As technology continues to change many industries rapidly, Karen Ignagni, president and CEO of EmblemHealth, a New York City-based not-for-profit health insurance company, is striving to meet the challenges of providing health services to customers, including union members.
“We have a principal at EmblemHealth, which is to do as much as we can to make sure we provide the maximum amount of health security to our customers, and in particular our union customers,” Ignagni says. “A part of that was stepping back and reimagining our entire product suite.”
One of the new products that EmblemHealth has developed over the past year is its HMO “Preferred” plan.
“From the moment you call as one of our members you get a live agent – a concierge that is charged with all of your needs,” the Ignagni says. “You might need help making a doctor’s appointment, you might need help finding a doctor, this concierge helps you through that.”
The reimagined HMO Preferred plan includes dedicated “gold line” service, complete with health coaches that will provide help to customers in navigating diseases like diabetes or heart disease so that they do not have to manage it on their own, according to Ignagni. There is also support for nutritional counseling, weight management, behavioral health and stress.
“Our coaches are doing a yeoman’s job,” says Ignagni. “Those are issues that hit us all day to day.”
Another aspect of the program is the care management, according to Ignagni.
“So when people have cancer, they have a care manager helping them through a very complicated and frightening set of choices they have to make,” the EmblemHealth president says. “If you are having hip surgery or knee surgery our care managers will help you with the process.”
The purpose of the product is to make sure that Emblem’s union members feel like they are having the Gold experience.
Members who get the HMO Preferred plan have access to centers of excellence, according to Ignagni.
“We partner with Memorial Sloan Kettering for cancer care,” says Ignagni. “We partnered with the Hospital for Special Surgery for orthopedic procedures, so that all of our union members have no muss, no fuss, one stop-shopping and can call our concierge to directly get these first class facilities through our care management program.”
The vision behind designing the plan was “providing a health plan and a set of services that all of us at EmblemHealth would want,” Ignagni adds.
Real time health, guidance through a terrible diagnosis and top-tier health care were EmblemHealth’s goals with this new product.
“How do we help our members get the support they need when they need it and at the level that all of us would want,” says Ignagni.
Ensuring that their health care program is both high-grade and affordable is a top priority for EmblemHealth.
“We think about what are the highest quality institutions, then you want to make sure that you are negotiating with those institutions and getting the best value for your members money,” says Ignagni. “We go and visit and partner with these institutions and basically talk with them about our mission as a not-for-profit plan, and there are not many in our area.”
When EmblemHealth saves money for its customers it is put back into their benefit programs, not into the pocket of those on Wall Street, according to the CEO.
“We have an eight-decade legacy, so they know us well and they want to do their part for city workers and the other workers that we serve,” Ignagni adds.
With the Affordable Care Act being stripped of its provisions for those with preexisting conditions, and the political uncertainty that comes with the 2020 election, EmblemHealth says it wants to be a bastion of stability for its members.
“It’s cloudy in terms of the political system,” says Ignagni. “At the ground-level, however, everything we do today we will do tomorrow, which is about pursuing excellence for our members, reducing costs and making sure the quality is at the level all of us will want.”
Emblem Health is also employing artificial technology in delivering its services.
“Artificial intelligence now is a very important part in how you do back office work and there are tools that you can use to make your platform more efficient,” Ignagni says. “There are areas in artificial intelligence that helps customer service reps.”
A.I. prompts are intended to help customer service representatives learn if they are speaking too fast, or bypassing certain health care details.
Ignagni says compiling medical research on new developments in health care is also helping EmblemHealth leap forward in its care for its members through its partnership with HealthReveal.
“What does the latest in scientific literature say about diabetes – best care, about pulmonary disease – best care,” Ignagni says about the HealthReveal artificial intelligence collation system. “This curates that research. So that is another example of new technology and innovations.”
EmblemHealth has also partnered with Cityblock, a Google-backed entity that has developed an outreach program that brings health care to customers’ homes.
“We’ve added that to our suite of products to give that personal touch to people who can’t get out and may need some help getting out, or may be intimidated about getting out,” says Ignagni.