Digital health ecosystems to expand the boundaries of value creation for insurers

Digital Health Ecosystem

Digital health ecosystems, what are they?

While many of the incumbent health insurers in the past have experimented with leading-edge technologies such as internet of things, artificial intelligence and analytics, siloed technology pilots may not have not generated the value from investment in digital health technologies as expected. An important link missing from these experiments in the past has been a lack of end to end integration of the digital health offerings with the insurance policies. The answer to addressing this issue for insurers is to provide digital health ecosystem products to their customers.

A digital health ecosystem is a dynamic integration of digital tools and technologies and systems to establish a cohesive network of players and enable them to jointly offer a range of consumer centric, seamless digital services. The service providers in a digital ecosystem are unified with an objective to increase business performance, propel growth, and deliver value to the consumer and other stakeholders. Unlike a traditional commercial partnership, the customer solutions in a digital ecosystem are jointly developed with contribution of an element or capability to the solution by each stakeholder. A symbiotic relationship in the ecosystem allows an amplification of abilities of all contributing parties in the ecosystem. Consequently, the joint value of the ecosystem is much higher than the value of all players on their own.

Technology is a driver of seamless, interconnected services

A technology platform functions as a backbone on which digital health ecosystems operate  thereby making interconnectivity among insurers, providers, physicians, and other healthcare stakeholders feasible. An increased flow of data and shared insights is usually the driving force behind a successful digital ecosystem that can facilitate historical and real-time data exchange. Access to newer services, interactions with caregivers and data analytics for personalized treatment to improve healthcare outcomes are some of the benefits that digital health ecosystems have demonstrated.

Ecosystems help insurers connect with other stakeholders and bring opportunities for offering a comprehensive bouquet of value adding services

The potential benefits of digital health applications have not only been recognized by the healthcare industry but also by employers, regulators and governments worldwide. A majority of insurers now offer a wide range of stand-alone health and wellness services and digital tools. Telemedicine, remote-monitoring and diagnostic applications have become an integral part of the provider’s digital armoury since long. Pharmaceutical companies too have embraced digital in not only their marketing offerings but also in therapeutic areas with treatments beyond pills, clinical trials and real-world evidence settings. A common link between the offerings provided by these stakeholders is often a technology start-up that provides new digital health solutions. The insurers are uniquely positioned to notch up a strong place by leveraging technologies that serve as the foundation for digital health ecosystems and benefit all involved parties. By connecting with other players in the healthcare ecosystem the insurer can provide a comprehensive 360-degree service to customers. Regular touch points, along with the digital health services continuum create an opportunity for insurers to significantly improve member experience and also their control costs.

Insurers can leverage a digital ecosystem to establish multiple touch points and effectively influence a patient’s journey towards better health outcomes 

 Healthcare sector has since long been a beacon of change that has greatly accelerated in recent years. Expectations of the consumer from insurers driven by digital developments in healthcare too have grown. As more advanced medical services become available on a regular basis and the prices of healthcare services continue to rise, insurers will not only have to make efforts to control their spiralling costs but also connect with users at multiple points in the continuum of care and add value that goes beyond the value of the product. Creating a digital ecosystem environment to stay connected with the customers can help insurers drive healthcare value and also retain them.

Some of the examples where insurers can add value for their customers and also influence positive health outcomes to control their own costs are:
  1. Health education and engagement using digital platforms: A substantially large insured population can have access to digital health coaches who can monitor a person’s fitness data from tracking devices and dietary patterns to give personalised, real-time advice.
  2. Screening and diagnostics: Reminders and information on check-ups and health services and data analytics to identify high risk cases based on early symptoms by insurers can help customers seek suitable, timely medical interventions.
  3. Improvise greater access to medical care and remote monitoring: Insurers can support their customers by providing access to their empanelled network of physicians and providers not only for appointments, but also facilitate second opinions and remote monitoring using telemedicine.
  4. Care management and disease management programs: A vast patient population often gets left out of the care continuum when outside the physician’s office. This can adversely affect outcomes in chronic diseases that are highly dependent on lifestyle habits of an individual. A huge share of the insurer’s premium too is spent on claims pertaining to acute exacerbations of chronic conditions. Digital health platforms offering real-time dietary and lifestyle recommendations and social integration of patients with communities to share treatment experiences with other patients can bring these patients back into the care continuum.   

Trusted ecosystem partners and a clear strategy to leverage data are the cornerstones in creating a successful digital health ecosystem

Insurers who want to move beyond their existing role as purveyors of insurance, should consider leveraging their unique position and take up an active role in the digital health ecosystem. The healthcare data landscape that has taken shape in recent years is an ideal opportunity for insurers to make sophisticated analytics efforts directed towards enhancing patient health and also prevent unnecessary costs on treatment. Once the insurer decides to occupy a seat at the ecosystem table, selecting an ideal partner to join them there will require a certain degree of savviness, to successfully collaborate outside of its core business, all to achieve economies of scale, scope and skill.

A trusted ecosystem partner can bring greater reach and have vast amounts of data that can be leveraged to inform better customer insights and experiences using advanced big-data analytic techniques. Effective data aggregation with a clear strategy to share and leverage data is always in the best interest of all partners in the ecosystem.

Trusted ecosystem partners can effectively help insurers in expanding the value propositions for their customers with capabilities that extend the existing offerings and also introduce new services. For example, insurers can collaborate with a digital partner who can offer personalized health services and foster customer engagement. Lastly, trusted partners can give insurers a wide range of skills, capabilities and technologies which otherwise are cost intensive. For example, data driven technology driven start-ups usually have in-house teams of data scientists. Insurers can leverage these competencies from their partners, on the other hand making de-identified insurance data by insurers will be a strong value-add for these partners.

Given that ecosystems can offer a clear underlying value for all stakeholders, the time is just right for digital health ecosystems to emerge at scale. For an insurer striving to create an ecosystem environment, the most crucial step is to first aggregate the right components to set-up the necessary digital backbone and identify the right partners.

Reference
  1. Draft global strategy on digital health 2020– 2025. (2020).World Health Organization (WHO).
  2. National Digital Health Blueprint. (2019).  Ministry of Health & Family Welfare Government of India.
  3. 3. Four Areas of Digital Health That Are Driving the Future of Healthcare. (2020). HIMSS. Retrieved December 24, 2020, from https://www.himss.org/resources/four-areas-digital-health-are-driving-future-healthcare
  4. Wyman, O. (2019). Asia Health Ecosystem Series, Volume I. Oliverwyman.com. Retrieved December 24, 2020, from https://www.oliverwyman.com/our-expertise/insights/2019/feb/asia-health-ecosystem-series.html