Transformations in Global Private Health Insurance Models

Innovations and Strategy Considerations

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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

1. Executive Summary
2. Health Insurance - Key Findings
Need for Health Insurance
Trends
Innovation
Future
3. Scope and Segmentation
Geographic Coverage
Market Definitions
Private Health Insurance Markets Covered
4. Future Perspectives—3 Big Predictions
5. Perspectives on Healthcare and Insurance
Comparison between Healthcare expenditures and the Income
Growing Need for Health Insurance
6. Health Insurance Around the World
7. Health Insurance Classification
8. Public Health Insurance – Coverage Models
Beveridge Model
Bismarck Model
National Health Insurance Model
No Insurance/OOP Model
9. Private Health Insurance
Market Background
Types of Private Health Insurance
10. Distribution in Select Major Economies
11. Primary
12. Duplicate
13. Complementary
14. Supplementary
15. Distribution Channels Employed Globally
In-Person
Partnership
Convenience
Mass Outreach
Distinct Formats
16. Types of Health Insurance Plans
Major Health Insurance
Catastrophic Plans
Ancillary Plans
17. Global Diversity in Health Insurance Coverage
18. Countries with UHC
19. OECD Countries Health Insurance Coverage
Health Insurance Coverage by Type, Most Recent
Private Health Insurance Coverage by Type, Most Recent
20. Percent Population Covered by Health Insurance - Countrywise
21. Private Health Insurance Potential, Global
22. Market Overview
23. Private Health Insurance - Market Perspective
Total Private Health Insurance Market: Revenue Breakdown by Geographic Region, Global, 2015
24. Market Overview – By Region
United States
Europe
China
India
Southeast Asia
Brazil
Africa
25. Global Trends in Health Insurance
26. 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
27. An insurance format designed specifically for the low-income segment
Traditional Insurance
Micro insurance
28. Geographical Spread of Health Micro insurance across Countries
29. Private Health Insurance: Medical Cost Inflation, Global, 2015 and 2016
30. Private Health Insurance: Percentage of Employers Requiring Employee Contribution for Medical Premiums, Global, 2015
31. Private Health Insurance: Wellness Programs Offered by All and Leading Employers, Global, 2015
32. Employer Insurance Trends across countries
33. US Hospital/Health System View
Drivers
Impact
Requirement
Action
Success Stories
34. Interest Trends – 2016
Japan, The M&A Powerhouse
Easy Cash
Revenue
Modernization
Overseas Expansions
35. Private Health Exchange Lives Covered*, US, 2015-2018
36. Health Insurance Exchanges
Exchange Types
Sponsors
Plan Types
Segments
Employer Attractiveness
Payer Concerns
37. Adjunct Insurance Sector Trends
38. Peer-to-Peer (P2P) Insurance
Rise of the P2P Insurance Concept
Traditional Models of Community ‘Insurance’
Insurance Brokers
Company
Region
Insurance Line
39. 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
40. Today’s Health Insurance Environment
41. Disparities in Health Insurance Innovation Focus
42. Market Environment
43. Insurance Coverage Challenges
44. Health Insurance Innovations
45. Voluntary Dengue Fever Insurance
46. Telehealth + Micro insurance Product
47. Mobile Micro insurance
48. Better Care at Lower Cost
49. Technology & Transparency in Insurance
50. House Calls
51. Marketing Campaign
52. Health Products Marketplace
53. Free Apple Watch
54. Motion Wellness Program
55. Tying Bonuses to Health Outcomes
56. Solutions for Caregivers
57. Insurer-Provider Partnership
58. Integrated Care Delivery
59. Optimizing Care Interventions
60. Simplifying Insurance
61. Adjunct Sector Innovations
62. HIV+ Life Insurance Cover
63. Connected Home Insurance
64. Effective Digital Use
65. Disruptive Models (Adjunct Sectors)
66. Insurance for the Deductible
67. Crowdsourced Life Insurance
68. Vending Machine Insurance
69. Potential Innovation Avenues
70. Usage-based… Health Insurance?
71. Using Data to Transform Care Delivery
72. Claims Processing
73. Increasing Patient Engagement
74. Real-Time Fraud Detection
75. Machine Learning
76. Future Trends Watch
77. Wearables for the Quantified Self
78. Cybersecurity—The Anthem Case Study
79. Mobile Payments
80. Telehealth
81. Big Data Analytics
82. Medicine and Technology Advances
83. Potential Future Partners for Health Insurance
84. Member Services
85. We Savvy
86. Fit sense
87. Quantifyle
88. Health engine
89. Medlanes
90. Stride
91. Edaman
92. Healthmine
93. Process Enhancements
94. Social Intelligence
95. Insurance Social media
96. Co Vi Analytics
97. My Nexus
98. Rx Ante
99. Partners for Employers
100. Limelighthealth
101. JIH
102. Lumity
103. Healthagen
104. Dacadoo
105. Health Insurers’ Future
106. Essential Characteristics for Tomorrow’s Payer
107. The Private Health Insurer Roadmap
108. Future Health Insurance Scenario
109. Conclusion
110. 3 Big Predictions
111. Concluding Thoughts
112. Appendix
113. Innovations Index
114. The Frost & Sullivan Story - The Journey to Visionary Innovation
115. Emerging research
116. Growth Partnership
117. Visionary Innovation
118. Value Proposition: Future of Your Company & Career
119. Global Perspective
120. Industry Convergence
121. 360º Research Perspective
122. Implementation Excellence
123. Our Blue Ocean Strategy - Collaboration, Research and Vision Sparks Innovation


List of Figures & Charts

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



Keyword1
private healthcare
Keyword2
private health insurance model
Keyword3
private healthcare

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