Health has been and remains in most countries around the world a public service. What is the role of the private health insurers?
In a clear majority of developed nations, people tend to think of healthcare as a public service. While the systems can vary in funding, they are fundamentally universal in coverage. The US is the stand-out exception and the topic has been at the centre of intense political debate thanks to the Patient Protection and Affordable Care Act, often nicknamed Obamacare.
While this system doesn’t seem to be under any threat politically, healthcare costs are growing. Aging population and increasing numbers of those who are chronically ill demonstrate that the demographics of who we are caring for is evolving and added to this the cost of new technology and treatments doesn’t come cheap.
This has coincided with a period of economic instability, especially in Europe, the birthplace of universal healthcare. Governments are facing constraints on their spending and are forced to focus on the most salient difficulties of the day such as cancer, diabetes or cardiac diseases leaving other areas not covered. Moreover, people are more aware today than ever of their wellness and are consuming more and more preventative services, often outside of the scope of care covered by their national health system. Think of the prevalence of smartwatches, activity trackers and apps and the endless list of exploration via search engines. All this has created a “new normal” in how we interact with our health.
Private health insurers and health systems increasingly help Governments and patients carry that burden. Like always, in insurance we take part of the risks from those who are looking for coverage for their health expenditure and the competition in the private sector can be a driver for innovation to be latterly applied across all of the healthcare sector.
Of course, this isn’t without risks for the insurers and private health providers. The complex situation national health services find themselves results in growing consumption, higher unit prices and higher participation in the overall cost of care.
What is the role of Europ Assistance in this context?
Europ Assistance acts as the health services provider of the Generali Group. Most people will recognize EA as a travel insurer and assistance player or as a leader in roadside assistance. Yet, healthcare really is at the heart of Europ Assistance business. In fact, the travel business has its foundation in our medical team and medical network. We have over 370 internal medical professionals who support Generali and EA customers in distress when they need medical support. These are typically emergency doctors and physicians who work part-time at EA and part-time at leading hospitals. They provide medical consultation, assess cases and coordinate care working closely with our global network of preferred providers that consists of over 750.000 doctors, medical facilities and emergency units In every corner of the world. This capability is also the foundation of the medical services we offer to customers outside of the travel sphere, such as Generali and other private insurers who are looking to offer increased services to their customers. Services often replace compensation reducing their claim costs and improving the loss ratio. More importantly health services bring them closer to their customers and are a differentiator and way to improve brand preference. Nothing better than our brand payoff, “You live, We care”, explains Europ Assistance’s role in health services.
Generali is moving from being a “pure payer” in the healthcare sphere to become a “Health Partner”. This is really linked to what we do and sets us up to be a companion to patients across the various medical situations that arise during their life and to Generali in this important transformation.
What kind of services can this include?
Firstly, our service comes with a culture. Not only are we experts in this field but our company culture “We Care” means that all of our employees from the doctor, the assistance operator up to the CEO all work with the understanding that we are Caring, Available, Reliable and Easy to work with. For key attributes that really qualify our services and approach to customers and patients.
Secondly, a large amount of what Europ Assistance does is B2B2C. Each business partner has very specific needs and priorities when it comes to services. It therefore is about sitting down with Generali and our other commercial partners to understand how the partnership can work: discussing claims data, how customers live, how and where they consume health are all part of the conversation in building relevant services. The ultimate goal being to support patients in finding better but less expensive care solutions.
Our strategy and service offering is based on 3 pillars:
- Medical orientation, this is about building an understanding of patients at a large scale to better manage individual cases. Through profiling we gain a greater understanding of wider patient groups that in-turn allows us to look at the individual patient’s care with a strong understanding of their needs in advance. This enables us to coordinate the delivery of appropriate healthcare together with our internal medical team and with external providers. This can range from looking at groups of healthy people, those at risk or those who already have, including chronic, conditions. We also give the patient more control over their personal care with innovative digital solutions such as MyClinic, where the patient can go at their own pace for medical check-up and arrange potential discussions with physicians.
- Telemedicine, this is about giving easy access to healthcare professionals according to the needs of the patient. This could be about seeing a nurse, GP or a specialist and is all about convenience and speed. EA has provided medical advice over the phone since it was established, and today we are investing in new digital solutions to provide medical consultation also via video and chat.
- Health programs, once we have built the medical orientation and profiling of the patient groups it enables us to provide a dedicated health program that can help individuals with their condition, or if they are at risk.
What about e-health, connected health, digital health? We can see more and more academic papers and press coverage about those topics. What are you doing here?
As shared before, expectations from the public has changed. They are more aware, they are more demanding and that means nobody can look at healthcare without being digital. This is already being reflected by standard health players and it’s working: in-patient stays are reducing; more people are purchasing “over-the-counter medicine” online.
For us it is about putting the patient at the centre of consideration. Health is about caring, it’s about being able to handle the delicate and stressful moments in people’s lives as well as being able to prevent them from happening. We know that better prevention occurs when the person is playing an active role as the main contributor with awareness to their own health. This means using chat, video, chatbots, virtual agents, self-diagnosis tools, etc. offer large advantages to engage the individual with their health and get information moving. All this without forgetting the human touch, which for most patients remains crucial considering the stressful situation they are confronted with.
This means offering choice for how the patient can interact with us. Let me give you an example, in Spain we operate a medical chat where Europ Assistance doctors answer over 20,000 requests per month from patients while in Italy our MyClinic solution enables patients to get themselves a first medical check-up before being invited to get in-touch by video with our medical professionals. Different uses of technology but with the same approach behind it.
Health is a very local concern, due to specific regulations, health and social organizations, priority of investments by the governments. How do you balance this?
We’ve got 300 million customers covering over 200 countries and territories. We are a global company but have chosen to remain local when it comes to operations. In fact, we run 36 local assistance centres that coordinate care on their respective domestic markets and for local travelers around the world. This is crucial to develop a real understanding of how the health world works. We like to think we’ve got global eyes and local hands.
This has been part of our core business for over 50 years now. It’s where our roots are and something we’re incredibly proud of.