iPMI Magazine Speaks With Global General Managers At Aetna international ^Featured

In this exclusive iPMI Magazine interview, Christopher Knight, CEO, iPMI Magazine, met with Global General Managers from Aetna international. The group interview focused on international health and medical insurance regional trends; the impact of COVID-19 on iPMI; plus predictions for the coming year. As always the interview raised some excellent points for the international private medical insurance market.

Have you recognised any notable trends in health insurance from your region over the past year?

Damian Lenihan, Executive Director - Operations and Distribution, Europe, Aetna International: The COVID-19 pandemic has amplified the importance of good physical, mental and emotional health for employees of all ages across Europe. This translates directly into employees having greater expectations for health insurance benefits from their employers. This is what we discovered in our research. Our ‘Polarised Perceptions of Corporate Health and Wellness’ study shows that in global business, 70 percent of employees feel that their mental health is most important and that they have been negatively affected during the pandemic. They expect employers to provide comprehensive mental health and well-being services as standard. Research also shows that these services are more important to employees now than previously. A real desire for digital services was also communicated. Results show that employers need to carefully choose the best comprehensive plans for their valued workforce. Plans that cover everything from health support, advice and guidance through to telemedicine services and the latest digital tools.

How has the COVID-19 pandemic impacted the private medical insurance market in your region?

Damian Lenihan, Executive Director - Operations and Distribution, Europe, Aetna International: The health insurance market has clearly evolved from helping people to recover to supporting prevention. Empowering people is much more of a focus. It is vital for individuals to manage their own physical, mental and emotional well-being and this should become a daily routine. The “well-care model” as we refer to it comes with an excellent set of tools and resources that we provide for members which supports them to lead happier, healthier lives. Prior to the pandemic, we were determined to provide mental health support. We invested in product enhancement and innovation. For example, our members have access to the award-winning chatbot app, Wysa, access to doctors via our sophisticated telemedicine service, vHealth, and to counsellors through the Employee Assistance Programme (EAP). To put all of this into context, we know that corporate and SME clients want to be cost efficient and are less likely to want to switch insurers at the moment. Preferences are for continued long-term relationships with a trusted health insurer.

What are your predictions for health insurance trends in your region over the next year?

Damian Lenihan, Executive Director - Operations and Distribution, Europe, Aetna International: Many of the trends from the past 18 months will continue for the next year. Health insurers will continue to offer all-round health care. We’ll see an acceleration in the roll-out of digital services, such as telehealth. This will be driven by members’ demand for services, which will be due to convenience and safety. Also, it goes back to people feeling empowered to self-manage health concerns. Preventative measures that will reduce the need for in-person medical care and potentially the number of claims and therefore costs. That being said, the continuing degree of global uncertainty indicates that we will likely work in an agile way for the foreseeable future. The investment will be in efficient operations.

Have you recognised any notable trends in health insurance from your region over the past year?

David Healy, CEO EMEA, Aetna International: COVID-19 has increased expectations from employees about health insurance benefits packages. Recent research we conducted found that 76% of UAE employees believe comprehensive health insurance is more important now than before the pandemic. A further 66% said their employer should be spending more on health benefits. Two thirds of UAE-based HR professionals also agree that there’s an expectation for employers to take more responsibility for their employees’ health. Consequently, plan sponsors are balancing workforce expectations with budget restrictions and are working with health insurance providers that offer holistic plans.

How has the COVID-19 pandemic impacted the private medical insurance market in your region?

David Healy, CEO EMEA, Aetna International: COVID-19 has had a negative impact on mental health and well-being. This ‘second curve’ of the pandemic is likely to be relevant for some time as people grapple with uncertainty. We believe we have a duty to champion change and our commitment is to ensure that mental and physical health are prioritised equally. We have made several product enhancements to meet the health needs of our members in the short and longer-term, regardless of location. For example, enhancements have been made to Focus, the health insurance product designed specifically for UAE small- and medium-size enterprises (SMEs). This includes inpatient and outpatient psychiatric treatment and psychotherapy for patients with non-emergency medical conditions.

What are your predictions for health insurance trends in your region over the next year?

David Healy, CEO EMEA, Aetna International: Arguably the biggest trend will be health insurers’ continued focus on providing their members with accessible telehealth services. There are a few drivers that make telehealth a key cog in the primary care model. The first is convenience — across the Middle East, telehealth services afford ready access to experienced doctors and some services take it a step further by combining primary care with concierge-style diagnostics and prescription services, where patient samples are taken, and medicines are delivered, to the office or home door.

Second, telemedicine doctors provide the full range of primary care. They take patient histories and either prescribe treatment plans or arrange specialist referrals, after considering the physical and mental effects of a range of afflictions. This approach is vital in a post-COVID world where we have seen an increase in the number of patients with comorbidities.

Third, is the treatment of extant comorbidities. Through 2020 and beyond, the pandemic made it harder for patients with chronic conditions such as diabetes to keep up with their medication and regular check-ups. Telehealth played a vital role in delivering uninterrupted care including diagnosis, treatment, home blood-monitoring, delivery of prescriptions and consultation when needed.

