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Top Trends in Health
Insurance: 2020
November 2019
Link: https://www.capgemini.com/top-
trends-in-2020/
2© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Market forces push realignment pressure on the health insurance industry
Insurers become more transparent to bolster customers trust
A holistic insurance experience gives customers a wide range of value-added services
Insurance chatbots offer an engaging and guided customer experience
Wearables and digital platforms drive changes in behavior and increase Rx adherence
Insurers are leveraging predictive analytics for risk profiling and early intervention
APIs drive data interoperability within the healthcare industry
Automation boosts claims processing efficiency and may enable real-time payment
Changing
Business
Environment
Evolving
Customer
Preferences
Emerging Risk
Landscape
Enhancing
Operational
Efficiency
TREND 1
TREND 2
TREND 3
TREND 4
TREND 5
TREND 6
TREND 7
TREND 8
Source: Capgemini Financial Services Analysis, 2019
Health insurers are responding to shifting market dynamics
Top Trends in Health Insurance for 2020 by Capgemini
3© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
3© Capgemini 2019. All rights reserved |
Disintermediation
Vertical
integration
Horizontal
integration
Cost sharing
Purchaser/
plan sponsor
Payer Provider Pharma
Collaboration and integration are happening across the health insurance value chain to
address emerging risks and to provide quality care to members
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 1: Market forces push realignment pressure on the health insurance industry
4© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
4© Capgemini 2019. All rights reserved |
Customers are
seeking more
information
while purchasing
health insurance
plans
Regulatory
pressure to
improve
transparency
is intensifying
Trusted
players such as
BigTechs are
entering the
industry
Insurers can boost customer relationships by enhancing
transparency and empowering members with more information
about coverage and costs
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 2: Insurers become more transparent to bolster customer trust
5© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
Value-added
services
Smartphone
use is on the
rise and the
app ecosystem
is strong
Differentiation is needed
in the highly
commoditized
insurance market
Collaboration is
becoming
easier because
adoption of
APIs is up
Consumers seek
convenient access to
innovative health
products and services
Value-added services can help insurers improve customer
engagement and differentiate offerings in a commoditized market
5© Capgemini 2019. All rights reserved |
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 3: A holistic insurance experience gives customers a wide range of value-added
services
6© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
6© Capgemini 2019. All rights reserved |
Guided and comfortable
experience for customers
24 x 7 availability of support
services to customers
Cost savings for insurers
High scalability of customer
support services
AI-driven chatbots could help insurers interact meaningfully with customers –in a cost-
efficient way
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 4: Insurance chatbots offer an engaging and guided customer experience
7© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
Wearables are helping
insurers gain valuable
insight into members’
lifestyles
Rising health care costs
are driving consumers
to adopt healthy
lifestyles
Members are willing to
share personal data for
better risk coverage and
discounts
Payouts are often
significantly higher
because of poor
medication adherence
Customers who adopt healthy habits and adhere to prescribed Rx would enjoy more
positive health outcomes and boost insurers’ overall profitability
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
7© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Trend 5: Wearables and digital platforms drive changes in behavior and increase Rx
adherence
8© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
8© Capgemini 2019. All rights reserved |
Predictive analytics offer insurers insightful assessment of potentially
high-risk customers, which can mitigate loss and boost profitability
Early interventions
are needed
More data is available
than ever before
More customers are
willing to share data
Risk profiling accuracy
is critical
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 6: Insurers are leveraging predictive analytics for risk profiling and early
intervention
9© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
9© Capgemini 2019. All rights reserved |
Interoperability
Interoperability will enable insurers to streamline data sharing and empower
patients with health data knowledge and control
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 7: APIs drive data interoperability within the healthcare industry
10© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019
Source: Capgemini Financial Services Analysis, 2019
10© Capgemini 2019. All rights reserved |
Automation technologies can make claims processing faster and more efficient, which
satisfies members and reduces operational costs.
Faster claims
processing
Strategic
use of
human
resources
Top Trends in Health Insurance for 2020 by Capgemini Risk
Landscape
Operational
Efficiency
Business
Environment
Customer
Preference
Trend 8: Automation boosts claims processing efficiency and may enable real-time
payments
A global leader in consulting, technology services and digital transformation,
Capgemini is at the forefront of innovation to address the entire breadth of clients’
opportunities in the evolving world of cloud, digital and platforms. Building on its
strong 50-year heritage and deep industry-specific expertise, Capgemini enables
organizations to realize their business ambitions through an array of services from
strategy to operations. Capgemini is driven by the conviction that the business
value of technology comes from and through people. It is a multicultural company
of over 200,000 team members in more than 40 countries. The Group reported
2018 global revenues of EUR 13.2 billion.
About Capgemini
Learn more about us at
www.capgemini.com
This message contains information that may be privileged or confidential and is
the property of the Capgemini Group.
Copyright© 2019 Capgemini. All rights reserved.
