Microsoft Gets in the Health Insurance Exchange Game

08 February 2011 | Jack Hersey, General Manager, U.S. Public Sector Health and Human Services, Microsoft

​Today, Microsoft announced that it is getting into the Health Insurance Exchange market with new turnkey technology solutions to help states quickly and cost-efficiently roll out new Insurance Exchanges (HIXs). These solutions are part of Microsoft's broader set of offerings for health and human services, designed to assist states in reducing the cost of service delivery, while improving quality and efficiency.

Our interoperable framework not only helps states build their exchanges, but it also has the capability to connect a state's new and existing government systems, including Medicaid, within a consistent architecture to make information-sharing and integration across public and private organizations more seamless.

In several states, we've already seen the power of technology to connect disparate benefits systems, boost information-sharing and care collaboration, and streamline case coordination. Health Insurance Exchanges, while somewhat unique in their requirements, are one more opportunity for technology to help transform the way both health coverage and care are delivered to our citizens.

Still, this news left some in the healthcare industry asking – why would Microsoft put a big focus on State Health Insurance Exchanges when the fate of health reform is still undetermined?

Reform of the health delivery system, whether ultimately mandated or not, is already happening. True, the details may still be in flux but the underlying business drivers remain constant - efficiency, fair market practices and improved access to care, and reduced costs – will remain regardless of government mandates.

Indeed, the states aren't waiting on reform. Already, 48 U.S. states are in the process of drafting health insurance exchange plans while two other states already have operational exchanges in place. And, on Jan. 20, the federal government announced more funding will be available for states to help with the building of insurance exchanges.

For most states, the idea of standing up a health insurance exchange is daunting. They have to make decisions and solve problems that lie outside their traditional areas of expertise, such as integrating databases, collecting monthly premiums, and calculating tax subsidies. But it doesn't need to be a complex challenge.

How do we make it simple? We bring in proven, experienced partners, like Extend Health, whose service center technology runs on our foundational platform. Extend Health currently operates the largest private Medicare health insurance exchanges in the country, and the state of Nevada is already working with Extend Health to move Medicare-eligible retired government workers from group Medicare insurance to private coverage. So, by leveraging our core platform technology with the expertise of our partner ecosystem, we can dramatically expedite the time to implementation for a state HIX.

So how does this fit into Microsoft's view of the healthcare market? This new offering is just one of several solution areas, including health information exchanges, enrolment and eligibility, and health-enabled business intelligence/analytics and case coordination. Each represents part of Microsoft's broader strategy for Health and Human Services to assist states in reducing the cost of service delivery, while improving quality and efficiency. In order to achieve those goals, public and private health care entities, whether they be states, private insurance companies, the Dept. of HHS or local benefits offices, need to work together to enable greater consumer involvement in their care. The environment has been slowly changing for several years, and state-wide health insurance exchanges are just the next step to achieving an integrated health ecosystem.

Jack Hersey
General Manager, U.S. Public Sector Health and Human Services, Microsoft