Oct 2020

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Driving an industry overhaul

Source: Middle East Insurance Review | Aug 2020

From a resurgence in primary care to the acceleration of new virtual healthcare delivery methods, COVID-19 is presenting the health insurance industry with opportunities to bring real value to people’s lives while reducing healthcare costs across the board.
David Healy, CEO – EMEA, Aetna International
Throughout the COVID-19 crisis, we have frequently encountered the phrase ‘front lines’ when we heard and read of the unimaginable pressures faced by medical, technical and administrative staff in hospitals and clinics. They have done nothing less than put their lives on the line for the rest of us.
Their selflessness inspired the health insurance segment to also play its part, extending coverage periods, and offering free support for COVID-19-related services, from diagnostics to treatment. Provision of telemedicine services was one example of an initiative that may change the industry in years to come, as it revealed many benefits that previously had yet to be proven.
As we emerge from the coronavirus tunnel, we will, of course, reflect on what we have lost. This is only natural. But we should also take great comfort in how the pandemic shone light on unexplored corners, exposing weaknesses and inefficiencies around the world in the way we approach many aspects of our lives. 
Abstract discussions on possible changes to operational models have now taken on new urgency. They are no longer abstract. Steady-as-she-goes projects such as remote working and distance learning were accelerated across the GCC, as governments and businesses realised that continuity required decisive action.
Positive findings
The healthcare sector experienced similar pressures, albeit on a far greater scale. Amid explosive surges in demand for consultations, we have seen a great deal of attention paid to the delivery of primary-care medicine. Across the region, GPs that normally observe a (on average) 9-to-6, Sunday-to-Thursday work week are now on hand for extended periods. This may come to subvert the more expensive practice of patients making appointments directly with specialists.
Meanwhile, telemedicine has moved from an exploratory model to a first-line service. UAE providers and health authorities have been offering virtual COVID-19 consultations and some insurers are also starting to cover such services.
The resurgence of primary-care methodologies and the emergence of telehealth go hand in hand. Together they represent real value for employers, as plan sponsors, and their members. There is evidence to suggest that the per-capita cost of healthcare can be driven down by applying the primary-care approach. Furthermore, a majority of this primary care can be done without the need of physical contact with a doctor. And because of the pandemic, we now have proof that around 60% of primary care can be done without physical contact. More importantly, patients will no longer be reluctant to use virtual consultations, and this will give us the opportunity to downsize direct-to-specialist engagements. 
COVID-19 – and the isolation and social distancing that have come with it  – has also shone a light on the importance of mental well-being. Several insurance providers already offer services and plans that address this, but COVID-19 will mandate that these offerings become the norm, rather than the exception.  
New value
The old adage ‘every cloud has a silver lining’ rings true here. From a resurgence in primary care and the acceleration of new virtual healthcare delivery methods to a renewed focus on mental health, COVID-19 is presenting the health insurance industry with opportunities to add the kind of value that will help to bring real enhancements, not just to healthcare services, but to the way people live their lives — all while reducing the costs of healthcare across the board. 
Such changes will not happen in isolation. They will require buy-in from many participants, but our customers will drive this industry overhaul. Their new behaviours will make it possible and inevitable. M 
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