Can digital health turn payers into preventers?

Despite valiant efforts, health insurers today are, for the most part, still viewed by consumers as a payment system for their illness bills – period. They’ve yet to win the hearts and minds of consumers as the caring partner – with their best interests in mind – striving to help them achieve happier, healthier lives. But with a carefully crafted digital health strategy focused on prevention, health insurers can change this negative perception and move up the value stream – a win-win for the insurer and member.

The insurer’s digital health strategy must focus on transforming the current disjointed offering of dozens of health-tech services into a single integrated ecosystem of solutions residing on one digital health platform.

Illness vs. Wellness

Historically, health insurers have invested in digital health solutions focused on treatment of illness and management of chronic conditions. (i.e., disease management, care management, etc.), aimed at reducing the high costs associated with them. For example, a telemedicine call is less expensive than a live doctor visit, and a diabetes management program can reduce episodic events and hospitalizations.

While these are valid applications for digital health technology with a calculable ROI, the absence of a robust focus on preventing these conditions in the first place surrenders an enormous opportunity to increase personal engaging touch-points with members and reshape the insurer’s image (we care partner – predict & prevent), while reducing health care spend. In fact, the American Medical Association’s research has shown that lifestyle modifications can reduce annual health care costs by nearly $2,700 per participant and have a 3-year ROI as high as 42%.

A Revised Digital Health Strategy

Designed and implemented wisely, expanding the prevention-focus of the digital health strategy can shift the public’s perception of health insurers from adversary to teammate. Today, IoT is everywhere. Thirty-four percent of adults in the U.S. now track their health with the use of wearables, devices or apps. Zettabytes of health data are being collected: lifestyle information, biometric data, stress and emotional wellbeing, medical and family history, etc. The data exists, and the promise is that health insurers could use this information to better predict and prevent which individuals have rising health risks and intervene before a catastrophic health event or chronic condition develops.

The Big Digital Health Opportunity

So, what’s preventing insurers from effectively using this data for precisely this purpose? The challenge up till now has been that the data from these devices, apps, point solution vendors, care management programs, medical records, etc. resides in silos (i.e., separate, non-integrated systems). Even when health insurers are providing digital health solutions to their populations, this disconnect fails to ensure that the right members are using the right applications, at the right point in time, and if they’re having any impact.

The need for a single digital health platform to integrate the incoming data and create a personal health improvement journey for each member has never been stronger. Only then will health insurers be able to maximize the impact of their prevention efforts, translating to better health outcomes, improved member satisfaction, cost reductions and a transformed image as the member’s true health partner (we care partner).