Infosys Seeks To Jumpstart Health Insurance Exchanges

As information technology companies continue to seek new opportunities in the lucrative healthcare IT market, Infosys Technologies Ltd. has launched a health insurance exchange platform that it says will help states establish insurance exchanges mandated under the Affordable Care Act. Such exchanges are designed to offer the public a wider choice of insurance plans and increase competition among vendors.

Dubbed the Infosys Health Benefit Exchange, the platform seeks to help states set up their insurance exchanges, while assisting payers to market their health insurance plans to more than 100 million people, executives at Infosys said.

Consumers and small businesses looking for healthcare coverage will have access to insurance-related tools such as real-time eligibility verification and enrollment, and cost-of-coverage calculators. The platform also offers information on tax-deferred savings accounts and other support services designed to expedite and simplify finding, purchasing, and managing the most appropriate health insurance plan. According to Rajiv Sabharwal, chief solutions architect for the Healthcare Practice at Infosys, the platform is a response to the expected 32 million individuals who will become insured under the provisions of the health reform law.

To prepare for this, the U.S. Department of Health and Human Services has announced several funding initiatives to help states establish health insurance exchanges by 2014, which is the target year in which states should have their exchanges fully operational.

However, Infosys executives believe states need more help to meet that target.

"The exchanges have to be in place in January 2014. The federal government will support the states with the operational cost in the first year, but the states will have to be self-sufficient by 2015," Sabharwal said in an interview.

He also said the government is providing monetary support to the states to set up the exchanges, but the states are going to need help in terms of technical resources and tools.

"Our platform will allow the states to set up the exchanges at a very rapid pace and at a much lower effort and cost. Also, in 2015 when the federal government mandates the states to be self-sufficient, it will be very difficult for states to support the exchange operations from a cost perspective," Sabharwal said. "Our per-member-per-month model of an extremely low fee, which is to be borne by the payers participating in the exchange, will reduce (and in some cases eliminate) the state's financial obligations to support the exchange operations."

Among the key features of the Infosys Health Benefit Exchange are:

-- Benefit Management Language (BML): The BML aims to standardize the structure of benefit packages across participating carriers, which will allow for efficient searches and "apples to apples" comparison for users.

-- Data-driven clinical recommendation engine: The recommendation engine leverages clinical data repositories, clinical decision support systems and/or data gathered during plan selection and enrollment to recommend suitable plans for users. All clinical data are provided or authorized by the user, and the privacy of any personal information is safeguarded.

The Infosys Health Benefit Exchange also will offer educational features about specific insurance topics for both patients and benefit administrators. Additionally, social media tools will give users the ability to create and join communities where various regulations and conditions can be discussed, company officials said.

The Healthcare IT Leadership Forum is a day-long venue where senior IT leaders in healthcare come together to discuss how they're using technology to improve clinical care. It happens in New York City on July 12. Find out more.