The Digital Evolution of Health Insurers: How mobile technology is changing the game

 

With smartphone adoption on track to reach 80% of the developed world by 2020,1 organizations across a variety of industries are discovering innovative ways to monetize data through APIs and they are creating and delivering new digital services in the form of engaging, user-friendly apps to attract and retain consumers.

Fueled by the growth of public and private exchanges and millions of newly insured consumers entering the marketplace, the healthcare insurance industry is facing increased competitive pressure over price and quality and has adopted the characteristics of a true retail industry. In response to evolving consumer and market demands, healthcare payer organizations recognize that a robust digital strategy can offer a competitive advantage, and they are making key IT investments to support the delivery of user-friendly, engaging digital experiences for their members.

According to McKinsey’s recent Digital Enablement Survey, Healthcare payer organizations are devoting a larger proportion of their IT budget to building digital capabilities, with forecasts suggesting that digital transformation will account for more than 50% of their strategic IT budgets within the next three to five years.2

Engaging members in a convenient, meaningful way through mobile

In the new era of value-based care, patient engagement has become a key strategic initiative for organizations across the healthcare ecosystem. Healthcare payer organizations understand that more engaged patients translate to healthier patients and better outcomes, which in turn helps control healthcare costs and reduces the overall burden on our health system.

In addition to promoting better health outcomes and reducing the cost of care, having extensive mobile capabilities could influence consumers to pick one health insurer over another, further driving home the importance of having a robust digital strategy in place. Yet, despite growing consumer demand for an improved digital experience, healthcare payers must be able to balance the benefits of deploying new digital services while complying with healthcare industry data privacy and security requirements. 

With more than 10.6 million members, Kaiser Permanente is one of the U.S.’s largest not-for-profit health plans, and one of the industry’s first major players to go “all in” on mobile. Through a portfolio of mobile apps, Kaiser encourages its members to remain fully engaged in their health and manage their medical expenses anytime, anywhere by enabling a variety of digital services such as secure access to health records, management of claims, physician communication tools, and tracking of fitness goals in real-time.

Reduced healthcare spending and improved care access for the chronically ill

Chronically ill patients, who the CDC currently estimates account for 86% of total healthcare spending3, present a higher risk for adverse health events. Healthcare payers are investing in digital tools to keep chronically ill patients continuously engaged in their care plan to prevent them from getting sicker or having a significant and costly health event.

One example of how healthcare payers can help chronically ill members substitute lower-cost, digitally enabled services for more expensive options is by supporting coverage for utilization of remote monitoring and virtual visits. Several large healthcare payer organizations such as Anthem and UnitedHealth Group have invested in development of their own direct-to-consumer virtual doctor visit service. The American Telemedicine Association is projecting that the number of virtual doctor visits in the U.S. will reach 1.2 million4. And, as reimbursement for these digital services becomes more pervasive and mobile adoption continues to rise, there is an expectation for more healthcare providers to expand their services to support more remote monitoring services and virtual visits. The Cleveland Clinic, for example, is creating a “Cleveland Clinic in the Cloud” to provide patients located anywhere in the country access its physicians remotely.

Greater cost and choice transparency for consumers

As many U.S. consumers face higher deductibles, gaining better visibility to the cost of treatment and variety of care options available to them is becoming critical in order to effectively manage medical expenses. Mobile device usage has altered how consumers access services and information across every aspect of their daily lives, and with disruption of many industries fueled by innovations in areas such as mobile payments, rise of on-demand services, and ever expanding digital ecosystems the potential for digital disruption across the healthcare payer landscape is tremendous.

From leveraging mobile geolocation technology to enable members to locate the best provider to meet their care needs at the most optimal cost, to offering rewards and discounts for their members based on real-time tracking of wearable device data, the potential for healthcare payers to facilitate improved outcomes through better digital linkage across the healthcare ecosystem continues to grow as the underlying technologies that enable these innovative digital experiences rapidly evolve.

Ready to take your digital strategy to the next level?

The digital future for healthcare insurers is bright, but it will require your organization to proactively engage with connected consumers to offer instantaneous, customized data and services. APIs are the lynchpin of a digital strategy because they enable integration between internal information and the broader ecosystem.

Axway provides everything your organization needs to:

  • Quickly build apps across a range of platforms
  • Securely unlock the internal back-end data and partner services needed to power rich omni-channel experiences
  • Analyze real-time information to measure success and drive continuous improvement

 

1GSMA – The Mobile Economy, 2015

2http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/why-digital-transformation-should-be-a-strategic-priority-for-health-insurers?cid=other-eml-alt-mip-mck-oth-1605

3CDC estimates 2016 - http://www.cdc.gov/chronicdisease/

4http://www.wsj.com/articles/how-telemedicine-is-transforming-health-care-1466993402

 

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