People matter, results count.

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Top Trends in Health Insurance: 2020

  • 1. Top Trends in Health Insurance: 2020 November 2019 Link: https://www.capgemini.com/top- trends-in-2020/
  • 2. 2© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Market forces push realignment pressure on the health insurance industry Insurers become more transparent to bolster customers trust A holistic insurance experience gives customers a wide range of value-added services Insurance chatbots offer an engaging and guided customer experience Wearables and digital platforms drive changes in behavior and increase Rx adherence Insurers are leveraging predictive analytics for risk profiling and early intervention APIs drive data interoperability within the healthcare industry Automation boosts claims processing efficiency and may enable real-time payment Changing Business Environment Evolving Customer Preferences Emerging Risk Landscape Enhancing Operational Efficiency TREND 1 TREND 2 TREND 3 TREND 4 TREND 5 TREND 6 TREND 7 TREND 8 Source: Capgemini Financial Services Analysis, 2019 Health insurers are responding to shifting market dynamics Top Trends in Health Insurance for 2020 by Capgemini
  • 3. 3© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 3© Capgemini 2019. All rights reserved | Disintermediation Vertical integration Horizontal integration Cost sharing Purchaser/ plan sponsor Payer Provider Pharma Collaboration and integration are happening across the health insurance value chain to address emerging risks and to provide quality care to members Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 1: Market forces push realignment pressure on the health insurance industry
  • 4. 4© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 4© Capgemini 2019. All rights reserved | Customers are seeking more information while purchasing health insurance plans Regulatory pressure to improve transparency is intensifying Trusted players such as BigTechs are entering the industry Insurers can boost customer relationships by enhancing transparency and empowering members with more information about coverage and costs Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 2: Insurers become more transparent to bolster customer trust
  • 5. 5© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 Value-added services Smartphone use is on the rise and the app ecosystem is strong Differentiation is needed in the highly commoditized insurance market Collaboration is becoming easier because adoption of APIs is up Consumers seek convenient access to innovative health products and services Value-added services can help insurers improve customer engagement and differentiate offerings in a commoditized market 5© Capgemini 2019. All rights reserved | Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 3: A holistic insurance experience gives customers a wide range of value-added services
  • 6. 6© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 6© Capgemini 2019. All rights reserved | Guided and comfortable experience for customers 24 x 7 availability of support services to customers Cost savings for insurers High scalability of customer support services AI-driven chatbots could help insurers interact meaningfully with customers –in a cost- efficient way Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 4: Insurance chatbots offer an engaging and guided customer experience
  • 7. 7© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 Wearables are helping insurers gain valuable insight into members’ lifestyles Rising health care costs are driving consumers to adopt healthy lifestyles Members are willing to share personal data for better risk coverage and discounts Payouts are often significantly higher because of poor medication adherence Customers who adopt healthy habits and adhere to prescribed Rx would enjoy more positive health outcomes and boost insurers’ overall profitability Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference 7© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Trend 5: Wearables and digital platforms drive changes in behavior and increase Rx adherence
  • 8. 8© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 8© Capgemini 2019. All rights reserved | Predictive analytics offer insurers insightful assessment of potentially high-risk customers, which can mitigate loss and boost profitability Early interventions are needed More data is available than ever before More customers are willing to share data Risk profiling accuracy is critical Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 6: Insurers are leveraging predictive analytics for risk profiling and early intervention
  • 9. 9© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 9© Capgemini 2019. All rights reserved | Interoperability Interoperability will enable insurers to streamline data sharing and empower patients with health data knowledge and control Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 7: APIs drive data interoperability within the healthcare industry
  • 10. 10© Capgemini 2019. All rights reserved |Health Insurance Trends 2020 | November 2019 Source: Capgemini Financial Services Analysis, 2019 10© Capgemini 2019. All rights reserved | Automation technologies can make claims processing faster and more efficient, which satisfies members and reduces operational costs. Faster claims processing Strategic use of human resources Top Trends in Health Insurance for 2020 by Capgemini Risk Landscape Operational Efficiency Business Environment Customer Preference Trend 8: Automation boosts claims processing efficiency and may enable real-time payments
  • 11. A global leader in consulting, technology services and digital transformation, Capgemini is at the forefront of innovation to address the entire breadth of clients’ opportunities in the evolving world of cloud, digital and platforms. Building on its strong 50-year heritage and deep industry-specific expertise, Capgemini enables organizations to realize their business ambitions through an array of services from strategy to operations. Capgemini is driven by the conviction that the business value of technology comes from and through people. It is a multicultural company of over 200,000 team members in more than 40 countries. The Group reported 2018 global revenues of EUR 13.2 billion. About Capgemini Learn more about us at www.capgemini.com This message contains information that may be privileged or confidential and is the property of the Capgemini Group. Copyright© 2019 Capgemini. All rights reserved. People matter, results count.