Last but not least, telehealth has the potential to drive down premium costs. While the economic recovery is well underway in the region, businesses are still watching costs. Data from our vHealth service shows that the more employees use telehealth services, the bigger the potential reduction in claims. Around 75% of vHealth users completely resolve their condition without the need for onward care and over 90% admit they would have gone to a hospital if a remote consultation hadn’t been available.

Have you recognised any notable trends in health insurance from your region over the past year?

Hemal Desai, Global Medical Director, Aetna International: The most significant trend over the past year has been the increased acceptance from people to consume multi-channel health care. People can choose how they interact with their health and well-being providers whether it be via chat, voice, video or physical services. This has resulted in a significant uptick in telemedicine and other digital health services.

One area that has benefited most from this multi-channel approach is mental health care, which has traditionally been difficult to access in the past. As a consequence, it is a greater part of the health insurance agenda than it ever was before. We have seen a major push for mental health and well-being provision which wasn’t something actively discussed in previous years. Corporate insurers across the board have seen that the COVID pandemic has triggered mental health concerns. With this, insurance providers are organically becoming health partners offering holistic solutions to drive positive health outcomes. Primary care is central to the health and well-being of individuals. Whilst the global trend is to live longer due to improved preventative care, people need to be able to have the resources to self-manage their health concerns.

How has the COVID-19 pandemic impacted the private medical insurance market in your region?

Hemal Desai, Global Medical Director, Aetna International: Many people avoided seeking health care when they needed it during the height of the pandemic. In some cases, people that actively needed treatment could not access it as hospitals were full dealing with COVID-19 patients. Those with mild symptoms or well-controlled long-term conditions hesitated to consult with their health care provider, which has led to accumulating burden of illness.  We’re seeing chronic conditions like hypertension and diabetes that are less well managed, resulting in longer-term complications or an increase in undiagnosed or late presenting cancers leading to poorer health outcomes and costlier treatments. Insurers may have seen an initial lag on claims as people avoided or could not access their health care settings, but this is more than likely to result in more disease complications and higher-value claims in the future. Many people think it will come back harder due to undiagnosed illness.

What are your predictions for health insurance trends in your region over the next year?

Hemal Desai, Global Medical Director, Aetna International: The impact of technology on the health sector is going to be profound over the next year and beyond. Artificial Intelligence (AI) together with remote patient monitoring will create a huge step change in how people access and are managed within virtual health care settings. It will enable new methods of diagnostic support for clinicians, new options in digital therapeutics and allow people to be more engaged in their own well-being. Accurate remote diagnosis of eye, skin conditions and heart arrythmias have already been achieved. The combination of AI and remote diagnosis and telemedicine will be game-changing for health care.

Digital health care is stickier than before - people now trust telemedicine, and this provides a platform for further growth and adoption. Accessible, consumer centric health care is appropriate for modern lives. Additionally, AI will continue to revolutionise remote diagnosis. The challenge for insurers will be developing the right funding environment to accommodate these newer technologies.

One such area of rapid advance is gene and cell therapies. A significant pipeline of exciting new therapies is due to come on to the international market to treat previously untreatable health conditions. 

COVID-19 has also potentially accelerated vaccination production for other illnesses such as malaria, HIV, and some cancers. It is very exciting that COVID-19 has accelerated this by improving vaccine technologies, such as mRNA, but also the vaccine development process and regulatory approval cycles. Preventing illnesses is really important from a health insurance perspective.

The impact of post-acute COVID syndrome (or long COVID) is also an area that health insurers will need to monitor closely. The impact and extent of long COVID may be significant but is not yet fully understood and extremely hard to predict. Long COVID potentially presents a significant challenge for health care systems, payors, employers and, most importantly, those suffering from the illness.

Have you recognised any notable trends in health insurance from your region over the past year?

Derek Goldberg, CEO APAC, Aetna International: There is an increased need for mental health support and services due to the toll the pandemic has taken on mental health in the region. We’re also seeing ‘flight to safety’ behaviours whereby customers are choosing to purchase insurance from more established insurers.

Driven by the prevalence of work-from-home and a reluctance to venture out into a physical health care setting when avoidable during a pandemic, there has been an increased demand for digitisation of customer processes. Telemedicine is one of the key capabilities required to support this demand, and we have seen an increase in both registrations and utilisation across our telemedicine programmes.

How has the COVID-19 pandemic impacted the private medical insurance market in your region?

Derek Goldberg, CEO APAC, Aetna International: Many insurance providers are removing their pandemic exclusions or developing dedicated products to cover pandemic risks. Unique to this pandemic, insurance may be used as an incentive to drive vaccination, for example new regulations allow Singapore employers to exclude unvaccinated employees from COVID-19 coverage under their health insurance plans.

What are your predictions for health insurance trends in your region over the next year?

Derek Goldberg, CEO APAC, Aetna International: Employers will continue to be conscious of budgets as the economic outlook remains uncertain in many countries, and, as insurers, we’ll be called upon to work collaboratively and creatively with our clients to devise health benefit programmes that manage costs and meet their financial objectives. Digitisation will continue to accelerate across all industries including health care. Long COVID (symptoms of COVID that persist long after the initial infection has cleared) and its implications for longer-term support and follow-up treatment will be an emerging part of the landscape.