Skip to main content

#idea - FSA/HSA Estimator Tool


What: “FSA/HSA” Estimator / Recommender tool for our Members. This tool will based on previous year/s of members ‘out of pocket’ expenses from Claims data.

Why: Allows our members to make an informed decision and save money with tax-fee benefit accounts. Guided, correct usage of these tax advantaged accounts will reduce member’s health care cost and thus contribute to our mission:To ensure all Californians have access to high-quality healthcare at an affordable price.

How: Claims data that we collect allows us to calculate ‘out of pocket’ expenses of our members. For members who are with Blue Shield for more than a year, we can use claims data coupled with elementary predictive tools to recommend whether a member should open an FSA / HSA account. Our tool will recommend optimum amount that member needs to contribute to these accounts. Our tool will also show how much money they could have saved in the past year/s if they had used an FSA/HSA account. For members who have an FSA / HSA account, we can demonstrate effectiveness, or lack of it, and whether they should increase or decrease their contributions in these accounts.

When: The calculator / tool will be available for our members during ‘renewal’ time. This will allow them to make ‘informed decisions’

Benefits:
- Save our members money by helping them take advantage of ‘tax advantaged’ accounts. Thus reducing health care out of pocket cost which aligns with our mission.
- Very simple tool to develop and implement. Assuming that we have most of claims and benefits data available, I expect the effort and cost to develop the tool to be low.
- Help us retain / renew members, as only we, as insurance carrier, can provide accurate ‘Out of pocket’ expenses based on their claims history. (Others can build FSA/HSA calculators, but having claims history and benefits information in one place allows us to do it with no input from the member. Other tools currently available, place the burden of reporting OOP expenses on members)
- Help us attract more members with a promise of helping them determine FSA / HSA contributions next renewal period.
- As insurance payer, only BSC has consolidated claims and benefits data to calculate ‘out of pocket expenses’ for members. This ‘data advantage’ makes it our responsibility to use it to help our members.
- Saving our members money may end up being a great way to 'engage' a Member thus aiding his receptivity to other wellness / health care related programs that we may offer.
- This idea has potential to become a good example of employee driven innovation, and will increase engagement and which in turn gets a closer to becoming a ‘better work place’.

Labels:

Comments

Post a Comment

Popular posts from this blog

#Idea - Improving Member’s Office Visit Experience

What: Make sharing Personal and Insurance details with Doctor’s office hassle free, accurate and ‘paperless’. Constraint: Work with existing infrastructure without requiring additional hardware at Provider’s office.   How: Extend BSC App by building a new functionality that allows sharing of Member’s data with Doctor’s office. Here is how it will work. On BSC app, members will have option to ‘share basic data with provider’. Member chooses this option and a ‘camera’ on the phone is activated. Member asks provider’s clerk to open a webpage (something short like BSCSHARE.COM) BSCSHARE.COM will display a QR Code on Clerk’s screen. Member hands over the phone to the clerk to focus on read the QR code with member’s phone. When the phone reads the QR code, Member’s basic information as insurance details are shown on Clerk’s screen. The clerk can now use this data to update their system (or in a not so ideal situation print the information, prints out the data on...
Post a Comment
Read more

Role of complexity in ‘Keeping it Simple’

" It can scarcely be denied that the supreme goal of all theory is to make the irreducible basic elements as simple and as few as possible without having to surrender the adequate representation of a single datum of experience." – Albert Einstein It is not simple to ‘keep it simple’. Process of ‘Keeping it simple’ involves complexity. We need to accept that we cannot keep it simple for everyone involved. Simplifying one constituent would almost always make it a bit more complex for others involved.   However, ‘keeping it simple’ can work wonders when we consciously decide to make it simple for constituent that matters. For most Organizations, ‘keeping it simple’ for the ‘consumer’ is a good strategy. Most Organizations get this right, but they also need to understand that making   it simple for consumer would result into a more complex (or at least ‘changed’) business process or operating principles for other constituents. In this age, it will requir...
Post a Comment
Read more

Day in the life of a core member of ‘Collaboration and Innovation Lab’

It is Friday. I arrive at the 50 Beale street office of Blue Shield of California. Instead of going to my desk, I head to the  ‘Collaboration and Innovation Lab’. As I step out of the elevator on 23 rd floor, I think about getting myself something to eat, but my excitement of first going to the ‘ Lab ’ (yes! we call it the Lab ) makes me turn right. As I walk past offices of our ‘C’ team, I get to catch glimpse of beautiful foggy Bay before arriving at the space we call our home for Fridays .   Suddenly, I realize that Friday’s have become even happier than they used to be. As a routine, first thing I do when I step in the Lab is read Rudyard Kipling’s poem ‘If’ painted on the wall. It reminds me every day of what me and all others on the Core team aspire to be. Though what Kipling wants me to be seems ‘ideal’ and ‘unachievable’, remembering how it has made me better, makes me keep trying. After all, the spoils that will come out of this is not what I...
Post a Comment
Read more