Transformations in Global Private Health Insurance Models

Transformations in Global Private Health Insurance Models

Innovations and Strategy Considerations

RELEASE DATE
15-Jun-2016
REGION
Global
Research Code: K09B-01-00-00-00
SKU: HC02648-GL-MR_18667
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Description

Healthcare as an industry is entering a phase of rapid transformation. Institutions across the stakeholder spectrum including health insurers, providers, and therapeutic developers face the proposition of adapt or collapse. The health insurance industry particularly is evaluating all aspects of its business models, policy holder engagement, and plan structures. Among the most disruptive changes occurring to private insurance include: Consumerism, Big Data & Analytics, Chronic Disease Prevention/ Management, mHealth Tools, and Transition to Value-Based Compensation. This study provides health insurers with an overview of the global private health insurance markets, including trends, innovation case studies, potential innovation avenues, future trends watch as well as potential partners.

Table of Contents

Need for Health Insurance

Trends

Innovation

Future

Geographic Coverage

Market Definitions

Private Health Insurance Markets Covered

Comparison between Healthcare expenditures and the Income

Growing Need for Health Insurance

Current Insurance Innovation Scenario

The Current Focus of the Insurance Innovation Scenario

Health Insurance Innovation Imperatives

Insurance executives’ responses to “Where do growth opportunities lie?”*

Innovation Process

List of Figures
  • 1. Global Per Capita Total Expenditure on Health
  • 2. Health Insurance Coverage by Type, Most Recent
  • 3. Private Health Insurance Coverage by Type, Most Recent
  • 4. Percent Population Covered by Health Insurance
  • 5. Private Health Insurance Potential, Global
  • 6. Total Private Health Insurance Market: Revenue Breakdown by Geographic Region, Global, 2015
  • 7. United States— Distribution Channels & Innovation Scale
  • 8. Europe - Distribution Channels & Innovation Scale
  • 9. China - Distribution Channels & Innovation Scale
  • 10. India - Distribution Channels & Innovation Scale
  • 11. Southeast Asia - Distribution Channels & Innovation Scale
  • 12. Brazil - Distribution Channels & Innovation Scale
  • 13. Africa - Distribution Channels & Innovation Scale
  • 14. Geographical Spread of Health Microinsurance
  • 15. Private Health Insurance: Medical Cost Inflation, Global, 2015 and 2016
  • 16. Private Health Insurance: Percentage of Employers Requiring Employee Contribution for Medical Premiums, Global, 2015
  • 17. Private Health Insurance: Percentage of Employers Requiring Employee Contribution for Medical Premiums, Global, 2015
  • 18. Private Health Insurance: Wellness Programs Offered by All and Leading Employers, Global, 2015
  • 19. Private Health Exchange Lives Covered*, US, 2015-2018
  • 20. Uninsured Proportion of Total Population
  • 21. Average adoption of fully electronic transactions among measured transactions
  • 22. OECD Country Rankings by Insurance Coverage
  • 23. Countries with no Private Insurance, Global, 2013
Healthcare as an industry is entering a phase of rapid transformation. Institutions across the stakeholder spectrum including health insurers, providers, and therapeutic developers face the proposition of adapt or collapse. The health insurance industry particularly is evaluating all aspects of its business models, policy holder engagement, and plan structures. Among the most disruptive changes occurring to private insurance include: Consumerism, Big Data & Analytics, Chronic Disease Prevention/ Management, mHealth Tools, and Transition to Value-Based Compensation. This study provides health insurers with an overview of the global private health insurance markets, including trends, innovation case studies, potential innovation avenues, future trends watch as well as potential partners.
