The international insurance community should brace for the impact of higher healthcare costs, according to the Mercer Marsh Benefits Health Trends Report 2023.

 

The insights of this global report raise the question, what is the most effective way for insurers to protect their clients’ and members’ interests and manage risk efficiently?

 

One of the top five trends identified in this year’s report is that plan management requires greater rigor, with robust strategies needed to prepare for more complex underwriting and plan design decisions.

 

Given this scenario it has never been more critical to manage financial and clinical risk exposure, while prioritising product satisfaction.

 

Managing risk is a moving target

The legacy of Covid-19 has contributed to higher downstream medical costs associated with increased utilisation and later-stage diagnosis of illness. Identifying and pre-emptively managing risks for future projections arising from such trends is becoming increasingly urgent, and essentially requires insurers to aim for a moving target.

 

This need not be an onerous, daunting prospect when you partner with forward-thinking technology informed by expert clinical guidance. Through global experience and insights, Agility Risk Solutions offers superior automation and risk management in specifically underwriting, pre-authorisation, claims adjudication, benefit management, reporting, the detection of clinical misconduct and customer communication.

 

Complex risks require advanced solutions

Agility’s belief is that, through our focus on big data insights, Artificial Intelligence and rule-based technology, it is possible not only to stay ahead of the curve but to harness and manage trends as they emerge. With next generation administration and risk management systems, we are delivering more value for insurers, sponsors and members – tailored to the specific needs of each through a mutually beneficial ‘more care, less risk’ approach.

 

A recent case study highlights the value of an automation strategy based on extensive intellectual property that is continuously reviewed against independent local and international guidelines by qualified clinical specialists. Interventions for specific disease groupings, yielded an impressive 11% reduction in costs for both type one and two diabetes, a 15% saving on asthma-related costs and a 31% cost reduction in hyperlipidaemia and cardiovascular risks. 

 

Coupled with a guaranteed saving on operational costs, this illustrates the solid results that can be achieved both in terms of financial and clinical risk management through the applications of this highly specialised technology.

 

Powerful technology for the competitive advantage

The MMB report notes the chilling prediction that up to a third of plan sponsors or employers are anticipated to consider reducing cover to manage costs. To remain competitive with rich benefits and affordable premiums, it is essential for insurers to find ways of maintaining or increasing benefits while keeping premiums to a minimum.