Thursday, February 16, 2012

How United Healthcare Got it Right



United Health Care to offer Software in the Cloud (Ducknet)

UHC fooled us all with their end run around IT vendors, EMRs, HIEs and physicians.  While the peanut gallery and bleachers were watching Howdy Doody, HHS, and CMS real entrepreneurs ran the pigskin into the end zone.

Insurers are much more than sending a bill and getting reimbursed for services. That is just the front end of their IT systems. IT experts know the real stuff in IT is in the ‘back end’, the guts of the system buried in non friendly code, algorithms, application interfaces, backdoors for different insurance companies, etc.

Dana Blankenhorn writes in “Seeking Alpha” , an investment newsletter,

“When I took on the health IT beat for ZDNet five years ago, it was with the assumption that this industry would act as every other industry had acted. That is, mainstream tech vendors would gradually take out the specialists.

It hasn't worked out that way. Last year Microsoft (MSFT) got out in favor of GE (GE), which has been involved all along. Google (GOOG) simply bugged-out, a rare failure for the company. Siemens (SI), long an also-ran in most enterprise computing, has also been a big player in health IT thanks to its imaging unit.

But the big winner may turn out to be UnitedHealth (UNH), a healthcare vendor based in insurance.”

While other insurers signed vendor deals seeing IT as an obligation, UNH bought small vendors, seeing it as an opportunity.

Last year it rolled out a new brand, Optum, for its health services, and this week it rolled out what it calls the Optum Cloud, backed by a new data center.

The healthcare law, meanwhile, will bring UnitedHealth and its competitors, like WellPoint (WLP) and Aetna (AET) millions of new customers, but also a level playing field in many cases. It's an incentive for insurers to cut physician costs. That would translate into lower rates on health exchanges, thus more income.

The question becomes, can UNH break out of this high? Well, consider that now it only has to execute on a strategy that has government approval, with new services and new platforms coming on quickly. Signs point to yes. This administration has done UnitedHealth some big favors.

So, Meaningful use fueled interest in insurers to maximize their profits through health insurance exchanges, if those ever come to pass in some states. The money invested by the tax-payer will come around into insurers and Medicare (federal government)

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