Disruption Hits Health Insurance Market
Progressive CIOs use the opportunity for digital transformation.
Health insurance is going through a significant evolution. Consumers have increasing choice, and insurers are looking for ways to engage differently and meaningfully with their members. Insurers no longer want to consider their members as part of a large, faceless risk pool, but rather see them as consumers trying to navigate the complex healthcare delivery marketplace. Insurers are aiming to reduce costs and improve coordination with providers as the industry moves toward member-centric models.
New, well-funded digital health insurance companies such as Oscar are shaking up the market with digital engagement models and low overhead costs. What can incumbent health insurers do to survive? Using new digital technologies to their full potential — and embracing the use of analytics — could be the answer.
Incumbent insurers have the advantage of the insights they can draw from their massive stores of data — that is, if they can liberate their data from functionally isolated silos often housed in legacy applications and managed with old-world technologies. There is a pressing need for incumbents to invest in data analytics to leverage value and insight from existing data stores and ingest new data to enable more compelling interactions with members.
Through analytics, insurers can use member information to predict what might happen next in the patient journey; hence, payers and their provider networks can start to offer alternative care models to minimize expensive medical care and intervention, and help consumers take control of their own healthcare.
Ultimately there are three forms of healthcare data — systems of record data (claims data, electronic health records), genomic and genetic data, and patient-generated data (biometrics, qualitative data). Healthcare CIOs need to ensure that they have future-proofed strategies for all three forms of data and their linkages so they can generate insights, develop new products and channels, and address new models of member loyalty and expectation.
A sound strategy for next-generation analytics could provide just the key health insurers need to unlock the potential of their data and fulfill their goal of providing patient-centric service.