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Business profile: Indy firm pioneered cloud storage for health care

Michael Schoeder
Win Norton, founder and chief technology officer for Healthx (right), cheers  as he and his engineering staff play video games during   lunch break at their office on Priority Way West Drive in Indianapolis .  .

If you've ever gone online through an insurance company website to review a claim or to check whether a doctor was in your network, then you have a sense of the type of service Healthx provides — even if you've never heard of the company.

The Indianapolis-based information technology firm quietly serves more than 150 payers nationwide, from third-party administrators to public and private insurers, through online portals. And it's registered millions of logins, helping payers give their members and health providers access to information ranging from the cost of medical services under a particular plan to whether a patient currently has insurance to cover their visit.

But in 1998, when chief technology officer Win Norton founded the company with health insurance industry veteran Greg Bell, the idea of remote, cloud-based storage was just taking hold.

"It was just the beginning of this cloud computing revolution. We saw it as the future of all software and we were determined to bring it to the health insurance industry," Norton says. "We saw that nobody was targeting this market."

Today, many large insurers still store all their data and create user portals in-house, but many are moving to the cloud, and Healthx alone stores more 750 million health care claims for its payer clients, Norton said. Experts say factors ranging from increasing consumer demand for pricing transparency to cost controls built into the Affordable Care Act, including efforts to reimburse care based on quality, not just quantity, have increased demand for the kind of services Healthx provides.

Consumers have more skin in the game with the growing prevalence of high-deductible plans that increase their out-of-pocket costs for health care, said Kosali Simon, health economist and professor in the School of Public and Environmental Affairs at Indiana University in Bloomington.

"Technology is enabling us to be smarter shoppers for all kinds of products, and health care is proving to be no exception," she said. This is true, despite complexities unique to health care, such as the individual nature of care received and the continued difficulties that remain for patients seeking pricing information upfront.

As part of its Healthy Indiana Plan contract, Indianapolis-based MDWise was required to provide information to raise awareness and increase transparency of health care costs, said Hollie Arruda, the company's director of marketing.

"To do this, we needed to add a web portal providing services that we hadn't previously offered to our members," she said. "We also wanted to be sure we found a solution that allowed us to improve our member experience and provide a centralized access point for all their health insurance information needs. The Healthx solution was a great fit."

Through portals that Healthx provides, MDWise now offers online access to more than 300,000 members across all of its plans. Those members can look up doctors, review medical and pharmacy claims, see out-of-pocket costs and get personalized information on recommended preventive care. "Our evidence has shown that those members who are engaged in their health care … are going to be healthier in general," Arruda said.

MDWise also expects increased engagement will help control costs and aid in member retention by improving the user experience. Through a Healthx pilot program, MDWise also made available a downloadable app for members with smartphones to access information provided through portals.

Doctors and other health providers can also check member plan eligibility through portals, information that's updated daily. But checking eligibility is just the tip of the iceberg on what's possible in terms of engagement for health care organizations, Norton said.

Though Arruda said MDWise doesn't currently offer additional engagement opportunities through Healthx portals for providers, Norton said that many providers' offices use portals to make sure they're hitting health payers' quality metrics to receive maximum reimbursement. These are partly driven by plans themselves and partly by the federal health care law.

"The Affordable Care Act has shaken up our market like you can't believe," Norton said. "Everyone is experimenting and innovating toward controlling the cost of health care and it's a heck of a lot of fun to be playing in that world right now."

Though he didn't give exact figures, Healthx CEO Tony Prince said annual company revenues now fall in the $15 million to $20 million range. "We've been at a 25 percent year-over-year growth rate," he said.

The company currently employs about 80 people, and he projected it would add another 20 employees over the next year.

Healthx recently served as the title sponsor for the Indy Chamber's first-ever Indy Civic Hack Day concluded May 31, gathering developers, entrepreneurs and technologists to solve real-world problems. "They're a fantastic partner in the tech community," said Matt Kirby, director of business attraction and development at the Indy Chamber.

He said local tech companies growing by leaps and bounds like Healthx are in a global competition for talent. Healthx officials agree that the technology business's prospects for future growth depend largely on its people. "The primary key to the success of Healthx has been recruiting and retaining talent," Norton said.

Healthx

What: Health IT company provides cloud-based solutions for payers to drive member and provider engagement

Headquarters: Indianapolis

Leader: CEO Tony Prince

Quote: "Reform and change in the health care market in general has really driven a lot of business," Prince says. "The health care industry … has been kind of a laggard in the IT field, and reform has changed that."