Patient reported data could be a critical source of information for insurers to improve outcomes and help control costs, the Health & Protection IPMI breakfast briefing has heard.
The method was highlighted as a key way for international private medical insurance (IPMI) providers to improve data from their global memberships, especially as collecting results from hospitals and clinics can be difficult.
Joanne Buckle, principal and consulting actuary for healthcare at Milliman, told the audience: “We have an opportunity here to really incorporate outcomes data and get better health outcomes, to not just be the writer of the cheque at the end – that’s really important.
“That will lead to better retention, it’ll mean we can manage medical inflation much more proactively and it gives customers a much more differentiated customer experience.”
Patient reported data
Buckle (pictured) was realistic about which parts of the world this would be possible in, but emphasised that it was possible in more mature places such as Europe and the USA.
Furthermore, she urged insurers to use their relationships with members to the fullest, especially as this does not need hospitals and clinics to cooperate – which can often be difficult to secure.
“It’s a question of working out what we can pull out,” she continued
“The patient reported outcome measures and patient reported experience measures are really interesting because you do not need a hospital on board to collect those.
“You can collect those directly from the patient, but I haven’t yet seen anybody with the ambition to do that at scale.”
Buckle continued: “I do think you can collect outcomes from patients at scale; you may not be able to tie them to a particular hospital, because maybe you’ve only got five hip replacements going through there in a year and two cancer cases over here.
“But there are certain pockets and we should be starting to think about where those pockets are, where there’s some really important insights.”
As part of this, Buckle encouraged insurers to be confident and expand their thinking in what could be gathered from their patients.
“Insurers don’t do a good job of asking for that patient voice,” she said.
“They very much focus on patients’ experience of the process, not their clinical experience, and you could do a much better job of asking people about their clinical experience and getting that information directly from them.”
Planning provider contracts with data in mind
In terms of other sources of data, Buckle also highlighted the industry could do a better job of obtaining data from healthcare providers. This was particularly important to build into place when initiating or renewing services.
“When you engage a third party provider, such as a remote GP service, about what you’re going to do with that data in the future, you get very broad-brush data back about your members having 200 medical appointments a day last yea,” she said.
“But which members and what for and how do we link it back to their claims data?
“When you’re going into those negotiations with third party providers, normally your focus is very much around getting robust access for customers and improving that customer experience?
“The focus is not necessarily, ‘what are we going to do with that data stream in two years to help us build a better profile of our customers?’ she added.
