The micro-frontier, where "these are their stories..."
Integrating VBs with health plan claims adjudication reveals industry edges that are being reshaped from complex labyrinths of disconnected systems towards more seamless "benesystems." While the VB industry has been in a state of continuous innovation and expansion for the past 2 decades, the pressure from jumbo players in the healthcare and broader benefits spaces keeps increasing. Which is likely a good thing. If API-based system enhancements from such players as Workday, MetLife and Cerner become the harbingers of an accelerating movement reaching across both ends of the market, that's surely a win-win dynamic.

Front and center
With APIs as central players in this transformation, real-time updates, customization, and enhanced user experiences are not only enabled, they can become the norm. There's really no other way (at least, not yet) to integrate various platforms and benefit systems to provide a unified, real-time view for vendors, consultants, employers and employees.

As large HR technology providers like Workday and SAP SuccessFactors leverage APIs to synchronize data between voluntary benefits and standard health plans, this near-instant synchronization is making the claims process more transparent and efficient.

It's not "coming;" it's here
The failure to embrace these sophisticated integration capabilities could have profound impacts on a carrier's competitiveness. Employers, increasingly seeking streamlined solutions that include prompt and inviting notifications to employees, may quickly dismiss carriers that fall behind in this area. In fact, the ability to send reminders for employees to use their VB wellness benefits may not just be an increasingly-important capability that supports broader health engagement, it may become table stakes.

Big players' blueprints can lessen the system architecture costs for smaller firms
It's essential to recognize how large VB carriers, healthcare technology firms, and health plan administrators are setting precedents that smaller firms can follow. Companies like MetLife and Aflac in the VB space, Cerner and AthenaHealth in healthcare technology, and even the BUCAs are employing APIs that are opening the door to more tailored packages that better address individual employee needs - in closer to real time.

By adapting such capabilities in ever more nimble ways, even smaller players will move towards offering more cohesive, transparent, and highly responsive benefits management systems. This will not be lost on employers looking to enhance their employees' "benefits experiences."

Crossing new chasms
Integrating VB and health plan claims, of course, is still a challenge. There is a need for standardized data formats, robust security measures, and user-friendly interfaces. Large players have the resources to navigate these complexities, but what about smaller firms?

The big companies’ adoption of next-gen tools and resources may, in turn, open doors for smaller players to analyze these case studies and adopt similar strategies, tailored to their capacities and their market demands.

The last word
Integrating VB and health plan claims is more than a technical feat. It represents a fundamental shift in how we think about and manage employee benefits.

Large-scale efforts by diverse tech-savvy players are not just signaling that a realistic path exists for smaller players, too - they're making it clear that it's a path that must be taken. The VB claims integration that's beginning to happen via APIs at the large end of the space is a less and less isolated phenomenon. As Dante might have said, "Abandon all hope, ye who <fail to> enter here."

~ Mark Head
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