Report: What the health plan of the future looks like

Doctor in hospital with health insurance related icons in modern graphic interface showing symbol of healthcare person, money saving, medical treatment and benefits
A new Deloitte report forecasts what tomorrow's health plans may look like. (Getty Images/nanostockk)

What form will the “health plan of tomorrow” take?

In short, it will be a digitally enabled, consumer-centric experience focused on prevention and wellness, according to a new report.

As more disruptors like Amazon and Google take an interest in the healthcare space, payers’ transformation into a technological patient experience is picking up, according to the white paper from Deloitte’s Center for Health Solutions. To paint a more complete picture of the key trends to watch, the group crowdsourced 28 policy, healthcare and tech experts.

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These disrupters will force insurers to look toward a model that is less focused on managing risk and instead supports members’ wellbeing, according to the report.

“We’re fully in the middle of a pretty significant shift in the healthcare industry, and health plans, I believe, are feeling the momentum of that shift more aggressively and are at risk of being impacted more imminently than some of the other traditional players in the marketplace,” David Biel, principal at Deloitte and one of the report’s authors, told FierceHealthcare.

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However, while insurers are feeling this push, the report notes that legacy organizations in the industry—which include providers as well—may be slow to adopt new ways of thinking because they’re entrenched in their current model. Biel said eventually that approach will be untenable and will separate the “winners and losers” in the race to the future.

Transformations in any industry tend to occur in three seven-year cycles, according to the report. Biel said healthcare is currently right in the middle of the first cycle, and many big names are piloting and testing emerging solutions—including data analytics and enhanced consumer-facing tools.

By the third phase, however, payers will need to “succumb” to change or face failure, he said.

“All of our trad players are going to end up somewhere in that economy, or they’re going to be losers in the environment,” Biel said.

RELATED: AHIP18—Insurers need to adapt to keep pace with challenges from retail, tech

Deloitte suggests five steps insurers should be taking now as they plan for these looming changes:

  1. Build an internal culture that focuses on business transformation
  2. Make investments in technology sooner rather than later
  3. Being reorienting staffers to what work will look like—highly automated and electronic—compared to current processes
  4. Incorporate governance for data into existing policies and practices
  5. Keep a close eye on cybersecurity risks, and be prepared for emerging threats

Biel said the level of change that’s on the horizon may seem daunting to payer executives who are planning for the future, but industry transformation is still early enough for some insurers to decide it’s not the right time quite yet for them to start down that path.

However, it’s crucial to begin having discussions about what the industry could look like in five or 10 years now, he said.

“That’s step one for everybody,” Biel said. “One shouldn’t be afraid to have that discussion.”

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