The insurance industry is seeing big changes in 2020. Payers face two big challenges. First, they need to stay ahead of rapid changes in the healthcare marketplace. Second, they want to provide a better member experience, while also reducing the total cost of care.
One of the complications is increased access to data and advanced data analytics — the latest disruptors in the insurance world. The result? Fresh competitive energy. So how can insurers use this competition to their advantage and stay relevant and innovative in the changing landscape?
Our data driven world and what it means for payers
We live in a data-filled world — we can’t escape it. Consumers expect to have reliable, near-immediate access to their data. Payers who can deliver on this demand will attract new members as well as retain existing ones.
Consumers have more access to data about their health and insurance than ever. The omni-channel customer experience is a given. Members can access their data from anywhere, anytime.
Customers are highly informed by technology and the internet. Companies that employ a digital-first strategy have the edge in customer satisfaction.
Advanced analytics is on the rise. Data fuels advanced analytics, bringing about new demand patterns and risk categories. This data creates new adaptation and fresh competition. For example, we’re seeing insurance claims processed via smartphone apps. Additionally, sophisticated algorithms are being designed to automate risk analysis and fraud detection.
So much data: now what do we do with it? Too much data can be a bad thing, particularly if you don’t know what to focus on.
Can data fix the broken healthcare system?
The influx of data can provide clues into the needs of members and help manage risk assessment. However, until the system changes to be aligned with driving better health outcomes, no amount of data can fix what’s broken.
The fundamental reason why healthcare doesn’t work today is a lack of shared goals among those paying for care and those providing it. This is where advanced primary care (APC) can make a huge difference when integrated into a payer’s health plan.
APC allows providers to focus on the right kind of care that produces better health outcomes for a population. Additionally, 80-90% of care is delivered in the primary care setting. This increases utilization at the primary care level, but utilization is then decreased throughout the rest of system, lowering the total cost.
Data alone can’t fix what’s broken. Rather, data and advanced analytics working in tandem with APC can solve the actual healthcare issues in a population.