Health insurers taking bull by the digital horns: CapGemini

by Leo Almazora22 May 2019

While trends such as increased life expectancy, medical inflation, and aging populations conspire to prompt consistent growth in health insurance premiums, rising challenges are forcing industry players to seek pre-emptive and digital-focused solutions.

“[L]ow interest rates, intense competition, internal operational inefficiencies, and market disruptions from new entrants are continuing to put pressure on health insurers,” global consultancy firm Capgemini said in a new report outlining the top technological trends in health insurance. “The healthcare sector is also experiencing a trend of increasing healthcare costs fuelled primarily by expensive experimental treatments, increase in non-communicable chronic lifestyle diseases, and higher life expectancy.”

As health insurers face an intensifying need to deliver cost-effective care, Capgemini said, they are leveraging technology to perform a demanding balancing act: shifting toward a population health model while satisfying customers’ demands for a convenient and personalized experience.

One crucial step toward that is to simplify the healthcare journey and improve treatment adherence, which is accomplished through population health management tools like apps and web-based services to customers and their care members. Aside from reducing healthcare costs and service costs, the report said insurers that have adopted this approach benefit from improved customer experience and brand presence.

As chronic, lifestyle diseases prompt a shift toward preventive models of care, insurers are turning to real-time monitoring of health indicators to enable timely care interventions as well as encourage healthier lifestyles through wellness initiatives. Supporting this trend is the growing popularity of wearable devices — a market that will be worth US$25 billion by 2019 with more than 245 million devices sold, according to CCS Insight — as well as customers’ willingness to share personal information, especially in exchange for lower premiums.

The need to contain healthcare costs through timely intervention and proactive risk mitigation has also fuelled the use of analytics. With advancements in artificial intelligence, machine learning, and image recognition technologies, insurers are better able to leverage analytics in making predictions about members’ susceptibility to ailments as well as parse data to determine correct treatment.

The report also noted the escalating prominence of telemedicine, with the international industry projected to exceed US$40 billion by 2021. With more people using mobile phones and imaging technology improving by leaps and bounds, more healthcare plan members are being offered access to off-site consultation, behavioural guidance, and care services. This has resulted in reduced in-patient visits, improved access for members in remote areas, convenience in care, and lower health costs.