SlideShare a Scribd company logo
Dr Aniruddha Malpani, MD
www.informationtherapy.in
Your pain points today
Intense competition - health insurance has
become a commodity. You need to differentiate !
You lose money per customer because of fraud
Your customers do not see any benefits - feel it is
a waste of their money when they do not make a
claim
Today, it is illness insurance – not health
insurance !
Our solution allows you to
Reduce your claims loss ratio
Acquire new customers
Retain your old ones
Today
Your subscribers hear from you only when:
The premium is due to be paid
The claim they present is rejected
Using the internet
You need to proactively establish a more
positive relationship with their customers.
 When people fall ill, they use the internet
extensively to research their treatment
options
Over 200 million Indian internet users
Can you help them in their time of need
with Information Therapy ?
Your website is a problem
Poor content - focus on your company and
not on your customer
Providing the patient with what he wants
to know – information about his symptoms
and his treatment options can build trust.
Why not embrace that opportunity ?
Not an easy task !
Writing high quality medical content specifically
for patients is difficult and time consuming
You can now instantly license the information
your subscribers need to manage their health
concerns from the world leader in patient
education, Healthwise Knowledgebase !
www.healthwise.org !
Knowledge is power
Deliver health information anywhere, anytime –
in an engaging fashion
Healthwise offers a digital platform, based on
which you can provide patient support programs
and coaching to help your members remain
healthy
We help you create cost-effective solutions that
use time-tested channels and integrate cutting-
edge new ones to deliver results.
Patient education makes
business sense !
Well informed patients make better and
less costly health care decisions, helping
your bottom line.
This has been proven by research.
Educating diabetics reduces medical costs.
Studies Health Technology Information. 2009;143:258-63.
Potential Return on Investment (RoI) on web-based
diabetes education in UK. Shabestari O, Roudsari A.
Patient education reduces
unnecessary surgery
Well informed patients say no to
unnecessary surgery, thus reducing
healthcare costs.
E. Murray et al., “Randomised Controlled Trial of an
Interactive Multimedia Decision Aid on Benign Prostatic
Hypertrophy in Primary Care,” British Medical Journal 323,
no. 7311 (2001): 493–496
Patient education reduces
unnecessary
surgery( hysterectomy)
A.D. Kennedy et al., “A Multicentre Randomised Controlled Trial
Assessing the Costs and Benefits of Using Structured Information and
Analysis of Women’s Preferences in the Management of Menorrhagia,”
Health Technology Assessment 7, no. 8 (2003): 1–76.
http://www.hta.ac.uk/execsumm/summ708.htm
The use of decision aids, consisting of evidence-based
information reduces health service costs as well as
improving patients’ satisfaction.
The reduction in hysterectomy rate is consistent with
trends observed in other studies looking at conditions
where patients have a choice between conservative and
radical surgical options.
Shared decision making
reduces costs ( hip and knee
surgery)
Group Health Cooperative (an integrated insurer and
hospital system) gave all 660,000 of their patients
access to decision aids
After introducing decision aids, rates of hip
replacement fell over 25%; knee replacement went
down 38%. Total spending went down 21% on patients
with hip osteoarthritis and 12% for knee patients --
but for the whole study population.
Introducing Decision Aids At Group Health Was Linked To Sharply
Lower Hip And Knee Surgery Rates And Costs . Health Aff September
2012 31:92094-2104. Arterburn, D et al. Group Health Research Institute,
USA.
Shared decision making
generates savings for health
insurance companies
Patients who received these tools had 5.3 percent
lower overall medical costs.
They had 12.5 percent fewer hospital admissions and
9.9 percent fewer preference-sensitive surgeries
including 20.9 percent fewer heart surgeries.
Enhanced Support For Shared Decision Making Reduced
Costs Of Care For Patients With Preference-Sensitive
Conditions. David Veroff et al. Health Affairs. Feb 2013.
http://content.healthaffairs.org/content/32/2/285.full
.pdf+html
Shared decision making
generate savings
A “remote” model of support combining telephonic
coaching with decision aids constitutes a low-cost and
effective intervention that could reach broader
populations without the need for direct involvement
of regular medical care team members.
Enhanced Support For Shared Decision Making
Reduced Costs Of Care For Patients With
Preference-Sensitive Conditions. David Veroff et al.
Health Affairs. Feb 2013.
http://content.healthaffairs.org/content/32/2/285.full
.pdf+html
Health insurance portability
Challenge and opportunity !
You need to create customer loyalty !
1. Build stronger relationships with existing
members
2. Attract customers from competing health
insurance companies by providing a unique
differentiator!
Better than wasting money on generic advertising
!
Our solutions can help you attract and retain
members now—and in the future.
Healthy customers = healthier
bottom lines !
Promote SelfCare. Help them to do as much for
themselves as they can
Provide Evidence-Based Guidelines, so that they
can ask for the right medical treatment that they
need - no more and no less
Provide Veto Power, so they can say No to
medical care they don’t need, thus preventing
overtesting and unnecessary surgery.
Healthwise Knowledgebase
Benefits
You will be promoting health – not just
selling illness benefits !
Proactively helping your customers to
remain healthy
Major differentiator – stand out from your
competitors
Learning from the USA
All the Top 10 health insurance plans in the US use
the Heathwise Knowledgebase on their website
Value add
Engage with your members
Encourage them to call you as point of first
contact
Build trust and loyalty
Send regular ezines to help them remain
well
Reduce unnecessary surgery (such as
hysterectomies and caesarean sections)
You have many needs –
we provide many solutions !
As healthcare costs rise, helping your
members manage their health becomes
increasingly important.
Reach your entire population with a scalable
interactive health management platform
Deliver targeted clinical education programs to at-
risk segments.
Provide condition-specific health information for
members managing chronic conditions.
Very cost effective investment
Annual license costs only a few rupees per customer
Great way to create customer delight !
The knowledgebase is a digital platform which serves
as a necessary starting point to engage customers
You need to build upon it further – for example, by
using a call centre
Help your members achieve lasting health behavior
change through a highly personalized, multi-modality
approach.