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Table of Contents | Executive Summary~ | Health Insurance - Key Findings~ || Need for Health Insurance~ || Trends~ || Innovation~ || Future~ | Scope and Segmentation~ || Geographic Coverage~ || Market Definitions~ || Private Health Insurance Markets Covered~ | Future Perspectives—3 Big Predictions~ | Perspectives on Healthcare and Insurance~ || Comparison between Healthcare expenditures and the Income~ || Growing Need for Health Insurance~ | Health Insurance Around the World~ | Health Insurance Classification~ | Public Health Insurance – Coverage Models~ ||| Beveridge Model~ ||| Bismarck Model~ ||| National Health Insurance Model~ ||| No Insurance/OOP Model~ | Private Health Insurance~ ||| Market Background~ ||| Types of Private Health Insurance~ | Distribution in Select Major Economies~ | Primary~ | Duplicate~ | Complementary~ | Supplementary~ | Distribution Channels Employed Globally~ ||| In-Person~ ||| Partnership~ ||| Convenience~ ||| Mass Outreach~ ||| Distinct Formats~ | Types of Health Insurance Plans~ ||| Major Health Insurance~ ||| Catastrophic Plans~ ||| Ancillary Plans~ | Global Diversity in Health Insurance Coverage~ | Countries with UHC~ | OECD Countries Health Insurance Coverage~ ||| Health Insurance Coverage by Type, Most Recent~ ||| Private Health Insurance Coverage by Type, Most Recent~ | Percent Population Covered by Health Insurance - Countrywise~ | Private Health Insurance Potential, Global~ | Market Overview~ | Private Health Insurance - Market Perspective~ ||| Total Private Health Insurance Market: Revenue Breakdown by Geographic Region, Global, 2015~ | Market Overview – By Region~ ||| United States~ ||| Europe~ ||| China~ ||| India~ ||| Southeast Asia~ ||| Brazil~ ||| Africa~ | Global Trends in Health Insurance~ | Macro Trends Impacting the Global Health Insurance Industry~ ||| Underwriting strain~ ||| Consumerism in health~ ||| Rise of big data analytics~ ||| Chronic disease pressure~ ||| Transition to value-based Care~ ||| Digital technology lever~ | An insurance format designed specifically for the low-income segment~ ||| Traditional Insurance~ ||| Micro insurance~ | Geographical Spread of Health Micro insurance across Countries~ | Private Health Insurance: Medical Cost Inflation, Global, 2015 and 2016~ | Private Health Insurance: Percentage of Employers Requiring Employee Contribution for Medical Premiums, Global, 2015~ | Private Health Insurance: Wellness Programs Offered by All and Leading Employers, Global, 2015~ | Employer Insurance Trends across countries~ | US Hospital/Health System View~ ||| Drivers~ ||| Impact~ ||| Requirement~ ||| Action~ ||| Success Stories~ | Interest Trends – 2016 ~ ||| Japan, The M&A Powerhouse~ ||| Easy Cash~ ||| Revenue~ ||| Modernization~ ||| Overseas Expansions~ | Private Health Exchange Lives Covered*, US, 2015-2018~ | Health Insurance Exchanges~ ||| Exchange Types~ ||| Sponsors~ ||| Plan Types~ ||| Segments~ ||| Employer Attractiveness~ ||| Payer Concerns~ | Adjunct Insurance Sector Trends~ | Peer-to-Peer (P2P) Insurance~ ||| Rise of the P2P Insurance Concept~ ||| Traditional Models of Community ‘Insurance’ ~ ||| Insurance Brokers~ |||| Company~ |||| Region~ |||| Insurance Line~ | Upcoming Social/P2P/Crowdsourcing Insurance Companies~ ||| Hudddle - Australia~ ||| PeersMutual Protection - China~ ||| LFN - France~ ||| PeerSure - South Africa~ ||| So Sure - United Kingdom~ ||| Others | Innovation in Health Insurance~ || Current Insurance Innovation Scenario~ ||| Rising consumerism~ ||| Why Innovation~ || The Current Focus of the Insurance Innovation Scenario~ || Health Insurance Innovation Imperatives~ ||| POLITICAL~ ||| ECONOMIC~ ||| SOCIAL~ ||| TECHNOLOGICAL~ ||| LEGAL~ || Insurance executives’ responses to “Where do growth opportunities lie?”