Insurance, by definition, exists to mitigate risk.
Traditionally, insurers take little or no active role in a client’s life until a triggering event occurs and a claim is made. This is especially true in health insurance, where insurers function as a third-party payer between the service provider and the consumer.
This traditional definition – and the role of health insurers – is changing. Digitalization is enabling and prompting health carriers to move beyond simply mitigating risk; insurers are now looking to become partners in maintaining customers’ good health and working to prevent triggering events from ever happening.
Data as the Driver
Digitalization starts with data, and the proliferation of new and vast data sources continues to gain momentum. The move from analog to electronic health records is slowly getting underway throughout the world and will enable greater and faster access to personal medical histories. Meanwhile, advances in genomic sequencing are providing unprecedented insights into individuals’ disease risk.
Technology such as glucose monitors, wellness apps, and wearable fitness trackers offer yet another source of actionable information. Personal health tech empowers patients to participate more fully in their own preventive care plans, both improving plan adherence and providing valuable insights to healthcare professionals.
As data has increased, so has our ability to process it. Predictive models can mine and analyze data to determine which diagnostics, monitoring, and treatment offer the most value for the money spent. This should allow insurers to price better, develop better products and resources, and pay for better results. This will then facilitate the transition within healthcare systems toward value-based care, in which providers are paid based on patients’ actual health results rather than on an entirely per-service basis.Read More +