Integration Station - Episode 1

SHOW NOTES

In our maiden episode of MST Solutions’ Integration Station podcast, we’re chatting with MST’s VP of Health Care and Life Sciences, Venkat Elapully. Venkat shares with us the driving forces behind self-service insurance shop and enrollment AND how this technology can transform the member experience and save many hours for overburdened enrollment teams.

HIGHLIGHTS

  • “The Salesforce Vlocity platform has come out with a lot of out-of-the-box functionality for shop and enroll. And then [MST Solutions] built on top of that some accelerators for a Medicare line of business, and for small groups, and for large groups.”

  • “The Vlocity platform itself offers a lot of functionality out of the box and to customize it or configure it for various health insurance requirements is pretty easy, so time to value is much faster.”

RESOURCES
Transcript

Jennifer: Good afternoon. Welcome to MSTs Integration Station. Joining me today is MST’s Vice president of Health Care Practice. He’s spearheading a lot of the work that we’ve been doing around developing solutions in the health care and life sciences space that directly answer some of the biggest challenges that the industry is facing today. Thank you so much for coming on with me, Venkat.  

My biggest question that I’m hoping you can give us some insight around is, as you know, our team here at MST has been devoting a lot of time to developing solutions around the health insurance space, just, trying to answer some of those major challenges, including self-service, shopping and enroll functionality. That’s a really big one. And with our current client, Banner Health, we’re doing a lot of work around Medicare enrollment. And what I’m wondering is – and I’m noticing in the industry that this is a pretty hot topic right now – a lot of people are comparing what they want from their insurance providers to shopping on Amazon. So what I’m wondering is, what are these main drivers behind creating an Amazon-like experience for member enrollment, and how close are we to really achieving that? 

Venkat: Thank you for inviting me, Jennifer. I’m happy to answer that question.  

Basically, if you look at Amazon, if you want to purchase a TV on Amazon, you can compare the features and pick the right one, pricing, and everything and pick the right one that you want from the features that are available there. Similarly, if we want to shop for vehicle insurance or automobile insurance, you can compare codes from multiple insurance companies, and then you can compare it pretty easily, what kind of deductible you want and how much coverage you need for a particular vehicle and how many drivers and things like that. So that is also has become as close to what you do in the Amazon shopping experience, but when it comes to health care, it is so complex. It is regulated. It’s really difficult for a consumer or a member shopping for healthcare insurance to pick the right health plan, right?  

That’s why we have a lot of [representatives in insurance] who are going to explain what it means in health care, what you’re getting. So, we want to at least make it easier for the customer: having a self-service shop and enroll where the consumer can go look at all the available plans for him to pick and choose and compare the benefits from one health plan to the other [and find answers to]: 

  • What am I getting for the premium I’m paying for the monthly premium? Whether I’m getting discouraged?  
  • What is the pricing of my drug which I’m taking right now?  
  • Whether my physician, my primary care physician is covered or not?  

So, these are some of the really critical things that as a person who is shopping for insurance, I would like to know: whether my current PCP is available in this new health plan, which am I going to choose for next year, whether these drugs which I’m taking for diabetics or whatever drugs I’m taking are covered, and what is the pricing of the drug in the new health plan. So those are all the critical things for a consumer. 

And then, it is not that easy if you don’t have a shop and compare tools like what we are developing, it’s very difficult to find out how much it will cost. So that’s why the Salesforce Vlocity platform has come out with a lot of out-of-the-box functionality for shop and enroll. And then [MST Solutions] built on top of that some accelerators for a Medicare line of business, and for small groups, and for large groups. I mean, in fact, even individual shop and enroll, which is going to be very, very attractive for people who are shopping for insurance on the health insurance exchanges. That will be critical because, if I’m comparing insurance plans across various health insurance companies, it will become much more cumbersome. And so that is the next step we will be investing in. But for now, we have built some accelerators for small group shop and enroll, and then we are working on Medicare shop and enroll with one of our clients, and then trying to build on top of other accelerators for the industry.  

Jennifer: That’s excellent. And the key thing, I guess, one of the bigger challenges, that some other insurance companies have is that very large number of regulations and guidelines that you have to follow. And I imagine those must cause kind of an issue with trying to create an Amazon-like experience if you will because such care has to be taken. Is that a correct assessment?  

Venkat: That is correct. So, there are a lot of things regulated in this insurance industry, especially when you are going with Medicare, which is the federally mandated health care. There are certain benefits, mandatory that are available – should be available – for the consumers right now. 

It may not be so much for commercial insurance, but [for government-subsidized insurance options] we need to ensure those benefits are available for the consumers. So, comparing those could be a little bit easier, but the others, like, you know, the benefits that these companies are offering on top of the mandated benefits are going to be very challenging.  

Jennifer: That’s pretty awesome. Thank you. And to bring it back to Vlocity Health, one of the things that we learned, just from the recent hackathon that our development team put together is how much faster you can implement some of these solutions because I think around all of the regulations and some of the different things it must have been a big challenge for fitting this kind of technology into different insurance companies large hospital systems. Have you observed that using Vlocity Health on top of Salesforce Health Cloud has really saved a lot of time for developers, which would then translate to faster time to value? Do you see any real-time savings in that space?  

Venkat: Definitely. Yeah. So, the Vlocity platform itself offers a lot of functionality out of the box and to customize it or configure it for various health insurance requirements is pretty easy, so time to value is much faster than if you’re traditionally building something like this from scratch. So, you are getting a head start. I would say we are cutting down the development time and time to market to almost one-fourth of the time. 

If you are doing/ developing something on your own from scratch, it’ll take much longer. It’ll also streamline a lot of other activities within the organization. Like, since you are giving self-service options to the consumers, you are reducing effort on other salespeople or, I mean, once you have the website, you are only answering the questions coming in from the consumers rather than you know, manually going in and acquiring the customer.  

Jennifer: Right. I understand. So, there’s really a lot of scalabilities that’s built into Vlocity Health, just out of the box. And it can save a lot of time over, say a custom code development project where you’re creating a lot of the code yourself, and that also makes it difficult to maintain. 

So, it’s pretty exciting that we’re able to bring, I think, this piece of technology into the insurance space and to be able to have your insight into where those pain points are. So, I want to thank you for coming on today and hopefully have you come on soon to talk about some more of these different aspects of the industry that make it so hard to bring digital transformation and how we’re able to get around some of those challenges. 

So, thanks again for that.  

Venkat: Thank you. Thanks, Jennifer.  

Jennifer: As always, you’ll find some resources below this video. And if you have any questions at all, then go ahead and put them into the comment section or shoot us an email, and we will get back to you with an answer. Thanks again.  

Questions? Ask them here, and we'll do our best to answer.