Accessing care in a globally mobile world
When abroad, finding the right care can be complex and the consequences of not receiving it can be medically and financially costly.
International private medical insurance providers have historically included access to primary care as part of their benefit structure. But this has not always been a guarantee of access to the very best medical facilities, especially for insured members in remote locations, and the related impact in terms of overall claims expenditure is becoming more and more severe.
The role of telemedicine
This challenge has been partly mitigated by technology: telemedicine or virtual GP services allow the member to have a remote consultation with a GP or consultant through their mobile device, and the convenience offered by these services means that remote employees, or those in more rural locations are obvious beneficiaries.
But even those in urban areas will save time and minimise claims by not having to visit a face-to-face GP – especially for routine consultations.
In the USA, telemedicine has been prevalent for many years and there are currently around 200 telemedicine networks, with 3,500 service sites.
A 2014 Towers Watson survey found that 37% of employers planned to offer their workers telemedicine consultations in 2015, with another 34% planning to do so by 2017.
It is expected that the use of telemedicine will continue to increase globally. In the UK the NHS has begun to pilot its own telemedicine service in some regions and many UK insurers now incorporate some form of virtual GP into their offering.
The flexibility of telemedicine means it holds great potential for the international insurance market, but operating globally does present additional challenges.
How, for example, can telemedicine efficiently serve the needs of a multinational and multilingual member base? How will cultural differences need to be taken into account and what additional IT infrastructures will be needed to offer the required operational agility and excellence of service a globally mobile workforce needs?
Finding a specialist
A further, fundamental challenge insurers must face is the provision of quality secondary care, by managing member’s experience around finding a specialist consultant.
Firstly, unless you have a ‘named referral’, the decision of who to book an appointment with might turn into an overwhelming issue for many. So some insurers offer a concierge specialist booking service, by sourcing the appropriate specialist and arranging an appointment for the member.
More commonly than a concierge service, insurers provide mobile applications or online portals that list the insurers’ ‘in-network’ medical facilities. This allows the member to choose a facility themselves, make contact and book an appointment in a convenient, user friendly way.
Global networks
The quality and degree of integration of a fully managed global network of hospitals and doctors are often among the defining attributes of an international insurer’s value proposition.
Such networks provide members with access to pre-vetted hospitals and clinics around the world, with reassurance of care quality and practical benefits such as cashless treatment (where the hospital settles the bill directly with the insurer).
From an employer’s point of view, not only do networks make it more certain that their employees are getting the level of healthcare they need, but treatment fees are also pre-negotiated meaning that healthcare costs are better managed, which ultimately affects premiums.
Finally, it’s not just the act of finding and booking a consultant that can be a problem for members. Especially in case of serious medical conditions, many members are naturally inclined to question the treatment plan or referral they’ve been given.
For this, insurers may provide a ‘second opinion service’. These are independent advisory services that provide reassurance for those wanting to confirm a diagnosis or understand a recommended course of treatment, by providing access to different specialists for an alternative assessment.
The importance of choice
Whilst there are many ways insurers can guide their members, ‘choice’ is also fundamental to getting them to the ‘right’ care. So, whilst the extensiveness of an insurers network will minimise the need to use any other facility, what’s best for the member might be accommodated in a hospital outside of the network, in which case an ‘open access’ policy, giving the member the choice of any hospital, is key.
Marco Giacomelli is head of Generali Global Health.
This article was provided by Generali.
In partnership with Generali Employee Benefits Network
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