[Webinar Recap] Prudential + Human API: Driving Innovation and Business Value with Digital Data
On the ‘Prudential + Human API: Driving Innovation and Business Value with Digital Data’ webinar session, Nick Zambruno sat down with Gretchen Juneau to discuss how Prudential adopted and has seen tremendous success with digital health data.
In case you missed it, we are recapping it here!
And if you want to watch the whole webinar for yourself… watch it here
Right off the bat, Nick asked Gretchen two questions:
How did Prudential get started with Human API?
Prudential was intrigued by the patient portal, believing it could be a differentiator for them. However, they weren’t entirely sure how to get started, so they initially debuted the process with captive agents, eventually ramping up implementation when COVID hit.
What goals does Prudential have that align with the Human API partnership?
There were many open questions when Prudential embarked on their underwriting transformation journey:
How will it fit into the process?
How will distribution react?
How will consumers like it?
Gretchen recalls that they realized they needed to just start getting data and using it. Once they started receiving data they could experiment and learn how they could use the data and begin automation.
And that is exactly what they did.
Business Impacts
By implementing digital health data, Prudential saw:
50% EHR hit rates: Prudential’s hit rates were higher than they had anticipated, seeing as much as of half of their cases return health info within a day.
2. The cycle time to issue policies decrease, leading to faster placement.
3. APS pivot created an efficient process, leading to cost savings, happier underwriters and case managers.
Underwriter Experience and Change Management
Change can take some time to adjust to. Prudential discovered how they needed to support their distribution, consumers and underwriters for this new process to be successful.
A completely new process for them, Prudential found that the patient portal was especially valuable when records are needed immediately (particularly end of year/quarter cases). Distribution has the ability to encourage their applicant to go through the process, getting records extremely quickly and allowing the case to place much sooner than it would otherwise.
They also found success repositioning the patient portal idea with their distribution. Distribution can be hesitant, but positioning patient portal as something that allows distributors to have more control over their cases, without having to rely on another vendor for their case to move along, was a real turning point. With some records coming within seconds, even some agents that initially didn’t want clients going through the process have come along after seeing the speed and coverage patient portal offers.
A mindset shift with underwriters has been just as important. There is a lot of change in a department that was once extremely predictable. Encouraging underwriters to be comfortable making decisions on their cases with just the EHR data, without ordering an APS just to see office notes is paramount and helps them become more comfortable with the data available.
Key to creating this mindset shift with the underwriters was transparency. Prudential prioritized giving underwriters visibility into how their peers were using the available data and created case studies to continually train their underwriting team. Gretchen mentions how important it has been to bring the entire team along on the journey.
There have been some huge positives by adopting this change. The APS pivot process has increased efficiency by reducing the manual work on underwriters. The manual work reduced is all administrative work for underwriters, meaning their job satisfaction has increased by their tasks being focused to what they truly enjoy.
Decisioning
To help Prudential understand how often the electronic records they were receiving were sufficient for the underwriter to make a decision, Human API conducted a study. We found conservatively that 65% of Prudential’s cases with an electronic record had a decision made with just the electronic record. Skeptical that the decision rate could be that high, Prudential conducted their own internal study. They ended up finding that their decision rate with electronic records was actually 71%, a full 6% higher than what they were presented with.
They were pleasantly surprised about the quality and robustness of data and realized they have been able to make decisions at a high rate on traditionally complex cases such as cardiac, cancer, and psych disorders with just the electronic record.
Cycle Time
Cycle time is intricately tied to placement rate. Reducing cycle time can greatly impact business. Prudential saw a 9 day overall reduction; a “game changer” in Gretchen’s words. This cycle time could be reduced even further, but Prudential values the patient portal process so much that they keep it open for 7 days, making the overall cycle time slightly longer.
Special Authorizations
Special authorizations are a huge pain point in the underwriting process, especially with producers. Human API created a solution to handle special authorizations directly with the client. Prudential has loved not having any underwriter or producer involvement in the process and being able to offer their clients a completely digital process that can be done as quickly as same day. Having Human API handle special authorizations has helped Prudential see huge efficiency gains.
Health Check
To facilitate the review of data, Human API created a custom ‘Health Check’ report for Prudential. Powered by Human API’s proprietary normalization and parsing capabilities, a report with two years of just vitals, labs and medications was created. The underwriters can quickly review the data on typically healthy, instead of a full 40+ page report, to identify any potential flags. And if something is flagged? The full electronic report is just behind the scenes if the underwriter needs it.
What’s Next
Prudential believe that the digital health data has value beyond just as an APS replacement. They are looking to use digital health data to replace exam and labs. They understand that implementing data more widely is a long-term goal and have dedicated data scientists and UW looking at how to get data into their systems and start plugging into rules and models. The process of examining digital health data has offered a great opportunity for vendors, data scientists and underwriters to come together and create great solutions.
Gretchen says “its an exciting time to be an underwriter!”
And we have to agree with her!
Q&A
Have you been able to employ automation in the review of EHRs? If so, can you share a bit about your experience?
Automation is the next step. Ordering is already automated, as well as post-issue auditing, and Prudential is currently working on automating other review points. Human API is dedicated to helping facilitate this next step.
Can you explain the process for the customer to provide access to their patient portals? What info do they need to provide the carrier? Is there a special authorization specific to this process or is it built into your standard company authorization?
The consumer interacts with the digital patient portal experience, whether embedded into an experience such as the application or presented to them via email. The consumer will identify their provider then connect into their patient portal with their credentials, with Human API providing any needed support during the process. This process is what provides the access and authorization to the health records.
Prudential, their consumers, and agents have loved the easy to connect process, with very few complaints and confusion.
How much did the placement rate improve by having the 9-days reduced cycle time?
It is hard to quantify exactly, but there is definitely attributable improvement. The correlation between cycle time and placement rate is undeniable.
