Healthcare InsurTechs bridge ecosystem gaps

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InsurTech firms within the health domain are leveraging AI, IoT, Machine Learning for better customer experience.

Following the successful trajectory of FinTechs, InsurTech firms aiming to simplify and improve the efficiency of insurance are becoming big business. And within this growing sector, healthcare-focused startups secured more than US$5 billion in investments in 2017 (roughly doubling 2016 finance figures) according to a report that covered 224 companies’ funding announcements.[1]

InsurTech firms within the health domain are leveraging artificial intelligence, internet of things (IoT), machine learning, and more to deliver innovative applications that improve customer experience while evolving and automating internal workflows and processes.

Capgemini’s Top 10 Technology Trends in Health Insurance: 2018 found these emerging InsurTechs to be focused primarily on improving integration of the overall healthcare ecosystem, which remains fragmented with non-integrated and siloed communication between stakeholders. Trend drivers such as mobile apps, IoT, and advanced analytics are enabling new applications that connect data sources and streamline processes. Interoperability remains the linchpin for both payers and providers.

Healthcare InsurTech firms are developing digital platforms that connect stakeholders such as brokers, carriers, providers, and exchanges. Among the benefits these newcomer firms offer are streamlined digital processes for insureds – digital payments, automated underwriting, digital enrollments and enablement of collaborative and connected care delivery. They support the healthcare ecosystem integration by aggregating data from various sources for easy access while helping carriers to better assimilate with partners as well as their incumbent technologies, and seek to improve member or patient outcomes at lower cost

Transformative healthcare InsurTech firms

Toronto-based startup League Inc. developed a digital health platform that connects insureds to a comprehensive network of health services and benefits, giving them a choice, convenience, and savings. League offers businesses a mobile app that allows employees to access benefits information, healthcare providers, and a digital payments wallet.[2] Users opt-in to services ranging from check-ups to preventative care and wellness benefits.

Philadelphia analytics firm Picwell offers an advanced predictive recommendation engine for health plan selection via collaboration with brokers, employers, payers, retail pharmacies, and exchanges to recommend the most optimal plan for individuals based on predictive analytics of more than 900,000 health-insurance variables. Picwell’s application programming interface (API) allows businesses to control their employees’ benefit experience while flexibly integrating into any existing system environment, including direct-to-consumer portals, call center platforms, and more.[3]

Dubai-based Bayzat created a mobile app that helps customers compare health insurance plans from leading insurers in the United Arab Emirates and access benefits and provider networks with a highly visual and easy-to-understand interface. The app features advanced search functionality of medical symptoms as well as an intuitive map of potential providers.[4]

New York InsurTech, Oscar Health is disrupting health insurance through an online platform that allows individuals (and now businesses) to quickly and easily acquire health insurance. The company initially offered plans only in New York but has expanded to five additional states. Its mission is to take advantage of the new healthcare marketplaces created in the United States by the Affordable Care Act (Obamacare). The company believes it can beat larger insurers through its focus on customer service and technology, which includes a mobile app for booking appointments and consulting with a physician. Oscar was valued at $3.2 million in the first quarter of 2018.[5]

InsurTech solutions that streamline and integrate the healthcare ecosystem benefit insurers through cost efficiencies and simplified processes. Through aggregator platforms and apps, health insurers can build partnerships with other stakeholders, such as providers and pharma companies, and better integrate with the healthcare ecosystem. At the same time, the importance of differentiation and comprehensive product design will rise for health insurers as advanced comparison platforms filter out the most suitable product for a customer based on their profile.

What’s more, new technology tools are redefining customer engagement as they enable seamless, real-time, direct communication and even care delivery. This is leading to a paradigm shift towards proactive wellness initiatives where the healthcare stakeholders step in at earlier stages of patient care and help the patients through their healthcare journey. This not only helps them enhance their customer experience but also lowers the overall healthcare costs and leads to a win-win for members and insurers. Capgemini’s Digicare platform aims to equip healthcare stakeholders for this new future by providing a range of patient engagement tools to their customers for obtaining more information, making appointments, symptom tracking, medication adherence, and staying connected 24/7 with care providers. This proactive patient engagement is exactly what customers demand as well, as per the World Insurance Report 2018 which highlights how customers across all demographic segments had at least a 15 percentage point higher positive experience if their insurers were seen as being proactive.

The future of healthcare will no more be bound within traditional definitions and firms who build a comprehensive and proactive approach to customer engagement with the help of technology will stand to gain a strong competitive edge.

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[1] MobiHealth News,” 224 digital health funding deals in 2017,” December 28, 2017, http://www.mobihealthnews.com/content/224-digital-health-funding-deals-2017

[2] League website, “League Introduces Health Insurance Products for Canadian Businesses,” October 12, 2016 https://blog.league.com/league-health-insurance-products

[3] Picwell website, “Enhance your benefits lifecycle by starting with the decision that matters most,” https://www.picwell.com/products, accessed April 2018

[4] Bayzat website, accessed October 2017 at https://www.bayzat.com/health-insurance/family/

[5] TechCrunch, “Oscar Health raises $165 million at reported $3B valuation,” Darrell Etherington, March 27, 2018, https://techcrunch.com/2018/03/27/oscar-health-raises-165-million-at-reported-3b-valuation/

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