White labelled
Your logo here
Engage with Health Guardian/
Health Coach
Rich actionable content –
changes behaviour !
Shared decision making with
interactive decision aids
Try it out yourself at
www.healthlibrary.com/healthwise.php

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How health insurance companies can become more profitable

  • 1. Dr Aniruddha Malpani, MD www.informationtherapy.in
  • 2. Your pain points today Intense competition - health insurance has become a commodity. You need to differentiate ! You lose money per customer because of fraud Your customers do not see any benefits - feel it is a waste of their money when they do not make a claim Today, it is illness insurance – not health insurance !
  • 3. Our solution allows you to Reduce your claims loss ratio Acquire new customers Retain your old ones
  • 4. Today Your subscribers hear from you only when: The premium is due to be paid The claim they present is rejected
  • 5. Using the internet You need to proactively establish a more positive relationship with their customers.  When people fall ill, they use the internet extensively to research their treatment options Over 200 million Indian internet users Can you help them in their time of need with Information Therapy ?
  • 6. Your website is a problem Poor content - focus on your company and not on your customer Providing the patient with what he wants to know – information about his symptoms and his treatment options can build trust. Why not embrace that opportunity ?
  • 7. Not an easy task ! Writing high quality medical content specifically for patients is difficult and time consuming You can now instantly license the information your subscribers need to manage their health concerns from the world leader in patient education, Healthwise Knowledgebase ! www.healthwise.org !
  • 8. Knowledge is power Deliver health information anywhere, anytime – in an engaging fashion Healthwise offers a digital platform, based on which you can provide patient support programs and coaching to help your members remain healthy We help you create cost-effective solutions that use time-tested channels and integrate cutting- edge new ones to deliver results.
  • 9. Patient education makes business sense ! Well informed patients make better and less costly health care decisions, helping your bottom line. This has been proven by research. Educating diabetics reduces medical costs. Studies Health Technology Information. 2009;143:258-63. Potential Return on Investment (RoI) on web-based diabetes education in UK. Shabestari O, Roudsari A.
  • 10. Patient education reduces unnecessary surgery Well informed patients say no to unnecessary surgery, thus reducing healthcare costs. E. Murray et al., “Randomised Controlled Trial of an Interactive Multimedia Decision Aid on Benign Prostatic Hypertrophy in Primary Care,” British Medical Journal 323, no. 7311 (2001): 493–496
  • 11. Patient education reduces unnecessary surgery( hysterectomy) A.D. Kennedy et al., “A Multicentre Randomised Controlled Trial Assessing the Costs and Benefits of Using Structured Information and Analysis of Women’s Preferences in the Management of Menorrhagia,” Health Technology Assessment 7, no. 8 (2003): 1–76. http://www.hta.ac.uk/execsumm/summ708.htm The use of decision aids, consisting of evidence-based information reduces health service costs as well as improving patients’ satisfaction. The reduction in hysterectomy rate is consistent with trends observed in other studies looking at conditions where patients have a choice between conservative and radical surgical options.
