Forging the way toward a preventive model of care

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Today’s insurers are working to reduce escalating healthcare costs while also catering to policyholders’ changing requirements.

As healthcare costs climb as a result of pricey experimental treatments, growing instances of chronic non-communicable lifestyle diseases, and higher life expectancy preventive care models are being adopted to manage disease through early identification when ailments are more readily treatable.

Within this dynamic environment, consumer expectations are changing with more and more patients demanding a digital, convenient, and personalized experience from health insurers. In fact, 45.7% of tech-savvy customers and 38% of Gen-Y customers said they were willing to receive proactive, personalized offerings from their health payer according to the World Insurance Report (WIR) 2018.

The result? Today’s insurers are working to reduce escalating healthcare costs while also catering to policyholders’ changing requirements.

Adoption of a preventive care model may help to achieve both goals. In fact, insurers are increasingly implementing new models that encourage healthier lifestyles through wellness initiatives to nip health incidents in the bud, according to the Top-10 Technology Trends in Health Insurance 2019.

Preventive care models work to keep people healthy. The goal is to identify diseases before they become catastrophic. Preventive care includes medical services that defend against health emergencies such as annual physicals, well-woman checks, and dental cleanings. Some medicines are preventive, including immunizations, contraception, and allergy medications. Screenings, such as tests for skin cancer, high cholesterol, and colonoscopies, also are effective preventive measures.

Preventive care model drivers

Forging the way toward a preventive model of care

Source: Capgemini Financial Services Analysis, 2018

Not surprisingly, many insurers now monitor members’ health parameters in real time to enable timely care interventions that can lower care costs. The growing popularity and acceptance of wearable devices and the willingness of policyholders to share data with payers – especially if it means a discount in premiums – have become significant health monitoring aids.[1]

How are insurers supporting preventive care?

United Healthcare has partnered with Dexcom, a San Diego-based company that manufactures continuous monitoring systems for diabetes management, to offer participants a sensor-based device that measures glucose levels. This wearable helps users understand how their eating and exercising patterns affect sugar levels so that they can modify their behavior.[2]

Payers are also encouraging fitness by offering proactive wellness initiatives that reward members who commit to a healthy lifestyle. Mumbai-based Aditya Birla Health incentivizes fitness by offering rewards of up to 30% off annual premiums based on the user’s fitness activity as registered via wearables’ data.[3]

United Healthcare integrated the Apple Watch into its digital wellness program to give participants access to an activity tracker and offer the opportunity to earn rewards (up to $1,000 per year) by meeting pre-defined daily walking goals.[4]

The firm also launched a Healthy Savings program that enables members to buy pre-qualified healthy foods across 200 food and beverage brands at a discounted price by scanning the Healthy Saving mobile app during checkout.[5]

To successfully navigate the future regulatory and competitive landscape, however, health insurers will have to prepare to work within oversight parameters that shield at-risk consumers from discriminatory treatment.

Implications of the growing aging population are becoming clear, and many payers are offering solutions catered to this demographic.

Dutch insurer CZ partnered with Qorvo, a connected devices firm, and launched an e-health system in the Netherlands that enables the elderly to live more independently. The system consists of a non-intrusive set of motion and open/close sensors, and a room-monitoring gateway that detects adverse changes.[6]

Patient noncompliance (failure to take prescribed medication or follow a treatment course) is a common concern – particularly with the elderly. As a result, more and more insurers are encouraging the use of digital tools and wearables to help policyholders stay on track with their care path.

Finally, insurers are adopting a model focused on holistic population health by developing more community-based care programs. Anthem Blue Cross Medi-Cal launched a Health Homes Program to coordinate care of Californians with multiple chronic conditions or severe mental illness who require frequent hospital or emergency room visits, or homeless individuals who may benefit from enhanced care management. The program provides a contact to coordinate users’ health services, transportation to medical appointments, and understanding of medication and available community services.[7]

Humana developed a population health strategy focused on improving chronic conditions and social detriments to community health by leveraging wellness programs and interventions. The insurer targets food insecurity, loneliness, and social isolation because of their impact on healthy days and clinical outcomes.[8]

The shift to a preventive model of care and proactive wellness initiatives will result in enormous benefits for both insurers and patients by executing timely care interventions based on real-time data from connected devices, ensuring compliance and meaningful engagement.

To learn more about how insurers are leveraging the latest preventive models of care in the industry, feel free to connect with me on social media.

 

[1] Insurance Journal, “Young Consumers Willing to Let Insurers Spy on Digital Data – If It Cuts Premiums,” Julie Edde, June 19, 2018, https://www.insurancejournal.com/news/internation;al/2018/06/19/492646.htm

[2] UnitedHealth Group website, “UnitedHealthcare and Dexcom Bring Wearable Technology Solution, One-on-One Coaching to People Battling Type 2 Diabetes,” January 10, 2018, https://www.unitedhealthgroup.com/newsroom/2018/0110dexcomwearableces.html, accessed August 2018

[3] Livemint, “Wearables data may influence your health, life insurance premiums,” Shaikh Zoaib Saleem, December 18, 2017, https://www.livemint.com/Money/GFfQPU9H24nME447kF7dNL/Wearables-data-may-influence-your-health-life-insurance-pre.html

[4] UnitedHealth Group website, “UnitedHealthcare Helps People be More Active with Apple Watch,” March 7, 2018, https://www.unitedhealthgroup.com/newsroom/2018/0307motionapplewatch.html

[5] UnitedHealth Group website, “UnitedHealthcare Makes Nutritious Foods More Affordable with Healthy Savings Program for People in Virginia and Washington, D.C.,” November 13, 2017, https://www.unitedhealthgroup.com/newsroom/2017/1113healthysavingsprogram.html

[6] Home Toys, Qorvo press release: “Qorvo IoT Solution Powers Senior Home Care,” January 6, 2018, https://www.hometoys.com/content.php?post=37772

[7] FierceHealthcare, “Anthem Blue Cross Medi-Cal signs on to state’s Health Homes Program,” Rose Meltzer, July 25, 2018, https://www.fiercehealthcare.com/payer/anthem-blue-cross-medi-cal-signs-to-state-s-home-health-program

[8] Humana website, http://populationhealth.humana.com/social-determinants, accessed February 2019

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