Why insurance companies need to start using Health Intelligence to accelerate underwriting and innovate faster
By Nick Zambruno, Insurance Solution Lead at Human API
In this article, I share why insurance companies need to start using health intelligence to accelerate underwriting and drive faster innovations.
We’re living in a time where we have access to the world’s information at our fingertips. A few taps on our devices can take us anywhere online in nanoseconds. Each digital interaction generates information about what we’re doing and where we’re at in a particular moment. This data is continually captured in our daily lives and increasingly used to engage us in new ways, and it’s also happening with our healthcare data. According to a recent article by RBC Capital Markets:
“Every second, an exponential amount of healthcare data is generated and mined for valuable insights. Today, approximately 30% of the world’s data volume is being generated by the healthcare industry. By 2025, the compound annual growth rate of data for healthcare will reach 36%. That’s 6% faster than manufacturing, 10% faster than financial services, and 11% faster than media & entertainment.”
As open health data access continues to gain massive momentum, supported by emerging technologies, growing adoption of the new FHIR standard, and federal regulations, there’s a looming opportunity to power new services and products for many different industries, including life insurance.
Life insurance underwriting today is a pivotal part of the insurance buying journey, yet it’s still largely a lengthy and manual process requiring expert underwriters to review a large amount of medical information for each case. Faced with legacy constraints, workflows, and APS retrieval which takes on average 15 days to secure, insurers are burdened with processes preventing them from delivering digital experiences to meet modern consumer expectations. And although electronic health records (EHRs) adoption is increasing across the industry, the attending physician statement (APS) is still the “gold standard” being used to assess the mortality risk of individual applicants.
The reality is there’s already an abundance of valuable information stored within EHRs today which can empower underwriters and underwriting teams to make more decisions faster, without compromising risk. The challenge for carriers is in being able to ingest and parse through large volumes of digital health data in a timely manner, especially given the rising number of accelerated underwriting programs which can force carriers to balance risk and speed.
Going Beyond Accessing Health Data to Using Health Intelligence
After working closely with our insurance customers the last several years, we’ve learned data access is just one of the first steps on a true underwriting transformation journey. More health data such as EHRs are being made available to insurers and consumers every single day due to both private investments and public regulations. As health data access becomes commoditized, carriers are moving from focusing on data collection to data usage and are actively looking for ways to get better at using available data.
While digital data sources such as EHRs provide a much faster path to securing health data, it’s still a relatively new data source with a different format compared to the traditional APS. This variance can create some friction in the adoption and application of EHRs in underwriting workflows. To get the most value out of EHRs, medical information needs to be structured and presented in an organized format to align with the specific use case. For example, when looking at an EHR on a “for cause” case, a valuable report shouldn’t just present the raw history but will instead make it easier and faster for the underwriter to understand the progression of the key impairments driving risk.
The solution lies in creating health intelligence from aggregated EHR and APS data. Health intelligence is actionable information structured and presented at the right time, in the right context, to the right underwriter to accelerate underwriting decisioning without compromising risk. Carriers able to analyze EHRs and empower their teams with this insight will be able to improve the success of accelerated underwriting by simplifying the review process. This “health intelligence” created from EHRs maximizes the utility of all available medical data by presenting the right information, in the right context, at the right time.
By applying health intelligence within existing workflows and processes, insurers have the chance to deepen competitive advantages, reduce cycle times, drive higher revenue growth, and improve customer engagement. Health intelligence helps underwriting professionals work with more efficiency by amplifying their expertise with information to simplify decisioning, as extracting the true story of an applicant’s medical history and the progression of their impairments can be time-intensive and difficult with traditional medical evidence. What’s the true mortality risk of this insurance applicant with a key diagnosis? How is their health trending over the last 5 years? These are just examples of questions underwriters can quickly answer if the right information is presented to them programmatically, resulting in better decisions in less time without compromising risk. As digital distribution channels continue growing due to modern consumer demand, health intelligence holds the potential to improve and sustain accelerated underwriting success and power better customer journeys at scale.
Health intelligence for life insurers also holds the potential to deliver new value in many use cases by making it easier to get to desired outcomes faster. For underwriters, it may be an underwriting decision or risk classification. For consumers, it may be behaviors which help them get healthier and insights into what they should keep a closer eye on. By aggregating a critical mass of structured and normalized EHR data, carriers can use actionable intelligence to improve the customer experience throughout the entire policy lifecycle.
Using Health Intelligence to Power People, Process, and Technology
Moving beyond accessing data to using intelligence to streamline workflows and processes and better serve customers is a shift well underway in most major industries. Technology giants such as Netflix and Amazon have mastered how to apply intelligence created from data to align these people, processes, and technology to innovate and consistently grow market share. And while health intelligence will not fully automate all aspects of underwriting or solve all operational inefficiencies, it will amplify the impact organizational functions can deliver by providing actionable information in the right use case to optimize business outcomes.
Health intelligence operates best at the intersection between people, process and technology to drive organizational change and innovation.
Using EHR data in new analytical ways will help carriers grow their business by improving all aspects of the customer journey, from acquisition through in-force engagement. By ingesting health data programmatically, carriers can create and use health analytics to identify the best data sources for each product and customer over time. Speed to data and depth of data are two characteristics of medical evidence orders that carriers have to manually balance and orchestrate with EHRs data sources and the APS. By analyzing the data in medical orders and their impacts on underwriting decisions and placements over time, insurers can help their underwriting teams make decisions faster by automating evidence retrieval and delivery of the best available information for an applicant or product.
With health analytics at the population level, carriers can gain deeper insight into which distributors are sending more preferred applicants (and identify ways to replicate that success), grow the volume of preferred customers from distribution channels, and better understand which health data sources are providing the best data for each product. Building on this knowledge, carriers can optimize their medical retrieval to leverage data sources best fit for each product and customer, delivering a fast, personalized and digital shopping experience that modern consumers want without adding risk. This continuous feedback loop allows health intelligence to be applied across the organization to optimize workflows and processes - driving lasting business growth.
