Customers don't need Health Insurance!

Customers don't need Health Insurance.. they need to keep in, or get back to, good health.

Health Insurance Industry has regularly developed products and services which have focused on paying bills for the health events that clients face during their lifetime. I believe that we need to change the paradigm - How does Health Insurance Industry enable customers to keep in, or get back to, good health?

Today I list three technologies or services that are easy to integrate within Health Insurance Solutions and can be the first step in this paradigm shift.

(In the next articles on the topic, I will focus deeper into actual implementation of each of these. I will also introduce implications and health insurance implementations for technology trends such as AI and Blockchain)

ONE: Internet-of-Things - Connected Health Devices

Here I don't just refer to activity tracking devices like fitbit, but include monitoring devices like Weight, Blood Pressure and Blood Sugar monitors.

The value of integrating these within the technology service framework offered by insurance companies is seen not just by reduced claim cost of major events, but by the fact that automated alerts generated by the system can allow active medical management:

1. Customer Alerts - measure and track their health and provide personalised information

2. Medical Technologists - highlight "at-risk" clients who need detailed evaluation and early detection

3. Medical Practitioners - ensure higher treatment compliance and low cost & improved follow-up

TWO: Remote Medical Assistance & Telemedicine

Most healthcare models are very busy (with increasing cost and decreasing doctor-patient interaction time). A major cause of this burden is from consultations for "common and minor" events which require little or no real treatment. At the same time, both from a customer's perspective of peace-of-mind as well as medical need to detect the hidden signs of more significant condition, these consultations can not be ignored.

"Telemedicine" in its different forms has been in practice for many years now, however instead of simply as a means of alternate form of medical service it should be integrated within the Healthcare - Health Financing model.

1. Video or Tele Consultation - Reduced travel &/or waiting times as well as integrated single window multi-speciality consultation

2. Medical Records Management - Client controlled access of complete medical history avoids both mistakes as well as inadvertent loss of past information & trends

3. Remote Emergency Support - Quick and appropriate simple emergency procedures can be life saving and also serve as a tool to access the nearest and most appropriate medical center

THREE: Customer Information Solutions (click here for follow-up article)

I have long maintained that the biggest gap in current Health Insurance Solutions is lack of clarity of what is covered by the policy compared to the healthcare cost. This gap is manifested at the time of claim through rejections or delayed/partial service delivery and results in deep consumer dissatisfaction.

1. Cost of Treatment/ Service - It isn't enough to provide a list of inclusions & exclusions, we need to provide how a "real life event" will be serviced and what it will cost

2. Service Options - Clarify how treatment options exercised by the client will affect coverage & cost, e.g. within a network hospital higher coverage may be available compared to outside network

3. Provider Search Tools - Easiest of all is to enable customers to locate their prefered providers, e.g. by type of medical need, type of service provided, location, etc.

4. Status of Service Request - This is so basic that seems obvious first step, yet often missing

#Claims #Technology #Customer #NeedsAnalysis