Health Insurance covers benefits arising out of medical expenses incurred from sickness, injury, accidents, and accidental death.

With developments in the medical and healthcare provision sector, which has led to massive digitization and automation, the health insurance industry has had to follow suit.

Payers, which can be government agencies, private companies, or nonprofits, have to put in a mechanism that efficiently handles insured’s records, processes payment of premiums, and helps in the swift handling of claims.

Digital transformation is therefore a key aspect of any modern health insurance company, agency, or such other entity. Here we look at how digital trends and new technologies are changing the sector.

  1. What is digital transformation?
  2. What technologies are transforming the health insurance sector?
  3. Digital transformation and its impact on the health insurance industry
  4. Why digital transformation in health insurance?
  5. What Are the 4 Main Areas of Digital Transformation?
  6. What Are the 3 Main Components Of Digital Transformation?
  7. Digital Trends Digitization in Insurance Health

Health Insurance Digital Transformation

What is digital transformation?

Digital transformation in health insurance relates to the adoption and implementation of technology and evolving trends in health insurance.

Over the years, trends in other industries, especially in health, payments, and record keeping – including companies going paperless in their operations – have forced players within the health insurance space to adopt innovative and optimization-focused processes to keep pace with the digital transformation or risk being left behind.

The health insurance industry has to ensure it copes with not just the transformation, but the potential disruption from “insurtechs.” Providers have to look at their consumer-facing services, in the modern market, a requirement to maintain an edge over competitors. The transformation is all about leveraging new technologies.

What technologies are transforming the health insurance sector?

While payers in the health insurance sector have been slow to jump onto the digitization wagon, the last few years have seen many companies begin to make substantial investments in their digital programs.

Some of the technologies insurers are tapping to lead their own digital transformation include artificial intelligence (AI), blockchain technology, telemedicine, 5G technology machine learning, predictive analytics, and live chat, among other automation processes.

Digital transformation and its impact on the health insurance industry

Apart from aligning insurance functions with modern developments, digital transformation is helping health insurance providers cut human errors, streamline and hasten patient claims processing as well as reducing overall operational costs. All these are achievable via disruptive applications- both on the web and on mobile.

Companies are also seeing the value in customer satisfaction and an overall rise in business through better digital marketing approaches.

Insurance providers that are finding the digital leap too high have managed services providers (MSPs) and outsourced IT support solutions that can help them take that all-important step towards digital transformation.

To improve customer relations and cultivate competitiveness, insurers are investing in digital solutions that are transforming member-facing functions. These include enrollment of the insured, rolling out insurance policies, and empowering agents and brokers.

Payers are also using digital solutions to increase customer retention or to help when transitioning into new offerings. Personalized messaging and targeted analytics are also driving sales for health insurance.

For some providers, artificial intelligence is helping improve payment integrity while a reimagining of operations has transformed both back-end and front-end functions and collaboration.

Companies are tapping into AI, machine learning, and predictive analytics to optimize operations to speed up claims. Payers are now launching applications that have made it possible for policies and claims are processed instantly.

AI-powered computer applications are helping providers onboard and analyze thousands of new users, with integrations into health systems providing for roadmaps that allow companies to move from textbook services to tailoring offerings to the needs of the insured.

Digital transformation has also forced insurers to personalize services via apps, where customers and brokers can seamlessly process information. Clients can view premiums and chat with company representatives, pay their premiums, or file claims – all in one app.

Insurers are also reaping from transformative Internet of Things (IoT) and wearable devices to collect accurate data, improve underwriting, and offer self-service dashboards and apps that customers can log in to from whenever and wherever.

In health insurance, another transformation is being witnessed by an emerging technology called blockchain and distributed ledger. The burgeoning technology is proving critical in security, privacy, and tamper-proof operations. It means improvements against data breaches or potential tampering.

Why digital transformation in health insurance?

The need to adopt transformative technologies has seen over 90% of insurers plan for the long-term plan. Digital solutions, features, and functionalities are reshaping the health insurance industry and further developments in AI, ML, blockchain and predictive analytics will only continue to revolutionize the sector.


What Are the 4 Main Areas of Digital Transformation?

The main areas of digital transformation are data, technology, processes, and organizational change. Digital transformation affects how the health insurance industry uses technology and data, to improve its organizational structures and streamline its internal processes.

Prior to undergoing digital transformation, most health insurance providers don’t have standardized digital data. That makes it less useful when they need it to model their financial outlook. Moreover, they may not have invested in the right technology that can help them standardize their data collection.

Those two areas are the first ones that a health insurance provider has to deal with, in their digital transformation journey.

What Are the 3 Main Components Of Digital Transformation?

Just like in other industries, in health insurance, the three main components of digital transformation are business models, operational processes, and customer experience. And each of those three components has three elements that are used to form a digital transformation strategy.

Digitizing Customer Experience

Customer experience involves having a deep understanding of a customer. Insurance health providers can create better products for customers if they understand them better.

The second element is top-line growth, where the focus is on getting more sales from individual customers. That creates more growth than focusing on growing the customer base alone.

The third element is customer touchpoints. Here the focus is on giving the client multiple means of communication. Answering customers’ questions in a timely and accurate manner make them happy and loyal to a brand.

Digitizing Business Models

In the process of digital transformation, insurance health providers have to change how their businesses’ functions interact with each other. In turn, that changes some of their business activities and their business boundaries.

In that regard, the three elements of transforming business models are the digitization of business processes, creation of new digital business functions and products, and globally digitizing the business’s operations.

With a global digital business presence, insurance health providers can reach their customers wherever they are in the world. That not only grows their customer base but also helps them offer better services. It also allows them to grow globally, but still, keep a lean workforce.

Digitizing Operational Processes

It’s obvious that the greatest impact of digital transformation is felt by the customer. However, businesses have realized that transforming the internal processes, which aren’t touching directly on the customer, is impactful as well.

For health insurance providers, they are achieving that by digitizing all processes, digitally enabling workers, and digitally managing business performance.

That frees the workers’ repetitive tasks and allows them to work on tasks that require creativity. It also reduces the labor requirements needed to achieve the insurance provider’s services.

Digital Trends Digitization in Insurance Health

Right now, trends in health insurance are about integrating the various technologies into their systems; overhauling or archiving legacy functionalities, and focusing on aligning services to customer needs as well as the industry’s changing ethos.
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