Across all industries the competitive landscape is changing faster than ever. To stay relevant, modern organisations must renew themselves continuously and evolve with their customers’ wants and needs. In practice, this means customer-first culture, strategic partnerships, growth mind set and organisational structures that can rapidly accelerate ideas and insight into scalable action.
The renewal challenge applies to health care payers as well, especially due to the increasing care needs driven by “silver tsunami” and chronic diseases. But what are the right carrots and sticks to manage this upcoming cost burden and resource scarcity?
Instead of just digitising current processes, we need a paradigm change. Smart health insurers and e.g. governmental payers position themselves as platforms by steering and enabling bottom-up innovation towards strategically prioritized goals and outcomes. To my opinion, payers have a key role in designing an integrated and continuously learning health system for and with the people it serves.
This kind of mission-oriented approach requires not only a partnership mind set and active collaboration with a diverse, cross-sectoral ecosystem (e.g. service providers, tech innovators, NGOs, professionals and customers) but also new kind of knowledge management tools and KPIs. Thanks to interactive digital touchpoints like AI-powered chatbots, data interoperability, analytics and other innovative solutions, we can eventually deliver precise health interventions at the right time, to the right population. To accelerate these preventative services, payers will need new funding mechanisms and instruments - meaning the utilization of value-based reimbursement models, impact investing (e.g. Social Impact Bond) or similar.
As the traditional health care system has only a limited impact on our health outcomes, we should put more focus on enabling behavioural change – like for example nudging and choice architecture - and developing services that support holistic well-being. Pioneering insurers and health systems have already started to put more emphasis on prevention with some transformative pilots - for example by delivering healthy groceries for identified risk-groups.
We all agree that one-size-fits-all services are not enough. Payers – in collaboration with the broad ecosystem - will have a critical role in speeding up the pace of population health breakthroughs. We will have more room to discuss it on Thursday 13 June during the session “From Payer to Partner – Health 2.0 Solutions for Insurers” at the HIMSS & Health 2.0 European Conference in Helsinki. See you there!
Management Consulting Manager, Accenture