At SeeChange, Giving Insured Patients Incentives to Stay Healthy

7/21/14Follow @xconomy

Before he founded SeeChange Health in 2008, CEO Martin Watson was working on new products for UnitedHealthcare Strategy, a wing of the giant healthcare network. As he looked at how the insurance sector was evolving, he thought United should start developing narrower products to help patients be more involved in their own healthcare. “Ultimately, it wasn’t a perfect fit for United,” he says. “So I raised my hand and said, ‘I’d like to give this a try’ and went off and started SeeChange.”

As Obamacare aims to change a broken healthcare system and more and more healthtech companies look to innovate, the insurance models consumers are used to are rapidly changing. For SeeChange, that means pivoting away from a system where patients head to the doctor when they’re sick, pay their copays, and are responsible for following through on medication and follow-up care. The company is working to incentivize patients to commit to their own preventative care, dealing with issues like weight gain and chronic conditions like diabetes before they become an even bigger problem. The idea is to keep patients healthier—and also to save money, both for insurance companies and employers.

Though the idea of incentivized care has been kicked around by a lot of healthcare reform advocates, Watson has only seen a few direct competitors—so far. “We’ve got a unique model right now, but we expect several others to be saying the same thing pretty soon,” he says. In New York, for example, Oscar Insurance has a similar model, but SeeChange has yet to see competitors in California.

SeeChange creates incentives and reminders to help motivate patients to take care of themselves—both through its own insurance company, and through the software solutions it builds for other companies, which integrate benefit plans with health data, claims, and action plans to give consumers a better view of their health and how they can improve it.

Six years after Watson founded SeeChange, the 85-person company is actually two different businesses—SeeChange Health Solutions, which provides software to other companies, and SeeChange Health Insurance. To date, the company has raised more than $80 million, with investors including Psilos Group and other institutional investors. Companies like UnitedHealthcare and Medica use its solutions products, while 4,000 employer groups with 35,000 employees between them have signed on for its insurance plans.

On the insurance side, the company offers fully insured plans for small to midsize employers, companies with between two and 200 or more employees, and self-insured plans for companies with 100 to 1,000 or more employees. “The idea was that typically, the really large, self-funded employers get the innovative designs, because they’re demanding it,” he says. “The smaller end of the employer segment, sometimes they just don’t get those innovations, because the insurance companies have to pick up those costs.”

SeeChange’s plans offer built in rewards; employees are given a six-month window to complete a biometric screening and a health risk questionnaire. When they do, they’re rewarded with breaks like a $1,000 deductible reduction, or a shift in coinsurance payments from 30 percent of the overall bill to zero. In some plans, the company will kick patients a few hundred dollars into a rewards account that can be used to pay other medical expenses.

When screenings find that patients do have health issues like high blood pressure or a high body-mass index, for example, SeeChange will … Next Page »

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  • Avoid SeeChange

    An organization that engages in egregious violations of HIPAA laws by one of their executives, Alan Katz, EVP, Sales & Marketing / Chief Sales Officer, and would prefer to endanger a child’s life by denying well established and credible care by a number of Doctors with many years of highly specialized education and skills should not be receiving any accolades or recognition for their “unique” business approach, they should be put out of business. A
    truly representative article should be focused on how they tried to kill a
    child by denying care.