*~ || Innovation Process~ ||| Agents~ ||| Startups~ ||| Customers~ ||| Travel~ ||| Retail~ | Today’s Health Insurance Environment~ | Disparities in Health Insurance Innovation Focus~ | Market Environment~ | Insurance Coverage Challenges~ | Health Insurance Innovations~ | Voluntary Dengue Fever Insurance~ | Telehealth + Micro insurance Product~ | Mobile Micro insurance~ | Better Care at Lower Cost~ | Technology & Transparency in Insurance~ | House Calls~ | Marketing Campaign~ | Health Products Marketplace~ | Free Apple Watch~ | Motion Wellness Program~ | Tying Bonuses to Health Outcomes~ | Solutions for Caregivers~ | Insurer-Provider Partnership~ | Integrated Care Delivery~ | Optimizing Care Interventions~ | Simplifying Insurance~ | Adjunct Sector Innovations~ | HIV+ Life Insurance Cover~ | Connected Home Insurance~ | Effective Digital Use~ | Disruptive Models (Adjunct Sectors)~ | Insurance for the Deductible ~ | Crowdsourced Life Insurance~ | Vending Machine Insurance~ | Potential Innovation Avenues~ | Usage-based… Health Insurance?~ | Using Data to Transform Care Delivery~ | Claims Processing~ | Increasing Patient Engagement~ | Real-Time Fraud Detection~ | Machine Learning~ | Future Trends Watch~ | Wearables for the Quantified Self~ | Cybersecurity—The Anthem Case Study~ | Mobile Payments~ | Telehealth~ | Big Data Analytics~ | Medicine and Technology Advances~ | Potential Future Partners for Health Insurance~ | Member Services~ | We Savvy~ | Fit sense~ | Quantifyle~ | Health engine~ | Medlanes~ | Stride~ | Edaman~ | Healthmine~ | Process Enhancements~ | Social Intelligence ~ | Insurance Social media~ | Co Vi Analytics~ | My Nexus~ | Rx Ante~ | Partners for Employers~ | Limelighthealth~ | JIH~ | Lumity~ | Healthagen~ | Dacadoo~ | Health Insurers’ Future~ | Essential Characteristics for Tomorrow’s Payer~ | The Private Health Insurer Roadmap~ | Future Health Insurance Scenario~ | Conclusion~ | 3 Big Predictions~ | Concluding Thoughts~ | Appendix~ | Innovations Index~ | The Frost & Sullivan Story - The Journey to Visionary Innovation~ | Emerging research~ | Growth Partnership~ | Visionary Innovation~ | Value Proposition: Future of Your Company & Career~ | Global Perspective~ | Industry Convergence~ | 360º Research Perspective~ | Implementation Excellence~ | Our Blue Ocean Strategy - Collaboration, Research and Vision Sparks Innovation~
List of Charts and Figures 1. Global Per Capita Total Expenditure on Health~ 2. Health Insurance Coverage by Type, Most Recent~ 3. Private Health Insurance Coverage by Type, Most Recent~ 4. Percent Population Covered by Health Insurance~ 5. Private Health Insurance Potential, Global~ 6. Total Private Health Insurance Market: Revenue Breakdown by Geographic Region, Global, 2015~ 7. United States— Distribution Channels & Innovation Scale~ 8. Europe - Distribution Channels & Innovation Scale~ 9. China - Distribution Channels & Innovation Scale~ 10. India - Distribution Channels & Innovation Scale~ 11. Southeast Asia - Distribution Channels & Innovation Scale~ 12. Brazil - Distribution Channels & Innovation Scale~ 13. Africa - Distribution Channels & Innovation Scale~ 14. Geographical Spread of Health Microinsurance~ 15. Private Health Insurance: Medical Cost Inflation, Global, 2015 and 2016~ 16. Private Health Insurance: Percentage of Employers Requiring Employee Contribution for Medical Premiums, Global, 2015~ 17. Private Health Insurance: Percentage of Employers Requiring Employee Contribution for Medical Premiums, Global, 2015~ 18. Private Health Insurance: Wellness Programs Offered by All and Leading Employers, Global, 2015~ 19. Private Health Exchange Lives Covered*, US, 2015-2018~ 20. Uninsured Proportion of Total Population~ 21. Average adoption of fully electronic transactions among measured transactions~ 22. OECD Country Rankings by Insurance Coverage~ 23. Countries with no Private Insurance, Global, 2013~
Author Siddharth Shah
Industries Healthcare
WIP Number K09B-01-00-00-00
Keyword 1 Private Healthcare
Keyword 2 Private Health Insurance Model
Keyword 3 Private Health
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