decisions. Consumers have willingly embraced these Web-enabled functions, which provide them with more personalized and accurate information, greater efficiency and 24x7 availability.

Employers have significantly reduced their administrative expenses by deploying tools that permit task and time shifting from their HR staff to benefits-eligible employees. Benefits selection and enrollment processes have moved from paper forms and materials to online applications—accessible via secure company intranets. Major ERP software providers like PeopleSoft, SAP and Oracle have focused on enhancing the self-service functionality of their HR applications. These tools reduce administration costs, increase service levels and allow human resource departments to shift focus from burdensome administrative activities to more strategic efforts.

Employees of companies using these online tools are able to select benefits from various options. Details of coverage and costs for health plans can now easily be compared and common questions answered, such as “Is my current physician in this plan?” Some health-plan types, such as HMO’s, require the member to select a primary care provider (PCP) who functions as a gatekeeper to the healthcare system. The ability to quickly and easily search geographically for those doctors meeting an individual’s specifications simplifies this selection process.

With more advanced HR self-service applications, users can not only search for a provider, but select primary care providers for themselves and dependents using “shopping cart” functionality—similar to online retailers. This allows for a quick and simple enrollment transaction. The timeliness and accuracy of this electronic information transfer reduces administrative costs and data-entry errors. Out-of-network claims generated by errors in provider selections and outdated printed directories are avoided.

Health plans are also rushing to capitalize on the advantages that self-service options bring to their members. Their primary goals are to increase customer satisfaction and reduce administrative expense. According to a survey by Cap Gemini Ernst & Young, provider search capabilities are the most common online functions deployed by health plans, with location, specialty and name being the leading search attributes. Some Web sites also provide useful tools such as maps and turn-by-turn driving directions to provider offices.

A popular byproduct of the healthcare provider search, a personalized provider directory, has resulted in significant cost reductions for plans. After requesting a geographic search for physicians or other providers, members can have that information captured in a personalized directory and delivered online immediately. These concise directories contain the most current information about only those providers of interest to the member. Some plans have reported reductions in their demand for traditional printed directories of over 70 percent and significant decreases in call center requests for provider information.

In addition to online physician search and directories, health plans utilize their Web sites to provide other self-service conveniences to members. Some plans offer access to claims information and electronic Explanation of Benefits statements, while more advanced sites provide online checks of claim status. Basic address-change options and replacement-card requests are common functions, and many plan sites offer general healthcare information, wellness suggestions and medication directories. All of these features provide members with an increased ability to control and manage their healthcare options.

Tom Lauerman and Stu Bauman are cofounders of GeoAccess Inc., supplier of an Internet physician search engine and leader in managed care services and software. Phone 913.904.0500 or e-mail at media@geoaccess.com