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When considering private medical insurance, much emphasis is put on the number of hospitals or specialists an insurer works with. However, quantity doesn’t necessarily mean quality or appropriateness. That’s why we believe there’s a better way of assessing the value of health insurance.
The best way I can describe this is to use a food analogy. Take the example of choosing a restaurant. In a hospital list approach, what we as the insurer are doing is giving your clients a ‘directory’. It literally is a list of bricks and mortar where treatments can take place and the effort is down to the client to find a place on that list to go to.
If your client is picking a restaurant, they might not always get a clue from the restaurant’s name what food they specialise in or even if they’re good at it. The same can be said from choosing a hospital from a list.
When faced with this choice, it’s likely that your client’s decision will be based on the hospital that’s closest to them. They’re also likely to assume that every hospital can do every speciality equally well. However, like restaurants, different hospitals will have their unique areas of expertise.
It’s a similar story for specialists. When it comes to health, quality is paramount. But how do you measure quality? In the medical sense this could be the perception that the best specialists are London-based. Harley Street is a prime example, but it’s just a postcode. Another measure could be the volume of procedures the specialist has undertaken.
However, medicine is moving at such a pace that a specialist using the latest technology may have carried out fewer procedures but delivered far better outcomes. And, some conditions can now see better outcomes from non-invasive interventions, such as the use of physiotherapy to treat back pain. Measuring on volume alone could prove unreliable in this situation.
So, how does your client know what’s best for them? This is where a guided approach can deliver real value.
Continuing the restaurant analogy, a guided customer journey is one where we personalise the search option for your client’s unique clinical need and offer them a choice of a restaurant based on what food they want to eat provided by a chef with proven experience.
Central to this approach is data. At Aviva, our supplier strategy is based on a range of things such as customer feedback, quality standards – including Care Quality Commission and Health Improvement Scotland ratings, the facility’s specialities (and outcomes where available) technology and capabilities. This insight means that we can continually review and refine our supplier list based on clinical performance.
Where a guided customer journey option has been selected, this data and experience enables us to identify the most appropriate facility and specialist for your clients at point of claim. During their first call with our claims’ consultants, they’re offered a choice of specialists and hospitals. Once your clients decide, we can arrange appointments there and then, booking the treatment directly with the hospital and specialist (where this facility is available) on their behalf.
This approach isn’t new. A guided pathway model been successfully adopted by the NHS for conditions such as stroke, cancer, and heart attack. In the case of stroke for example, outcomes are much better if the patient goes to a hyperacute stroke unit. This is because hyperacute stroke units have a specialist team, backed by the right equipment, procedures, and protocols. So, where possible, paramedics will take the patient to the centre of excellence. Similarly, a guided option, will enable clients to go to different facilities based on different claims.
This approach also delivers continuity of care. For example, if your client has knee pain, they’ll be able to access everything from the initial consultation through to diagnostics, injections, surgery, and rehabilitation through one of our network providers. They’ll also have the reassurance that the facility was hand-picked based on factors like experience, the governance they have, their commitment to quality and their transparency with outcome measures.
Looking to the future, the pandemic has clearly demonstrated that healthcare doesn’t have to be delivered through traditional hospitals. We’ve seen an increased adoption of digital health and community-based care, meaning that places of care delivery are already starting to be dynamic. With groups such as the Royal College of Physicians talking about concepts such as ‘hospital without walls’ this trend is set to continue into the future. A guided customer journey will enable this change while helping to delivering sustainable value-based healthcare personalised to your clients’ individual needs.