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This Startup Is Lowering Companies Healthcare Costs With AI The use of chatbot technology is making it possible to cut medical costs while improving results.

By Marsha Hunt

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Healthcare costs are rapidly increasing. For companies that provide health insurance for their employees, they've been getting hit with higher and higher premiums every year with no end in sight.

One Chicago-based startup experiencing explosive growth has been tackling this very problem. This company leverages artificial intelligence and chatbot technology to help employees navigate their health insurance and use less costly services. As a result, both the employee and employer end up saving money.

Justin Holland, CEO and co-founder of HealthJoy, has a strong grasp on how chatbots are going to change healthcare and save companies money in the process. I spoke with Holland to get his take on what CEO's need to know about their health benefits and how to contain costs.

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What's the biggest problem with employer-sponsored health insurance? Why have costs gone up year after year faster than the rate of inflation?

One of the biggest issues for companies is that health insurance is kind of like giving your employees a credit card to go to a restaurant that doesn't have any prices. They are going to order whatever the waiter suggests to them that sounds good. They'll order the steak and lobster, a bottle of wine and dessert. Employees have no connection to the actual cost of any of the medical services they are ordering. Several studies show that the majority of employees don't understand basic insurance terms needed to navigate insurance correctly. And it's not their fault. The system is unnecessarily complex. Companies have finally started to realize that if they want to start lowering their healthcare costs, they need to start lowering their claims. The only way they are going to start doing that is by educating their employees and helping them to navigate the healthcare system. They need to provide advocates and other services that are always available to help.

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I've had an advocacy service previously that was just a phone number and I never used it. I actually forgot to use it all year and only remembered I had it when they changed my insurance plan and I saw the paperwork again. How is HealthJoy different? Is this where chatbots come in?

Phone-based advocacy services are great but you've identified their biggest problem: no one uses them. They are cheap to provide, so a lot of companies will bundle them in with their employee benefits packages, but they have zero ROI or utilization. Our chatbot JOY is the hub for a lot of different employee benefits including advocacy. JOY's main job is to route people to higher quality, less expensive care. She is fully supported by our concierge staff here in Chicago. They do things like call doctors offices to book appointments, verify network participation and much more. Our app is extremely easy to use and has been refined over the last three years to get the maximum engagement and utilization for our members.

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I've played around with your app. You offer a lot more than just an advocacy service. I see that you can also speak with a doctor in the app.

Yes, advocacy through JOY and our concierge team really is just the glue that binds our cost saving strategies. We also integrate telemedicine within the app so an employee can speak with a doctor 24/7 for free. This is another way we save companies money. We avoid those cases where someone needs to speak with a doctor in the middle of the night for a non-emergency and ends up at the emergency room or urgent care. Avoiding one trip to the emergency room can save thousands of dollars. Telemedicine has been around for a few years but, like advocacy, getting employees to use it has always been the big issue. Since we are the first stop for employee's healthcare needs, we can redirect them to telemedicine when it fits. We actually get over 50% of our telemedicine consults from when a member is trying to do something else. For example, they might be trying to verify if a dermatologist is within their insurance plan. We'll ask them if they want to take a photo of an issue and have an instant consultation with one of our doctors. This is one of the reasons that employers are now seeing utilization rates that are sometimes 18X the industry standard. Redirecting all these consultations online is a huge savings to companies.

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What other services do you provide within the app?

We actually offer a lot of services and it's constantly growing. Employers can even integrate their existing offerings as well. Healthcare is best delivered as a conversation, and that's why our AI-powered chatbot is perfect to service such a wide variety of offerings. The great thing is that it's all delivered within an app that looks no more complex than Facebook Messenger or iMessage.

Right now we do medical bill reviews and prescription drug optimization. We'll find the lowest prices for a procedure, help people with their health savings account and push wellness information. Our platform is like an operating system for healthcare engagement. The more we can engage with a company's employees for their healthcare needs, the more we can save both the employer and employees money.

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It sounds like you're trying to build the Siri of healthcare, no?

In a way, yes. Basically, we are trying to help employers reduce their healthcare costs by providing their employees with an all-in-one mobile app that promotes smart healthcare decisions. JOY will proactively engage employees, connect them with our benefits concierge team and redirect to lower-cost care options like telemedicine. We integrate each client's benefits package and wellness programs to deliver a highly personalized experience that drives real ROI and improves workplace health.

So if a company wants to launch HealthJoy to their employees, do they need to just tell them to download your app?

We distribute HealthJoy to companies exclusively through benefits advisors, who are experts in developing plan designs and benefits strategies that work, both for employees and the bottom line. We always want HealthJoy to be integrated within a thoughtful strategy that leverages the expertise the benefits advisor provides, and we rely on them to upload current benefits and plan information.

Marsha Hunt

Growth Marketing Expert

Marsha Hunt is a Growth Marketing Expert business advisor and speaker with specialism in international marketing.

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