Tag: Venkatgiri Vandali

New Wave of Health Insurers Driving Change for Members and Incumbent Plans

Venkatgiri Vandali

By Venkatgiri Vandali, president of healthcare, Firstsource.

A new generation of health insurers has appeared in recent years, gradually gaining momentum in key markets in part by claiming to offer a more modern, digital consumer experience.

The advent of these modern, tech-driven upstarts bodes well for members of plans new and old alike, who are looking for health insurers to finally begin to offer the levels of customer experience, personalization and convenience they have long experienced in other markets like finance and consumer goods.

Consumers clearly want and expect their health insurance provider to offer the same quality of experience they enjoy in other areas of their lives, and plans that can meet that expectation will enjoy a significant competitive advantage.

Companies like Oscar and Clover arguably pose a serious threat to the status quo.  Oscar Health, widely seen as a leader in this new wave of companies, recently topped one million members and has reported north of $6 Billion in revenues for 2021. Clover Health, another new wave exemplar, targeting the lucrative Medicare Advantage (MA) segment, reported a 25% increase in its MA enrollment for this year.

They are growing fast, expanding their coverage areas (Oscar has recently expanded to cover 22 states), and successfully creating the impression that they leverage modern technologies, process automation and business cultures in ways that traditional health insurers have not.

However, the reality is that their customer experience innovations have not been particularly sophisticated, and many of the advantages they claim today – such as adopting mobile first strategies for member engagement — can be replicated by incumbent plans.

In fact, large health plans have been moving quickly to adopt new, digital customer experience technologies and business process automation (BPA), and the small- to mid-sized plans are poised to follow suit. Cultural change will likely be the toughest area for traditional health plans to transform, but technology may have a role to play there as well.

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