A human-centred approach to health insurance

These surging interests are combining potently in health insurance, putting unprecedented pressure on insurers’ digital capabilities. Outdated technology and a historic tendency to organise around business processes are making it hard for many providers to meet members’ expectations, let alone improve their customer experiences in a dramatic way.

The good news is, of course as we all know, there’s an opportunity in this challenge. Great member experiences are now key fundamental differentiators. And growing consumer demand for a single healthcare destination that consolidates insurance and health management services, such as gyms and hospitals, only heightens the possibilities.

Organisations that can deliver joined-up, digitally enabled healthcare experiences will create value for members, partners and themselves. The goal is to provide members with smooth, end-to-end journeys that are as easy to navigate as any other consumer experience. But how can insurers strengthen collaboration, overcome existing infrastructure and deliver new experiences at pace?

In our experience, there are three key actions for firms to prioritise:

1. Drive early intervention through intelligent data

The health benefits of prevention and early detection are unarguable, and health insurers hold the perfect position to support efforts on these fronts by pro-actively managing members’ health. Companies such as UK-based Bupa, with their Sanitas BluaU proposition in Spain, are already leading the way in providing automated remote monitoring as standard. Combining their customer data and traditional partnerships, such as those with healthcare providers, with the skills and resources of digital partners will help firms to aggregate data, identify correlations, stratify risk cohorts and generate personalised analysis. Benchmarking key indicators like cholesterol, heart rate, blood pressure, fitness, nutrition and sleep could then allow firms to notify members when they move outside a bespoke set of norms. They would then get personalised recommendations to improve their health.

In addition to preventative services, the intelligent use of data can create opportunities for cross-selling or up-selling, such as the provision of virtual consultations, at-home blood pressure monitoring or remote consultations on nutrition therapy. Activity monitoring could also help optimise post-operative recovery by encouraging adherence to medicinal regimes or exercise programmes.

For many insurers, existing systems and controls may make the prospect of implementing a client-centric approach feel daunting. But firms should avoid the trap of undertaking demanding in-house transformations before beginning to develop new models. Instead, insurers should identify ideal end-to-end customer journeys and then work backwards to consider what data this would require, how they could collect and update it, the internal behaviours they would need, how to incentivise them and so on. This will improve experiences and accelerate the transformation.

2. Increase transparency and enhance triage

Feelings of concern or distress often accompany the experience of seeking healthcare services. For health insurance members, the process of identifying entitlements and making a claim can often be a ‘pain point’ at a time of anxiety.

Insurers have an opportunity to harness digital technology to transform members’ experiences of accessing healthcare. Instead of asking members to wade through large volumes of generic information and make lengthy phone calls, firms should provide them with information contextually, based on point-in-time needs. Technology such as AI, chatbots and process automation, combined with better use of existing data, will help to provide an immediate, tailored portrait of the care members are entitled to and how they can access it. Companies such as Amazon Care already enable members to answer a few questions at the click of a button on their phone before directing them to the right level of care.

Providers can complement increased transparency with online triage services that route patients to appropriate treatment options, such as a pharmacy, and suggest simple pathways that require lower levels of pre-authorisation, such as physiotherapy. Virtual tools can also help explain and manage the practical steps preceding treatment, such as a consultation with a general practitioner.

Transparent, customer-centric communications and triage have the potential to shift members’ relationship with their insurer from ‘gatekeeper’ to a digitally enabled facilitator of healthcare, while significantly reducing the manual work of insurers.

3. Partner to personalise

Health is something personal, but health insurance can often feel distinctly impersonal – there’s often a lack of optionality and flexibility. Insurers need to ensure they’re tailoring services to the needs and preferences of individuals according to their age, financial situation, life stage, health circumstances and personal choices, not just traditional demographics. That requires an ability to contribute to – and draw from – an ecosystem of data-enabled partners, including devices and apps that members already use, hospital providers, fitness specialists, online retailers or social media platforms. One example in the UK is Nuffield Health’s partnership with Doctorlink to personalise health assessments and tailor health plans online using advanced clinical algorithms. There’s also clear potential for health insurers to work more closely with other financial services providers. After all, a change in health often has implications for earnings, savings, investments and even life transitions, such as the decision to retire.

When choosing an external partner, insurers will want to consider areas that both complement and add to their own market position, such as technology compatibility, strategic business development and customer experience innovation. Acting as an ‘ecosystem connector’ will help insurers become far more influential actors within the health and wellness sphere, creating value by integrating multiple services into managed member relationships. It will also create more relationship opportunities. For example, a health insurer might offer discounted gym access – or a set of services such as physiotherapy and dietary advice – as part of its policy. And additional services could create an even richer experience, such as online grocery deliveries linked seamlessly with nutritional therapy consultations. By focusing on the wellness of the customer, insurers can significantly reduce the potential for a claim due to poor health.

The power of experiences

Traditionally, health insurance offers no immediate benefits to the buyer beyond the peace of mind that comes from knowing they have it if they need it. As a result, the key differentiator has been price and the only chance to impress members has been during a claim – a difficult moment to create positive experiences.

Health insurers that can provide pro-active healthcare and intuitive member journeys have an opportunity to circumvent these historic obstacles. For some firms, that will require significant cultural change. A focus on data, transparency and personalisation will help insurers maximise the impact of their technology spend, differentiate themselves and achieve the greatest possible transformation in member experiences.

Today’s unprecedented circumstances give health insurers a window to accelerate the shift from treating ill health to delivering better health. The industry shouldn’t waste it.