Microsoft Launches State Health Insurance Exchange Platform

With partners such as Extend Health, Microsoft will provide a cloud-based platform for states to offer health insurance exchanges and comply with federal mandates.

With states mandated to operate interoperable health insurance portals by 2014, Microsoft has rolled out the infrastructure for its state HIX (health insurance exchange) platform, the company announced on Feb. 8.

While an HIE (health information exchange) allows health care providers to exchange EHRs (electronic medical records), an HIX is an online market for purchasing health insurance plans, notes Dave Meyers, chief technology strategist for Microsoft's U.S. public sector health care and social services group.

"It's less about pushing clinical records around and more about offering a marketplace to purchase health insurance," Meyers told eWEEK.

Components of the HIX platform include interoperable exchanges, as well as applications for enrollment, eligibility, business intelligence and case coordination, Microsoft reports. The HIX will also reduce the cost of delivering health care and boost care quality and efficiency.

Among the partners the software giant will work with on HIX is Extend Health, which operates a large private Medicare insurance exchange. Extend Health will contribute plan-comparison tools as well as enrollment and call center functionality, Microsoft reports.

"The Microsoft HIX solutions will save states time and money in the design and deployment of the technology underlying health insurance exchanges," Bryce Williams, CEO of Extend Health, said in a statement. "It frees states to focus on building proper consumer support to help citizens make their best choice from available health care plans."

The HIX platform will reduce costs by providing health care payers with analytics tools to measure health outcomes, according to Hersey. By using an HIX service, states can integrate health insurance delivery, determine eligibility, manage enrollment and offer enhanced privacy functionality, Microsoft reports.

Health insurance reform is a major part of ARRA (the American Recovery and Reinvestment Act), Jack Hersey, general manager for Microsoft's U.S. public sector health care and social services group, told eWEEK. In January, the Department of Health & Human Services released another round of funds to help states that are further along in building HIXs.

With the HIX, Microsoft plans to offer an interoperable platform for government and private sectors, the company reports.

Tools in the exchange will allow customers to choose among plans they're eligible for based on their medical history, Meyers said. "They can actually enroll in real time online," he noted. Licensed insurance agents are also available to guide customers through the choices, he added.

With the software's analytics capabilities to search demographic data, users can research plans for children, senior citizens or other groups.

Microsoft will incorporate its Windows Azure cloud platform, and its SharePoint applications will power HIX's consumer portal, Meyers said. The cloud platform will help insurers handle an abundance of queries, payment deductions and processing, according to Meyers. Meanwhile, back-end systems will allow the states to handle eligibility and enrollment.

The platform also uses BizTalk Server 2010, which allows companies to connect disparate business databases. "Employer systems are primarily served by BizTalk," Meyers said.

Access to multiple health care databases will make analytics checks of health plans possible, according to Hersey.

"You can do the BI analytics against the data to make the right decisions on delivering care, reducing fraud and improving outcomes," Hersey said.