Insurance Industry

Insurers Need to ‘Exploit’ Digital Technologies

Accenture survey shows P&C customers want a better digital experience and more customization from insurers.
By: | August 18, 2015 • 3 min read
Business creativity and success concept

Capturing the insurance customer of tomorrow is going to require a substantial investment in digital technology, a new report from Accenture consulting firm revealed.

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A survey of 13,000 P&C and life insurance customers in 33 countries showed that as much as $470 billion in insurance premiums will be up for grabs globally as a result of declining customer loyalty and perceived commoditization of products.

Fewer than one-third of insurance customers indicated they were satisfied with their current provider.

“The study data indicates insurers are not keeping up with rising customer expectations, leading to increased customer dissatisfaction with insurance providers,” said John Cusano, senior managing director of Accenture’s global insurance practice.

“This has created a ‘switching economy,’ which threatens traditional insurers by giving the advantage to companies most successful at exploiting digital technologies.”

Nearly one in four (23 percent) of the respondents said they would consider buying insurance from online service providers, including technology giants such as Amazon and Google.

Nearly half (47 percent) of the survey respondents said they want more online interactions with their insurers.

At the same time, the number of customers who believe that most insurance carriers are the same in terms of their products and services jumped 50 percent in the last year, up to 21 percent in this year’s survey from 14 percent in a similar survey last year.

“Today’s insurance customer is more empowered, more social and has higher expectations of his/her providers.” — John Cusano, senior managing director, Accenture global insurance practice

Furthermore, fewer than one in six customers (16 percent) said they would definitely buy more products from their current insurance provider. In addition, only one in four (27 percent) had a high estimation of their insurance providers’ trustworthiness.

“Today’s insurance customer is more empowered, more social and has higher expectations of his/her providers,” Cusano said.

While many consumers globally are using online tools to purchase insurance products, only 15 percent said they are satisfied with their insurers’ digital experience.

Jean-Francois Gasc, managing director, insurance, Accenture Strategy, Europe, Africa and Latin America

Jean-Francois Gasc, managing director, insurance, Accenture Strategy, Europe, Africa and Latin America

“Leading insurers realize the need to offer a broader range of innovative products and services and create a differentiated customer experience, which will likely require partnering with nontraditional players,” said Jean-Francois Gasc, managing director, insurance, Accenture Strategy, Europe, Africa and Latin America.

“As a result, traditional insurance providers face a stark choice: embrace digital and customer-centricity, or become a highly efficient manufacturing utility, leveraging capital and digital technologies to provide low-cost insurance product manufacturing and servicing,” Gasc added.

“Those who do neither are likely to lose out in this switching economy.”

The report noted that insurers need “a holistic digital business strategy that encompasses the entire enterprise” if they want to remain relevant.

While many insurers have improved their customer-centricity, only a minority — the “digital transformers” — have taken that holistic approach.

The report found that 82 percent of digital transformers have invested in digital channels and technologies to advance customer-centricity and provide tailored customer experiences across all products and channels. Only 56 percent of the “digital followers” have.

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To give customers what they value, many insurers will have to partner with other companies, probably outside of insurance, to form ecosystems that offer a broad and innovative range of products and services.

Sixty one percent of insurers are exploring the possibility of offering non-insurance products and services.

“Building digital capabilities can be challenging, especially for industry players with little experience and complex legacy infrastructures,” the Accenture report noted. “It makes sense, then, that 43 percent of insurers plan to acquire innovators/start-ups to build new digital capabilities, or have already done so.”

Steve Yahn is a freelance writer based in Croton-on-Hudson, NY. He has more than 40 years of financial reporting and editing experience. He can be reached at [email protected]
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Risk Insider: Carol Murphy

The Importance of Being Human

By: | August 13, 2015 • 2 min read
Carol Murphy has more than two decades of risk experience and currently leads U.S. Casualty sales and the Loss Portfolio Transactions practice at Aon. She can be reached at [email protected]

Signs are everywhere touting bigger and better risk data, new and improved analytics, and “actionable insights.” The pace of change is exciting and many new tools show promise. There’s so much upside!

Being curious, I wondered whether there’s any downside, any risks we are not seeing yet, and asked wise risk manager friends for their take. As our industry reflects on the future needs and opportunities to be met — where we need to be in five years, I was reminded of important truths we’d be wise to keep in mind.

