HealthCare: The Revolution is Finally Here

We are finally beginning to experience a long-awaited revolution in the insurance industry. Historically, insurance has been one of the last and slowest industries to embrace technology as a means of modernization and process innovation. The insurance industry is fragmented, without common standards, and until very recently did not attract many investment dollars, which exacerbated the general lack of incentive to modernize. However, in the past few years, we have seen signs of revitalization in the industry, and it is becoming an exciting time to be a part of the insurance community.

The Cost of the Manual Status Quo
According to a report published by the National Institutes of Health, “Healthcare costs in the U.S. now account for 16% of the country’s gross domestic product, and per capita healthcare spending is approximately twice that of other major industrialized countries. Inefficiencies persist within the healthcare system because—in contrast to other economic sectors in which competition and other economic incentives act to reduce the level of waste—none of the healthcare system’s players have strong incentives to economize.”

It has been said that 40 manual workflows make up 25% of an insurer’s cost of doing business. A recent report by Newsweek–sponsored by Salesforce and Deloitte, which included a survey of 300 C-level insurance IT executives–found that in the quote-to-enroll process, only 4.5% of new business is “mostly” or “extensively” low-touch. About 52% of the processes used are achieved manually. When taking time to dive deep into their process, John Hancock discovered that even for one line of coverage, 120 steps could be condensed to seven and turnaround time reduced from several days to a few minutes.

Doing Something About It
Those of us who have been in the industry for some time are all too familiar with the time-consuming processes that have been used for decades, and there are a variety of players who have decided to do something about it. The past few years have seen an unprecedented amount of investment money flowing into the insurtech industry, which is beginning to change the market outlook as well as boost competition, which in turn is motivating startups and established companies alike to embrace change. We are beginning to see new partnerships and the building of the infrastructure necessary to overhaul the industry, enabling a new focus on user experience and connecting APIs instead of the endless custom work typically required in this industry.

There’s a new optimism in the insurance industry that is catching fire. According to a recent report by Accenture, “In five years, nearly all the insurance executives in our survey expect the industry to be transformed by digital technologies.” Further, the report found that 90% of insurance executives state they have a coherent, long-term plan for technology innovation in place. Quicker turnaround times, automated processes and good user experience translate to more new business, higher retention and lower employee frustration and, arguably, could help bring down the costs of healthcare overall.

There are at least three areas that need to be addressed to help the insurance industry to modernize and innovate. Insurance professionals would agree that the most common problems in the old processes are the incessant need to copy and paste, the aggravating issue of double entry and the frustration of having to cross-reference multiple sources to get accurate information. We need to break down silos, open up data and replace legacy systems to get these processes running more smoothly and quickly.

Breaking down silos
In Accenture’s report, “47% of survey respondents also say lack of collaboration with the IT function is preventing them from realizing their technology investments’ value.” From our own experience and years working in the benefits industry, I cannot tell you how many hours, days and months have been lost simply copying and pasting information from one Excel file into another, having to log into multiple systems to manually log information or to simply verify that the information needed to accomplish the task at hand is indeed accurate. Unlike other industries, there are very few APIs available that allow systems to communicate and connect with each other. Because of this lack of connectivity, many employees at insurance companies end up using up to five to 10 systems simply to complete their everyday tasks.

Automating
Once there begins to be a focus on modernizing and upgrading core systems, a carrier can begin to think about real efficiencies, including automation. Automating even a few of the top 40 manual processes would increase productivity and performance. Imagine the ability to:

  • Automate the confirmation of group information for a master data store to automatically verify its accuracy
  • Auto-ingest census information by machine reading
  • Consolidate account information into a single record
  • Provide one point of entry to populate multiple systems

Automating these processes not only leads to quicker turnaround times and better efficiency, but it also enables insurance professionals to close more new business and gives them a competitive edge and a way to stand out from those companies that may be slower to adapt to new technologies.

Partnerships
Working with possible competitors, as well as vendors, is becoming increasingly important, and new levels of collaboration are necessary for companies that wish to thrive in the digital economy. There is no one system that does everything that an insurer needs; it simply does not exist at this point and may not exist for several years. McKinsey says that “ecosystems will account for 30% of global revenues by 2025” and that, “to succeed in ecosystems, insurers will have to take a hard look at their traditional roles and business models and to evaluate opportunities to partner with players in other industries.”

We are still facing an uphill climb to transform the insurance industry from stodgy to streamlined, but there are signs of a renewed energy and drive that show promise. As more and more insurance companies and partners see the value of digitization, automation and collaboration, everyone will benefit from a more connected ecosystem, and the insurance industry will do its part to make healthcare a more manageable, and possibly even satisfying, experience for the consumer.

Jason Andrew, Co-Founder, Limelight HealthHealthCare: The Revolution is Finally Here

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