The healthcare insurance industry is constantly evolving. From the landmark 1965 bill that established Medicaid and Medicare to the Affordable Care Act’s enaction in 2010, many landmark moments have helped shape the modern insurance field. Of course, some healthcare insurance trends are more subtle — but just as important to know about regardless, especially if you’re in the healthcare field.
6 Insurance Trends to Look Out for in 2021
The health insurance industry is evolving rapidly due to various factors, from the uptake of cutting-edge technologies to the impact of COVID-19. Here are some changes to keep an eye on in 2021.
1. Changing Demographics are Impacting the Need for Insurance
Overall, the consumer demand for health insurance is growing worldwide. There is a growing middle class in emerging markets (such as Argentina and Vietnam). This expanding consumer base means more people have the money needed to spend on expanded health insurance coverage.
In developed countries, demand is rising because populations are aging. For example, in the United States, the aging baby boomer population has caused the 65+ demographic to grow by one-third from 2010 to 2020. More people need longer – and often more expensive – care. This shift is expected to result in more private insurance spending and out-of-pocket spending,
2. Insurers are Ramping Up Digital Capabilities for More Virtual Care
The COVID-19 pandemic forced people around the world to stay home to minimize the risk of infection. As a result, telemedicine took off. Health insurers have taken note of this trend and acted accordingly, implementing more digital wellness initiatives. Companies are also presumably eager to minimize the detrimental health impacts of COVID-19 that might cost them money (e.g., a sedentary lifestyle, isolation).
For example, Optum, part of United Health Group, established a virtual community center to encourage elderly individuals to stay fit during the pandemic. The offering included mental health classes, nutrition tips, and free online exercise courses. Such digital capabilities will likely become part of the “new normal” – not a fleeting healthcare insurance trend but a lasting shift.
3. Tech Giants are Entering Insurance with a Focus on Improving Customer Care
Diversification of players is another critical healthcare insurance trend to monitor. Big tech companies, in particular, are shaking up the landscape. These power players are investing in health tech startups to boost their expertise, collaborating directly with insurers, and (of course) using their technological prowess to revolutionize the ways that health is handled.
For example, cloud-computing technologies combined with natural language processing can mine information from diverse health databases. This mass of data can then be analyzed using cognitive computing and AI, allowing for more accurate and detailed insights regarding health outcomes based on real-world evidence.
Tech companies are also bringing a more consumer-centered approach with them, causing marketplace disruptions. Google put an impressive $225 million of funding into Oscar Health, which offers direct-to-consumer health insurance. Another example: Apple and Anthem are collaborating to see how wearables like Apple Watch can enhance patient-driven asthma management.
4. Artificial Intelligence is Improving Claims Processing
As tech giants enter the healthcare industry, they are bringing their cutting-edge tools with them. Artificial intelligence is one example, with AI poised to transform claims management. AI systems can be used to automate early-stage processing of claims – for example, checking that all information in a claims request is provided and following up in case of missing details.
AI-based solutions can also be used to flag fraud or improve auto adjudication of claims. For instance, U.S.-based insurer Humana is working with tech giant Oracle to develop claimed real-time adjudication. This can save time, money, and manpower. It also benefits the end-user. By streamlining claims processing, insurers can help patients get the money they are due faster.
5. Data Interoperability is Allowing for Better Coordinated Care Delivery
The health insurance industry consistently deals with large amounts of sensitive patient data. Effective interoperability across disparate technological systems can allow for a more streamlined exchange of medical information, ensuring better, more efficient care delivery. Unfortunately, different healthcare IT systems often lack the common standards needed to share and interpret data seamlessly.
This is an issue that healthcare providers, insurers, and governments are working to fix. For example, the Global Digital Health Partnership brings together more than 30 stakeholders – from government agencies to the World Health Organization – to improve digital health implementation. Meanwhile, the U.S. Department of Health and Human Services has put in place technical standards regarding healthcare data exchange.
COVID-19 has put added pressure on this issue, as health experts worldwide seek to exchange valuable information regarding symptoms, mutations, vaccine reactions, and more.
6. Consumers are Seizing Control of Their Care, Changing Healthcare Value Chains
The COVID-19 pandemic saw many Americans lose their jobs. This also resulted in millions losing their health insurance because many Americans still rely on their employer to provide health insurance. Thanks to the ACA, healthcare consumers have more options to get the coverage they need. This is expected to impact enrollment numbers, although it’s too soon to see precise outcomes.
Further, the value chains in healthcare are evolving, giving consumers more control over their wellbeing. Individuals with chronic illnesses in particular stand to benefit. Today, a person with diabetes can use a wearable device linked to a mobile app to monitor blood glucose levels. Simplified monitoring makes it simpler to make smart diet and exercise choices and touch base quickly with physicians.
This makes it easier to avoid the types of dangerous complications that would typically end up costing health insurers money. This signals another significant shift — towards value-based care. A fee-for-service model may be the norm now, but this approach is hampered by hugely divergent costs (of drugs, procedures, and treatments). A value-based approach may be a future solution.
Keep Up with Evolving Healthcare Insurance Trends
Share Moving Media assists medical manufacturers in leveraging changing healthcare trends to maximize market share. A full-service media company, we can help you create marketing and content campaigns to keep up with the constantly evolving marketplace. From HIPAA hot topics to co-marketing strategies, we strive to give you helpful news you can use.
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