Group private medical insurance has evolved considerably since the days that it was perceived as a ‘perk’ for senior staff. While it’s still a benefit designed to cover the cost of eligible medical treatment in private facilities, the benefits and the way the service is procured and delivered have changed considerably over the past few decades.
The world is now a very different place. Today’s environment can be challenging for employees and employers alike. The technological revolution is driving new behaviours, expectations and health risks. We are all juggling priorities and at times neglecting our health. Yet (often costly) advances in medicine mean many are living – and often – working longer.
Employers are seeing a knock-on effect. For many, sickness absence has increased, particularly in relation to mental health – which at one time wasn’t widely recognised or even talked about in the workplace.
Group healthcare now has more complex needs to meet, meaning that our role as a healthcare provider has changed. No longer is it sufficient simply to be ‘bill payers.’ Providers need to demonstrate that they can deliver an easily accessible, value-based, quality service that helps employers prevent illness and tackle their key health risks in the most appropriate, sustainable way.
The technological revolution has helped enable this change. Processes can now be automated, accelerating and simplifying the customer journey. Where telephone assessment of claims revolutionised the way in the 1990’s, digital is now the way forward. Time-poor group members want the option to manage their healthcare policy when and how they choose.
Added value services have become more sophisticated and easily accessible. GP Helplines have moved online. If the right provider is chosen, members can access support, pharmacy services and arrange online consultations at a time to suit them.
Gym discounts have evolved into holistic workplace wellbeing programmes, supported by digital communications to encourage engagement. Wellbeing is no longer seen as a ‘nice to have’. Employers are beginning to recognise that driving healthy behaviour can help their employees reduce key health risks and in turn sickness absence.
While there’s no doubt that technology is an enabler when it comes to accessing health support, it’s also driving behaviours which could increase health risk. Where addiction was predominantly associated with drugs and alcohol, we’re now seeing the advent of ‘technology-driven’ addictions such as ‘online gaming’ and ‘social media’.
Forward thinking insurers have already responded by re-assessing their mental health cover, with some now offering corporate customers the option to extend their cover to support employees with addiction.
So, what does the future hold for private medical insurance? One thing’s for sure, the medical world doesn’t stand still. We’re already seeing technological advances that take cancer diagnosis to the next level. Chronic conditions can now be managed virtually.
And treatment continues to become more personalised and targeted. As corporate customers look to demonstrate their duty of care to their employees and satisfy legislation, we’re seeing a demand for cover for conditions that traditionally sat outside the private medical insurance benefit structure, some of which require closer alignment of private and NHS treatment pathways. Gender dysphoria is a prime example.
However, all this comes at a cost. Healthcare providers have a key role to play in offering the cover corporate customers need, while keeping their healthcare sustainable.
The market is already starting to address this challenge through the case management of conditions such as musculoskeletal and mental health. Treatment is becoming personalised, with a move away from the ‘one size fits all’ benefit-led out-patient approach. This in turn helps ensure that the individual goes down the most appropriate treatment pathway – helping speed recovery and return to work rates.
Providers are also playing an increased role in guiding customers to the most appropriate treatment provider, following an open referral. We believe that both clinical knowledge and independent quality data are paramount when it comes to managing this process. This approach not only helps ensure that your clients’ healthcare is procured effectively and efficiently, but also gives them the confidence that treatment will be delivered in a safe, quality environment.
As an industry we need to keep innovating and focusing on delivering high quality, value- based healthcare. Working together in partnership with the specialist advice you can offer, we can help clients navigate the changing environment so that they’re better empowered to make the right choices when it comes to their company healthcare.
