Although insurers can increase their distribution channels and service offerings, Open Insurance provides the ability to go even further by sharing their “core business” infrastructure. In other words, provide tools for managing health records or expense reimbursements.
Putting insurance architecture services on display
As long-standing insurers, the big companies have major know-how and resources dedicated to creating insurance services and capabilities. By opening up their information systems, they can make them available to other players and generate additional revenue from them. On the topic of APIs and infrastructure sharing, it is worth mentioning the initiative taken in France to offer health professionals online control over their patients’ rights and the pricing of innovative care packages, through the IDB/CLC or Visio V2 standards. Also worth noting is the example of Ping An, the world’s number one insurer. Thanks to its market strength, Ping An has become the leader in developing artificial intelligence and algorithms for the insurance sector.
Ping An has developed numerous modules for assessing damages in home and motor insurance, image recognition algorithms for preparing health diagnoses, etc. However, the Chinese giant has not decided to stand out from the competition by keeping this technological know-how to itself but by making it available to other insurers through its Ping An Technology subsidiary. This means that a health insurer that wants to get image recognition for preparing a diagnosis just has to connect via API to Ping An’s module and can benefit from this business infrastructure. Thanks to its Good Doctor subsidiary, Ping An has been able to provide numerous products - deemed strategic in the context of the Chinese health system for example - that could benefit other insurers:
- "Private Doctor”: with annual fees ranging from €140 to €1,000, users can access an unlimited number of online consultations, discounts on medicines and home delivery, medical appointment services and assisted visits to hospitals for seniors. Behind the online consultation, a doctor is supported by “AI Doctor”, an artificial intelligence algorithm developed by Ping An and enriched by diagnostics databases created by doctors and covering thousands of illnesses. Thanks to this algorithm, a doctor could eventually take on around 10,000 patients.- “One-minute Clinic”: a kind of photo booth in which the patient is diagnosed using “AI Doctor”. The voice data is analysed when the patient describes their symptoms and is combined with text data from their medical records. The medicines prescribed are automatically distributed (more than 100 categories of the most widely used medicines). If the medicines are not available via the vending machine, the patient can order them directly via the Good Doctor app for home delivery.
- “Pharmacy Cloud”: remote consultations are given via the WeChat app, as well as e-prescription services valid in pharmacies.
These services have been put together thanks to networks of health establishments and professionals across different regions of China, as well as in other countries such as Thailand, which is renowned for the quality of its doctors. All of these products ensure a comprehensive online care pathway for members of Ping An’s healthcare platform.
The “AI Doctor” algorithm could soon be shared with other insurers because Ping An has grasped the strategic benefit this can provide and takes advantage of it to adopt a new business model: being the leader in technology tools dedicated to insurance players. The company explains that eventually, 50% of revenue will be generated by the sale of its technology services.
Distributing management capacity for broadened insurance uses
To conduct the activities and services that make up their traditional value chain, insurers draw on human and material resources, as well as an ecosystem of partners specific to their business. APIsation will impact these ecosystems, particularly the management representatives ecosystem. By providing an alternative to current exchange standards this will facilitate dialogue between insurers and their representatives. Given the presence of disruptive new players on the market, it is therefore conceivable to share your business know-how and leverage it.
A financial cost could be levied when a player connects, via API, to the “healthcare expense reimbursement” technology component.
If you are interested in this topic, the Cegedim Insurance Solutions team is at your disposal to answer to all your questions.
