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Debajyoti Das, Client Partner, Healthcare at Tata Consultancy Services Australia and New Zealand answers key questions senior leaders are asking about the big questions in healthcare.
Telehealth has been an emerging part of the healthcare industry, but the pandemic fast-tracked its acceptance more in six months than in the past 10 years. Even though telehealth has been around since 2010-11, it had never fully taken hold because of the comfort people felt with in-person visits to their GPs. But the rise of telehealth due to necessity in the past six-to-eight months has created a unique ecosystem.
The adoption of telehealth is strongest among younger generations, which is not surprising. However remote care or care-at-home is also becoming a viable option for all age groups as certain medications and procedures (for ex. dialysis, chemotherapy) are administered at the comfort of their homes which is a huge shift from the current operating model.
Millennials do not prefer to wait for an appointment or be kept in a waiting room to see a doctor. This younger generation’s desire for “healthcare on-demand” is why I believe telehealth is here to stay. For now, it looks like there will be a different mix of telehealth acceptance among the various demographics within societies.
Governments and healthcare organisations will jointly need to address the biggest issues in telehealth and remote care around privacy and confidentiality as the new trend continues.
All citizens need to see trust and transparency in these areas that have highly sensitive information. This could lead to new legislation that requires companies to demonstrate how they are enabling trust and transparency and ensuring the details a person is communicating to a doctor is private and confidential and won’t be stolen or hacked.
It raises multiple challenges within the healthcare industry, starting with how do organisations continue to foster the adoption of telehealth, remote care, and deliver trust to those people who choose this path for their health needs?
Australia has one of the best healthcare systems in the world. The private-public partnership model is a good one that drives excellence across the board. In terms of healthcare spending, Australia has one of the highest and ranks ninth in countries across the world. And it delivers results.
It provides quality safe and affordable healthcare for Australians and their families and is a reason why Australia has one of the longest life expectancies in the world.
This has been possible due to Australia’s very unique ecosystem of private and public investment, supported by academia, which has fueled innovation in the sector and delivered life-changing treatments and thus helped the overall healthcare ecosystem.
Importantly, this system has helped significantly during the COVID-19 era, one that has seen Australia record one of the lowest death rates amongst COVID-19 patients in the world.
One of the key challenges for the healthcare industry in Australia today is the limited participation of people through private health insurance organisations.
Within the private health insurance industry in Australia there are five major players as well as smaller health funds, but the combined overall coverage of the population is not as good as it could be.
There is pressure on health insurance companies to remain sustainable. We see a worrying trend across the private health insurance business – margins diminishing, revenue not going up which will make them unsustainable in the long run. Even though health insurance companies saw a higher level of member enrollment in the past few months, the situation is not optimistic. If you drill down into the age bracket of new sign-ups they are mostly aged above 40, which is not helping future business models.
There may be ways – possibly including through new legislation to encourage the younger generation to participate actively in the healthcare insurance model, bring in new business models to move towards Health Orchestrators, tap into new markets etc. For example, more rebates and tax credits could be offered to people who enroll early.
Another interesting discussion point is about employer-based health care, something that happens in some countries, which would also most likely require legislation if considered in Australia which can ease the burden on Medicare. This could translate to taxpayers saving money, which in the current economic climate is going to be a strong consideration.
To understand the context, we must remember that Australia has been on an economic growth trajectory for the past few decades, but now for the first time in a long while the economy is contracting.
The new trend that we are seeing is that every health insurance organisation is trying to be a healthcare organisation. I see Health Insurers changing themselves to become Orchestrators of Health with members being at the core of the ecosystem. This will drive better outcomes, establish a value-based care model, improve efficiency and foster trust and partnership across the various entities of the Healthcare ecosystem.
The health insurers need the young generation – especially the 25- to-35-year-old age bracket – to be enrolling in health care so that it gives them a cushion, but it hasn’t happened to the extent the health insurance companies would like. As a Health Orchestrator, health insurance companies are trying to improve the health of their members by partnering with gyms and wellness centres, providing incentives to buy smartwatches etc. All these are targeted at making the insured population healthier which will drive down the healthcare cost.
Another aspect for health insurance companies to consider in a rethink of their business models is how they can provide better products to customers. This includes how they can cater to the different age groups and individuals with varying criteria across a vast geographical landscape.
Health insurers currently have four major types of products with few permutations, but they are broad-based and do not meet everyone’s needs. So there is a need for personalised health insurance products to be brought into the market, and this can attract a new audience to participate in the health insurance ecosystem.
Evidence-based personalised wellbeing will allow a health insurance product to be based on a member’s preferences, which is becoming increasingly important. Health insurers should consider their investment around value-based care. Additionally, they should tap into the data and analytics to provide better outcome for their patients as well as mine the historical data combined with market sentiments to come up with new products and offerings.
The pandemic has taken a toll on the mental wellness of the population and the health insurers can have a huge role to play to alleviate this situation. Though few health insurance companies are providing some support to their members on mental wellness, there is a huge vacuum that needs to be filled. All health insurers should venture into mental wellness and see how they can better support their members (for example offer new products for mental wellness).