“Disruptive” DIGITAL BUSINESS MODELS For Health Insurers

The Top 10 [Ten] Disruptive Digital Business Models For Health Insurers

By Zhang Jie

Digital technologies will transform the health insurance business. Early adopters have started to implement new digital business models with initial success. A new report describes ten digital business models for health insurers that will disrupt the industry.

Dear Dr. David Marcinko and all ME-P Readers,

We are excited to announce the release of Research2Guidance’s new “The 10 Disruptive Digital Business Models for Health Insurers” report.

Please find below the special report story.

Advances in higher-quality digital technology—especially apps, sensors, and artificial intelligence (AI)—along with their proliferation among members have spurred the emergence of new business models.

The new report “The 10 Disruptive Digital Business Models for Health Insurers” published by Research2Guidance describes how start-ups, health insurance and general payer organizations have started using these technologies to venture into new forms of health insurance offerings and increasingly step into the healthcare provider role.

New digital models change the way the insurers interact with patients. For example, digital insurers have reworked the trust equation with the patient, outsourced much of their value chain to their members, and now know much more about them. Digital business models tend to also blur the lines between payer and care giver organizations. Some of the first-movers already crossed the line and started to offer services which have previously been provided exclusively by doctors and nurses. The ten digital business models are defined as follows:

  1. Digitally assisted member acquisition is a freemium business model concept.
  2. Mobile health concierge is a business approach designed for members to complete all health insurance tasks using mobile phones with the support from a concierge team.
  3. Peer-to-peer (P2P) insurance refers to a risk-sharing community.
  4. Mobile micro-insurance refers to the health insurance plans that cover short-term small health events or minimal ongoing health insurance.
  5. Health insurers tech platforms license their technology for the management of health plans and members to their customers.
  6. On-demand insurance is a usage-based model that enables members to access desired health plans upon request with the help of a mobile app.
  7. High-risk patient preventive care model concentrates on insuring and managing potentially costly patient groups.
  8. The payer & provider collaboration model stands for a closer, digitally enabled partnership between payers and care providers, especially hospitals.
  9. The API health insurance model uses a list of pre-defined health insurance products accessible to websites and app providers via an application programming interface (API).
  10. Direct primary care model. Within this model, a care provider or a hospital act like a health insurance company using a monthly subscription model.

First implementations of these models indicate the positive impact that they have on the company evaluation, the ability to attract new members, the cost structure, and new revenue streams. Currently, the main impact of digital business models is on company evaluation, which reflects the hype that some companies have created in the investor community. Companies like Oscar, Clover Health, and Bright Health are valued at over $1 billion USD each after only a few years of operation.

Health insurers and start-ups from the USA and China are the most aggressive in adopting new digital business models. Companies from other regions tend to choose a follower approach or implement copycats.

ASSESSMENT

The report also profiles first-mover digital implementations. Profiles include their target groups, operating models, service offerings, and early evidence for success where available.

Conclusion

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UPDATE: The Domestic Stock Markets and [Un]Social Media

By Staff Reporters

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The stock markets fell after new data showing U.S. manufacturing activity stalled and the service sector’s pandemic recovery has gone into reverse as a result of high inflation and mounting interest rate hikes, feeding concerns that the Federal Reserve’s efforts to cool decades-high price increases may force the economy into a recession. The Dow Jones Industrial Average fell 138 points, or 0.4%, to close at 31,899, while the S&P 500 fell 0.9% and the tech-heavy NASDAQ 1.9%; for the week, the indexes ended up 2%, 2.5% and 3%, respectively.

CITE: https://www.r2library.com/Resource/Title/082610254

US social-media companies also saw more than $130 billion wiped off their stock-market values after disappointing revenue from Snap Inc. and a lackluster report from Twitter Inc. raised new concerns about the outlook for online advertising. The Snapchat parent plummeted 39%, sinking to its lowest level since March 2020. Meanwhile, Facebook parent Meta Platforms Inc. fell 7.6%, Pinterest Inc dropped more than 13%, and Google owner Alphabet Inc. declined 5.6% in its biggest one-day drop since March 2020. Twitter also reported quarterly results on Friday, though Wall Street remains focused on the company’s legal battle with Tesla CEO Elon Musk, who is attempting to withdraw from a deal to buy the company. The stock rose 0.8% on the day.

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Americans Feel Politicians Lost Touch With Public Health Care Needs

A SURVEY-POLL

By Staff Reporters

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A recent poll of 2,510 American adults by Ipsos found:

 •  87% of Americans feel politicians have lost touch with what the public needs from their health care.
 •  86% of Americans agree that Congress should focus on cracking down on abusive health insurance practices that make it harder for people to get the care they need.
 •  71% of Americans would rather see Congress focus more on reducing the overall costs of health care coverage such as premiums, deductibles, and co-pays.

Source: Ipsos, “Americans frustrated with insurance coverage and costs,” March 1, 2022

CDC: https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html

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DICTIONARY: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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Big Data and Health Economics: S.W.O.Ts.

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By Brendan Collins

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Read Here: https://healthcarefinancials.files.wordpress.com/2019/01/big-data.pdf

CITE: https://www.r2library.com/Resource/Title/082610254

HIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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