One immovable truth is that it’s people that make a difference. Bringing their talent, experience and insight to bear, the best risk managers will extract from and add value to new tools. As an industry based on serving and helping protect people and organizations from risks, we rely on our people as the bedrock, not analytics.

While many emerging tools provide interesting information, “actionable insights” is in the eye of the risk manager — beholder. “Old-fashioned” experience and insight still matter, and our teams need to leverage all talents. A risk to consider is potential loss of talent in our industry as new tools foster efficiency, and could lead to talent loss or reduction in engagement.

As an industry based on serving and helping protect people and organizations from risks, we rely on our people as the bedrock, not analytics.

Now, I’m one of the engaged, but I learn from listening to the cynics too! We all realize that statistics can be misleading — providing different answers to the same information depending upon the positions being promoted.

Erroneous conclusions due to inadequate data are a related problem. The statistics can be built to support a position rather than the other way around.

As an example we know well, advancements in property modeling produced different results on static properties where in fact the risks hadn’t changed. So, a risk may be that new tools may polarize parties rather than building win-win frameworks.

Where improved transparency is the upside of the information age, a friend mentioned a potential downside: commoditization. Sameness due to an over-reliance on data may reduce the effectiveness and even the relevancy of insurance.

Strong skills in customizing policy language to respond to unique concerns are another “old school” but accretive skill. Indeed, comparability and customization of information to the customer is always a concern.

Traditional benchmarking that once seemed helpful just doesn’t work that well. Risks are not homogeneous. Magnitude matters. Claim profiles, financial objectives, coverage and structures vary.

Risks aren’t static. We need a compass directed toward emerging trends. So there’s a risk in drawing conclusions from inadequate or irrelevant data. But good progress in predictive modelling, leading indicators as well as multi-variable benchmarking is moving us in the right direction.

With exceptional insight and experience, veteran risk managers are adept at understanding analytics advancements and what is relevant to decision making.

In all the talk about actionable insights, we don’t hear a lot about wisdom. That means having the experience and insight to make the best decisions using incomplete information — most of the time.

Our industry needs to leverage our collective talents to build the next-generation tools, while remembering that those tools don’t replace personal interaction. The successful marriage of personal insight and experience with expanded analytics power will characterize our industry’s top contributors now and in the future.

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Sponsored Content by IPS

Managing Chronic Pain Requires a Holistic Strategy

To manage chronic pain and get the best possible outcomes for the payer and the injured worker, employ a holistic, start-to-finish process.
By: | August 3, 2015 • 5 min read
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Chronic, intractable pain within workers’ compensation is a serious problem.

The National Center for Biotechnology Information, part of the National Institutes of Health, reports that when chronic pain occurs in the context of workers’ comp, greater clinical complexity is almost sure to follow.

At the same time, Workers’ Compensation Research Institute (WCRI) studies show that 75 percent of injured workers get opioids, but don’t get opioid management services. The result is an epidemic of debilitating addiction within the workers’ compensation landscape.

As CEO and founder of Integrated Prescription Solutions Inc. (IPS), Greg Todd understands how pain is a serious challenge for workers’ compensation-related medical care. Todd sees a related, and alarming, trend as well – the incidence rate for injured workers seeking permanent or partial disability because of chronic pain continues to rise.

Challenges aside, managing chronic pain so both the payer and the injured worker can get the best possible outcomes is doable, Todd said, but it requires a holistic, start-to-finish process.

Todd explained that there are several critical components to managing chronic pain, involving both prospective and retrospective solutions.

 

Prospective View: Fast, Early Action

IPS_BrandedContent“Having the wrong treatment protocol on day one can contribute significantly to bad outcomes with injured workers,” Todd said. “Referred to as outliers, many of these ’red flag’ cases never return to work.”

Best practice care begins with the use of evidence-based UR recommendations such as ODG. Using a proven pharmacological safety and monitoring opioid management program is a top priority, but needs to be combined with an evidence-based medical treatment and rehabilitative process-focused plan. That means coordinating every aspect of care, including programs such as quality network diagnostics, in-network physical therapy, appropriate durable medical equipment (DME) and in more severe cases work hardening, which uses work (real or simulated) as a treatment modality.

