Both technological innovation and regulatory policies are driving a powerful change in different industries of the country, including the health sector. To achieve long-term sustainability, and efficiency, and to be future-ready, health insurers are trying to adopt the most advanced technologies.
In this article, we will show how these changes are leading gradually towards democratising health insurance, offering better services, and reducing premiums while protecting your health.
Top 5 Innovative Trends with the Potential to Change the Health Insurance Landscape
Here are some of the most tech-enabled trends that you can see impacting the health insurance scenes among insurance providers like ACKO:
1. Automation of Claims Processing
The Insurance Regulatory and Development Authority of India (IRDAI) had mandated all insurers to settle claims within 30 to 45 days, which has overwhelmed insurers as they are facing a surge of healthcare claims. To tackle the situation Third-Party Administrators (TPAs) and health insurance companies are looking into and turning to automation.
They are streamlining their claim processing with the help of real-time channels, Machine Learning or Artificial Intelligence (AI), Robotic Process Automation (RPA), Optical Character Recognition (OCR), and rule engines. In many cases, this automation allows touchless and real-time processing across the field, increasing accuracy, decreasing operator errors, and making settlements faster.
Overall, claim processing automation is bringing in a whole new level of accuracy and efficiency that matches the exceeding demand for health insurance claims.
2. Embracing Cloud and AI/ML for Future Growth
One of the best ways to ensure prosperity in the future too is by adopting advanced technologies. This is exactly what the health insurance companies are doing. They are improving their infrastructure and upgrading to cloud-based solutions aiming for scalability and improved agility.
Major insurance companies have already sifted their central systems to the cloud. Platforms like Google Cloud Platform (GCP) and Amazon Web Services (AWS) are catering to these increasing demands. Along with this development, insurers are also using advanced analytics and AI/ML technologies for the betterment of customer experience with a new service architecture.
Moreover, AI/ML helps insurance providers by efficacious outreach, guided selling, and detecting fraudulent claims (which is 15% of total claims each year).
3. Digital Strategies for Cost Containment
The Indian health insurance market has been very competitive recently and it has inspired many companies to put their efforts on cost containment. You can notice insurers use new distribution channels like Paytm, automate lead capture, and renovate their shopper portals as on Expenses of Management (EOM), IRDAI has proposed a 35% cap.
Technologies like AI chatbots, home healthcare, telemedicine, blockchain, WhatsApp integration, and RPA help lessen administrative costs. These strategies also help the Government to achieve its goal of Universal Health Coverage by 2030 which will potentially improve care delivery while lowering the premiums.
4. Wellness with Wearable Tech
In India, NCDs or Non-communicable diseases are a great cause of distress as they impose a substantial financial burden with out-of-pocket expenses and are a cause of 65% mortality in the country. That is why health insurance companies are partnering with brands that make wearable devices. For example, they are working with GOQii and Fitbit to extend personalised guidance.
Moreover, interconnected devices and wearables allow Remote Patient Monitoring (RPM). Through this insurers gather real-time information on their client’s health and manage chronic illnesses successfully. Hospitals and insurance providers collaborate with digital therapeutics firms such as Wellthy Therapeutics and wellness platforms like HealthifyMe to provide programmes for disease management, stress management, and smoking cessation.
5. Interoperable Health Records
As the standard data exchange protocols are still fewer than they should ideally be, the healthcare sector depends on manual processes despite all technological progress. An interoperable digital ecosystem is necessary to reach Universal Health Coverage in India. The Ayushman Bharat Digital Mission (ABDM) aims to offer a user nationwide access to health records through a unique 14-digit ID called ABHA and achieve seamless care transitions.
To achieve all this it is crucial to adopt data exchange frameworks such as Fast Healthcare Interoperability (FHIR) and standard code sets such as CPT and ICD-10. Evaluation of insurers’ and hospitals’ data governance policies and system capabilities is also essential.
They have to take help from tech giants such as Google and Microsoft to bridge interoperability gaps with API-first strategies and solutions. To hasten their decision-making, and clinical documentation, and offer extensive patient care they can also incorporate technologies such as Natural Language Processing (NLP).
The Bottom Line
As these innovative trends reform the health insurance industry, they promise to improve customer experiences, enhance efficiency, and reduce costs. Embracing advanced technologies, and digital tools, health insurers such as ACKO are well-positioned to meet future demands and contribute to the goal of Universal Health Coverage in India by 2030.
If you are looking for the most advanced health insurance plans in India, you can visit ACKO’s website.