how health insurance companies can become more profitable

Dr Aniruddha Malpani, MDwww.informationtherapy.in

Your pain points today Intense competition - health insurance has

become a commodity. You need to differentiate !

You lose money per customer because of fraud

Your customers do not see any benefits - feel it is a waste of their money when they do not make a claim

Today, it is illness insurance – not health insurance !

Our solution allows you to Reduce your claims loss ratioAcquire new customers  Retain your old ones

TodayYour subscribers hear from you only

when:

The premium is due to be paidThe claim they present is rejected

Using the internetYou need to proactively establish a more

positive relationship with their customers.

 When people fall ill, they use the internet extensively to research their treatment options

Over 200 million Indian internet usersCan you help them in their time of need

with Information Therapy ?

Your website is a problemPoor content - focus on your

company and not on your customerProviding the patient with what he

wants to know – information about his symptoms and his treatment options can build trust.

Why not embrace that opportunity ?

Not an easy task !Writing high quality medical content

specifically for patients is difficult and time consuming

You can now instantly license the information your subscribers need to manage their health concerns from the world leader in patient education, Healthwise Knowledgebase !

www.healthwise.org !

Knowledge is powerDeliver health information anywhere,

anytime – in an engaging fashionHealthwise offers a digital platform, based

on which you can provide patient support programs and coaching to help your members remain healthy

We help you create cost-effective solutions that use time-tested channels and integrate cutting-edge new ones to deliver results.

Patient education makes business sense !

Well informed patients make better and less costly health care decisions, helping your bottom line.

This has been proven by research. Educating diabetics reduces medical

costs.Studies Health Technology Information.

2009;143:258-63. Potential Return on Investment (RoI) on web-based diabetes education in UK. Shabestari O, Roudsari A.

Patient education reduces unnecessary surgery

Well informed patients say no to unnecessary surgery, thus reducing healthcare costs.

E. Murray et al., “Randomised Controlled Trial of an Interactive Multimedia Decision Aid on Benign Prostatic Hypertrophy in Primary Care,” British Medical Journal 323, no. 7311 (2001): 493–496

Patient education reduces unnecessary

surgery( hysterectomy)A.D. Kennedy et al., “A Multicentre Randomised Controlled Trial

Assessing the Costs and Benefits of Using Structured Information and Analysis of Women’s Preferences in the Management of Menorrhagia,” Health Technology Assessment 7, no. 8 (2003): 1–76.

http://www.hta.ac.uk/execsumm/summ708.htm

The use of decision aids, consisting of evidence-based information reduces health service costs as well as improving patients’ satisfaction.

The reduction in hysterectomy rate is consistent with trends observed in other studies looking at conditions where patients have a choice between conservative and radical surgical options.

Shared decision making reduces costs ( hip and knee surgery) Group Health Cooperative (an integrated insurer

and hospital system) gave all 660,000 of their patients access to decision aids

After introducing decision aids, rates of hip replacement fell over 25%; knee replacement went down 38%. Total spending went down 21% on patients with hip osteoarthritis and 12% for knee patients -- but for the whole study population.

Introducing Decision Aids At Group Health Was Linked To Sharply Lower Hip And Knee Surgery Rates And Costs . Health Aff September 2012 31:92094-2104. Arterburn, D et al. Group Health Research Institute, USA.

Shared decision making

generates savings for health insurance companies

Patients who received these tools had 5.3 percent lower overall medical costs.

They had 12.5 percent fewer hospital admissions and 9.9 percent fewer preference-sensitive surgeries including 20.9 percent fewer heart surgeries.

Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions. David Veroff et al. Health Affairs. Feb 2013.

http://content.healthaffairs.org/content/32/2/285.full.pdf+html

Shared decision making

generate savingsA “remote” model of support combining telephonic

coaching with decision aids constitutes a low-cost and effective intervention that could reach broader populations without the need for direct involvement of regular medical care team members.

Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions. David Veroff et al. Health Affairs. Feb 2013.

http://content.healthaffairs.org/content/32/2/285.full.pdf+html

Health insurance portabilityChallenge and opportunity !You need to create customer loyalty !1. Build stronger relationships with existing

members2. Attract customers from competing health insurance companies  by providing a unique differentiator!

Better than wasting money on generic advertising !

Our solutions can help you attract and retain members now—and in the future.

Healthy customers = healthier bottom lines !

Promote SelfCare. Help them to do as much for themselves as they can

Provide Evidence-Based Guidelines, so that they can ask for the right medical treatment that they need - no more and no less

Provide Veto Power, so they can say No to medical care they don’t need, thus preventing overtesting and unnecessary surgery.

Healthwise Knowledgebase

BenefitsYou will be promoting health – not

just selling illness benefits !Proactively helping your customers

to remain healthy Major differentiator – stand out from

your competitors

Learning from the USAAll the Top 10 health insurance plans in the

US use the Heathwise Knowledgebase on their website

Value add Engage with your members

Encourage them to call you as point of first contact

Build trust and loyaltySend regular ezines to help them remain well

Reduce unnecessary surgery (such as hysterectomies and caesarean sections) 

You have many needs – we provide many solutions !As healthcare costs rise, helping your

members manage their health becomes increasingly important.

Reach your entire population with a scalable interactive health management platform

Deliver targeted clinical education programs to at-risk segments.

Provide condition-specific health information for members managing chronic conditions.

Very cost effective investmentAnnual license costs only a few rupees per customer

Great way to create customer delight !The knowledgebase is a digital platform which serves as a

necessary starting point to engage customersYou need to build upon it further – for example, by using a

call centreHelp your members achieve lasting health behavior change

through a highly personalized, multi-modality approach.

White labelledYour logo here

Engage with Health Guardian/ Health Coach

Rich actionable content – changes behaviour !

Shared decision making with interactive decision aids

Try it out yourself at www.healthlibrary.com/healthwise.php