Todd emphasized working closely with the primary treating physician, getting the doctor on board as soon as possible with plans for proven programs such as opioid Safety and Monitoring, EB PT facilities, patient progress monitoring and return-to-work or modified work duty recommendations.

“It comes down to doing the right thing for the right reasons for the right injury at the right time. To manage chronic pain successfully – mitigating disability and maximizing return-to-work – you have to offer a comprehensive approach.”
— Greg Todd, CEO and founder, Integrated Prescription Solutions Inc. (IPS)

 

Alternative Pain Management Strategies

IPS_BrandedContentUnfortunately, pain management today is practically an automatic move to a narcotic approach, versus a non-invasive, non-narcotic option. To manage that scenario, IPS’ pain management is in line with ODG as the most effective, polymodal approach to treatment. That includes N-drug formularies, adherence to therapy regiment guidelines and inclusive of appropriate alternative physical modalities (electrotherapy, hot/cold therapy, massage, exercise and acupuncture) that may help the claimant mitigate the pain while maximizing their ongoing overall recovery plan.

IPS encourages physicians to consider the least narcotic and non-invasive approach to treatment first and then work up the ladder in strength – versus the other way around.

“You can’t expect that you can give someone Percocet or Oxycontin for two months and then tell them to try Tramadol with NSAIDS or a TENS unit to see which one worked better; it makes no sense,” Todd explained.

He added that in many cases, using a “bottom up” treatment strategy alone can help injured workers return to work in accordance with best practice guidelines. They won’t need to be weaned off a long-acting opioid, which many times they’re prohibited to use while on the job anyway.

 

Chronic Pain: An Elusive Condition

IPS_BrandedContentSoft tissue injuries – whether a tear, sprain or strain – end up with some level of chronic pain. Often, it turns out that it’s due to a vascular component to the pain – not the original cause of the pain resulting from the injury. For example, it can be due to collagen (scar tissue) build up and improper blood flow in the area, particularly in post-surgical cases.

“Pain exists even though the surgery was successful,” Todd said.

The challenge here is simply managing the pain while helping the claimant get back to work. Sometimes the systemic effect of oral opioid-based drugs prohibits the person from going to work by its highly addictive nature. In a 2014 report, “A Nation in Pain,” St. Louis-based Express Scripts found that nearly half of those who took opioid medications for more than a month in their first year of treatment then refilled their prescriptions for three years or longer. Many studies confirm that chronic opioid use has led to declining functionality with reduced ability to recover.

This can be challenging if certain pain killers are being used to manage the pain but are prohibitive in performing work duties. This is where topical compound prescriptions – controversial due to high cost and a lack of control – may be used. IPS works with a reputable, highly cost-effective network of compound prescription providers, with costs about 30-50 percent less than the traditional compound prescription

In particular compounded Non-Systemic Transdermal (NST) pain creams are proving to be an effective treatment for chronic pain syndromes. There is much that is poorly understood about this treatment modality with the science and outcomes now emerging.

 

Retrospective Strategies: Staying on Top of the Claim

IPS_BrandedContentIPS’ retrospective approach includes components such as periodic letters of medical necessity sent to the physician, peer-to-peer and pharmacological reviews when necessary, toxicology monitoring and reporting, and even addiction rehab programs specifically tailored toward injured workers.

Todd said that the most effective WC pharmacy benefit manager (PBM) provides much more than just drug benefits, but rather combines pharmacy benefits with a comprehensive ancillary suite of services in a single portal assisting all medical care from onset of injury to RTW. IPS puts the tools at the adjustor fingertips and automates initial recommendations as soon as the claim in entered into its system through dashboard alerts. Claimant scheduling and progress reporting is made available to clients 24/7/365.

“It comes down to doing the right thing for the right reasons for the right injury at the right time,” Todd said, “To manage chronic pain successfully – mitigating disability and maximizing return-to-work – you have to offer a comprehensive approach,” he said.

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This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with IPS. The editorial staff of Risk & Insurance had no role in its preparation.




Integrated Prescription Solutions (IPS) is a Pharmacy Benefit Management (PBM) and Ancillary Services partner to W/C and Auto (PIP) Insurance carriers, Self Insured Employers, and Third Party Administrators who specialize in Workers Compensation benefits management.
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