HIX adopts an Avatar to help consumers

By Anthony Brino
08:08 AM

One of the greatest concerns among patient advocates, regulators and insurers alike is that buying and using a health plan may be too complex a task for some consumers. One state exchange is hoping it found a scalable solution.

Connecticut’s state insurance exchange, Access Health CT, is contracting with the company CodeBaby to offer consumers an online avatar that helps explain all the benefits and cost sharing aspects of health plans, as well eligibility, enrollment and coverage questions.

The virtual assistant is named Tina on Access Health CT, available in both English and Spanish, and appears in the bottom right corner of the exchange website with the tag: “How can I help?”

Clicking on the link, a new box opens with options for the avatar to explain insurance terms or other issues, like the question “Can I keep my current doctor?”

The exchange is using the online avatar because so many consumers, even those on low incomes, are using the Internet as their basic guide to insurance and the channel for enrollment, according to Jim Wadleigh, Access Health CT’s acting CEO.

In the 2014 open enrollment, 45 percent of health plan buyers and 40 percent of new Medicaid beneficiaries enrolled online.

Still, there can be confusion for some consumers, which is one reason why many exchange goers across the country turned to consumer assisters and brokers in the last open enrollment period. The avatar may not be the same as a human counselor in-person, over-the-phone or online, but it might be able to help answer basic questions many people may have.

“Our goal during the 2015 open enrollment cycle is to make the process even easier, and encourage even more consumers to use the online system,” said Wadleigh.

Access Health CT is the first exchange to work with CodeBaby, a company founded in 2001 by two Canadian physicians turned gaming entrepreneurs and now based in Colorado Springs. Other insurers and healthcare organizations are also using the company’s avatar services, including Maryland and D.C.’s CareFirst BlueCross BlueShield, University Health Network in Toronto and MetLife.

This article originally appeared on Government Health IT sister site Healthcare Payer News

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