A HIMSS Event | SANTA CLARA, CA | SEPT. 16-18, 2019

San Francisco, CA
September 16-18, 2019 | Santa Clara, CA

Insurtech: Taking on the Big Payers

John Sharp, Director, Thought Advisory, HIMSS

Can one of the biggest players in the healthcare industry be disrupted? Health insurance has evolved and consolidated over the decades to create incentives and disincentives to providers and patients becoming a complex system of rules and costs controls. Insurtech is emerging as a hybrid of Fintech and digital health. An article by McKinsey describes this disruption as “the threat that inspires”. The article describes the trend as “technology-led companies that enter the insurance sector, taking advantage of new technologies to provide coverage to a more digitally savvy customer base.” These startups are utilizing new product innovations along with technology to gain traction against incumbents in the market.

The best know example is Oscar. Founded in 2013, it now offers products to individuals and small businesses in 9 states. Its model provides 3 basic features – an app which allows you to find a doctor without a referral and schedule an appointment, a concierge service and a doctor-on-call telehealth service 24/7. 

Another growing option is Clover Health which focuses on Medicare Advantage. They help patients to reach their health goals and manage chronic conditions while minimizing paperwork and providing broad coverage for dental, vision and hearing, in-home visits and telehealth all tied to an app.

One company which promises to simplify the care path for patients is Bind. They do this by giving patients their cost and care options up front, a kind of radical transparency. In addition, they point members to lower cost options in their local community.

These innovative approaches to health insurance are pushing traditional payers to become more innovative by offering wellness benefits and more flexible Medicare Advantage plans. However, Insurtech continues to expand into more states and partnering with providers and employers and are just beginning to scale.

Big Bets in Insurtech
Funding of insurtech startups doubled from 2017 to 2018 and they show no signs of slowing down as they breathe new life into one of the pillars of the healthcare system with frictionless, consumer-centric business models.

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