Vertical health destination and search engine Healthline has teamed up with US health insurance carrier Aetna to offer what the company is calling Aetna SmartSource — customized health search. The service, powered by Healthline, will roll out on Aetna’s member self-service website and offer personalized search results based on individual health records and profiles. That means that two different Aetna customers searching for “diabetes type II” will see potentially different results based on their individual health histories.
What’s different about this vs. what Microsoft, Google, and Revolution Health are doing is that it’s all taking place within the context of the existing relationship between insurance provider and customer-patient. Aetna already has the health records and histories of its insureds so there’s little or no effort for the users to obtain the benefits (so to speak) of the system. In other words, they don’t have to construct detailed profiles or upload information themselves.
What’s also interesting is that this is the most developed version of personalized search yet in the market. In the relatively protected context of the existing carrier-insured relationship, most of the concerns about tracking and data-mining go away. Aetna won’t be using search behavior on its site, presumably, to advertise or market products to its customers.
However, in a cautionary tale about corruption in the US healthcare industry, one of Aetna’s competitors in California, HealthNet, had a secret practice of canceling policy holders who were perceived as “expensive” in order to save the company money. It actually tied employee bonuses to the number of customer cancellations they accomplished. According to the LA Times:
One of the state’s largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.
Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.
The revelation that the health plan had cancellation goals and bonuses comes amid a storm of controversy over the industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized.
The hypothetical concern raised by this practice is that the carrier using personalized search could potentially monitor behavior and identify insureds who are conducting searches for, say, Leukemia, and potentially discriminate against them if the carrier thinks they’re going to start costing the company more in benefits — along the lines described in the report above. (Note: Aetna has not been accused of any such practice.)
Healthline will no doubt be pursuing similar deals with other carriers in the US, setting up a competing vision for management of personal health records with Google, Microsoft, and Revolution Health on one side, and the carriers, with enhanced services and capabilities, such as personalized search, on the other.
Aetna may also regard the Healthline provided search tools as features that will help the company retain customers. However, when people change jobs in the US they also typically change insurance carriers involuntarily because coverage is generally tied to the employer.
Therefore, in an ideal world, centralized management and consumer control of personal health records, along the lines of the Google and Microsoft systems, is the best solution because it would be independent of any carrier or health insurance program. But there are myriad other concerns, previously discussed, in those scenarios.
Nonetheless, the vision of personalized health profiles and customized health search offered by Microsoft, Google, and Healthline’s deal with Aetna represent the future. It will, however, be critical for data security measures and legal protections to be in place so consumer information cannot be improperly accessed or abused before they can have full confidence in these programs.