Digital Health Ecosystem Series, Part 3: Enabling Incumbents: 5 Main Steps How Insurers Can Build Digital Health Ecosystems

Insurers that create or participate in digital health ecosystems can play a pivotal role in the healthcare journey, as they disrupt traditional ways of delivering services and engaging with customers. Digital health ecosystems are built by prioritizing the need of users, selecting the appropriate digital health providers, and ongoing performance monitoring. Join us for this digital health ecosystem series as we define, evaluate, and explore the implementation of digital health ecosystems.

As consumers demand integrated digital health ecosystems that provide greater access, enable maximum well-being, and lower costs, their adoption is already beginning to disrupt insurance incumbents. Given that digital solutions hold the key to these demands, the time is right for digital health ecosystems to emerge at scale.

While a digital health ecosystem will look different if it comes from an insurer than from a health plan, all ecosystems should incorporate foundational elements of consumer-centricity, be digitally enabled, and seek full integration. Addressing these elements is a surefire way to break down traditional silos and enable a frictionless stakeholder experience.

The strategy an insurer adopts will dictate the role they play in creating or participating in a digital health ecosystem. These roles fall on a spectrum ranging from ecosystem orchestrator to participant. The roles within an ecosystem will not be discussed in this blog, but it is important to note that there are considerable pros and cons associated with each.

Building digital ecosystems allows insurers to reinforce their relevance to their clients by addressing their changing needs. Insurers build digital health ecosystems by:

Prioritizing the needs of their users

A digital health ecosystem strategy is implemented by carefully evaluating the specific areas of need identified by users and which ecosystem approach is best suited to addressing these needs.

Point Solutions Management from CVSHealth, a best-in-class ecosystem, identified the following three categories of client need which has helped shape their ecosystem strategy. These are areas of high medical costs, where digital tools can improve clinical outcomes; areas of productivity and member quality of life, which can be impacted by improved habits and clinical coaching; and areas of care complexity, where clients seek improved member engagement and ease of member navigation to maximize their health benefits.

By prioritizing the need of users, insurers can select potential partners that directly address the challenges raised by clients.

Selecting the appropriate digital health providers

One of the benefits that digital health ecosystems should provide to users is reliability. Therefore, vendor selection is crucial, so users trust that the solutions provided are best-in-class.

When selecting these providers, insurers should consider a seamless user journey, cost-savings benefits, and increased convenience for users. They should also analyze clinical safety, alignment with evidence-based clinical guidance, and validated outcomes.

The success and longevity of a digital health ecosystem will hinge on the value that these solutions provide to the insurer and the users.

Ongoing performance monitoring

The needs of the insurer, users, and providers are not stagnant. Requiring ongoing performance monitoring is essential to support users at scale. As stakeholder needs change, ecosystems should continuously monitor business models, financial viability, and clinical and safety outcomes.

At Research2Guidance we support health insurance companies to build digital health ecosystems based on R2G’s innovation management approach. Our approach is divided into five major phases:

  1. Awareness & Insights: Understanding market trends and competitor activities.
  2. Prioritization & Roadmap: Defining partnership areas with the highest impact.
  3. Screening & Partner Search: Identifying and selecting the best partners.
  4. Partner Management: Starting and testing partnerships.
  5. Upscale Integration: Integration into organization and service offering.

Our innovation management approach has successfully been adopted to help various health insurers create a digital health ecosystem for their clients. If you want to know more about our previous work, please get in touch. (We also invite you to read part 1: “Enabling incumbents: building digital health ecosystems to unlock value for insurers” & part 2: “Enabling Incumbents: Top 4 Reasons for Health Insurers to Build Digital Health Ecosystemsof our Digital Health Ecosystem Series)

The digital health ecosystem series has tackled the what, who, why, and how of building digital health ecosystems for insurance incumbents. There are numerous benefits and approaches for those adopting this model. The time to start exploring your positioning within a digital health ecosystem is now, as these are quickly disrupting the industry, shifting from nice-to-have to must-have platforms

Insurers that invest in digital health ecosystems and best-in-class providers will experience improved customer satisfaction, lower costs and remain competitive in the changing landscape. If you have enjoyed the digital health ecosystem series and are eager to learn more, then please don’t hesitate to have a chat with us.

Research2Guidance has done extensive research and projects within the health insurance industry. We understand the challenges and opportunities that accompany the digital health ecosystem model, as we hope to help you unlock its value.

Get in touch if you want to learn more about building digital health ecosystems and how our team can assist you.

    Leave a Reply

    Your email address will not be published. Required fields are marked *