  • 12. Shared decision making reduces costs ( hip and knee surgery) Group Health Cooperative (an integrated insurer and hospital system) gave all 660,000 of their patients access to decision aids After introducing decision aids, rates of hip replacement fell over 25%; knee replacement went down 38%. Total spending went down 21% on patients with hip osteoarthritis and 12% for knee patients -- but for the whole study population. Introducing Decision Aids At Group Health Was Linked To Sharply Lower Hip And Knee Surgery Rates And Costs . Health Aff September 2012 31:92094-2104. Arterburn, D et al. Group Health Research Institute, USA.
  • 13. Shared decision making generates savings for health insurance companies Patients who received these tools had 5.3 percent lower overall medical costs. They had 12.5 percent fewer hospital admissions and 9.9 percent fewer preference-sensitive surgeries including 20.9 percent fewer heart surgeries. Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions. David Veroff et al. Health Affairs. Feb 2013. http://content.healthaffairs.org/content/32/2/285.full .pdf+html
  • 14. Shared decision making generate savings A “remote” model of support combining telephonic coaching with decision aids constitutes a low-cost and effective intervention that could reach broader populations without the need for direct involvement of regular medical care team members. Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions. David Veroff et al. Health Affairs. Feb 2013. http://content.healthaffairs.org/content/32/2/285.full .pdf+html
  • 15. Health insurance portability Challenge and opportunity ! You need to create customer loyalty ! 1. Build stronger relationships with existing members 2. Attract customers from competing health insurance companies by providing a unique differentiator! Better than wasting money on generic advertising ! Our solutions can help you attract and retain members now—and in the future.
  • 16. Healthy customers = healthier bottom lines ! Promote SelfCare. Help them to do as much for themselves as they can Provide Evidence-Based Guidelines, so that they can ask for the right medical treatment that they need - no more and no less Provide Veto Power, so they can say No to medical care they don’t need, thus preventing overtesting and unnecessary surgery.
  • 18. Benefits You will be promoting health – not just selling illness benefits ! Proactively helping your customers to remain healthy Major differentiator – stand out from your competitors
  • 19. Learning from the USA All the Top 10 health insurance plans in the US use the Heathwise Knowledgebase on their website
  • 20. Value add Engage with your members Encourage them to call you as point of first contact Build trust and loyalty Send regular ezines to help them remain well Reduce unnecessary surgery (such as hysterectomies and caesarean sections)
  • 21. You have many needs – we provide many solutions ! As healthcare costs rise, helping your members manage their health becomes increasingly important. Reach your entire population with a scalable interactive health management platform Deliver targeted clinical education programs to at- risk segments. Provide condition-specific health information for members managing chronic conditions.
  • 22. Very cost effective investment Annual license costs only a few rupees per customer Great way to create customer delight ! The knowledgebase is a digital platform which serves as a necessary starting point to engage customers You need to build upon it further – for example, by using a call centre Help your members achieve lasting health behavior change through a highly personalized, multi-modality approach. 
  • 24. Engage with Health Guardian/ Health Coach
  • 25. Rich actionable content – changes behaviour !
  • 26. Shared decision making with interactive decision aids
  • 27. Try it out yourself at www.healthlibrary.com/healthwise.php

Editor's Notes

  1. Insurance companies need to find ways to differentiate themselves from the competition. Fraud is causing loss to occur Consumers see little value or benefit Health insurance has focused on the illness, not on the health of their customers.