The health insurance sector stands apart from Life or P&C insurance because of its unique model and number of stakeholders. Its challenges are sector specific: a fragmented ecosystem, margin pressures, regulatory uncertainty, and disjointed data access for stakeholders. However digital tools and data analytics appear to be addressing some of these long-time challenges. While technologies such as RPA, AI, the blockchain, and advanced analytics are acting as levers to enhance both the top-line as well as the bottom-line for health insurers, APIs and emerging InsurTech firms are creating a more streamlined and integrated healthcare ecosystem. This report explores the top-10 technology trends that will impact health insurance firms’ strategic planning.

1. Top 10 Technology Trends in
Health Insurance: 2018
November, 2017

2. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved.Health Insurance Trends 2018 | December 2017 © 2017 Capgemini. All rights reserved. 2
Top 10 technology trends in health insurance in 2018
Cloud
Competition
from Providers
Social
Media
Wearables
RPA and AI Blockchain API
Predictive and
Behavioral Analytics
Value-based
Analytics
InsurTech
Customer
Experience
Orientation
Digital
Analytics

3. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved.Health Insurance Trends 2018 | December 2017 © 2017 Capgemini. All rights reserved. 3
Provider competition spurs insurers’ focus on
customer convenience for ensuring customer retention
Comparative Advantages of Providers Comparative Advantages of Health Insurers
Clinical data
Cost
More customer touchpoints
Actuarial capabilities
Underwriting expertise
Claims expertise
To gain a competitive edge, health insurers should develop greater customer centricity by exploring innovative
offerings and value-added services
Source: Capgemini Financial Services Analysis, 2017;

4. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved.Health Insurance Trends 2018 | December 2017 © 2017 Capgemini. All rights reserved. 4
Having an effective social media strategy is
becoming an important priority for health insurers
Source: Capgemini Financial Services Analysis, 2017;
Social Media
Strategy
 Consumer sentiment data
 Customer life-style need data
 Social listening
 Customer engagement
 Improving public relation
 Customer engagement
 Customer education
 Expanding customer reach
 Customer engagement

5. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved.Health Insurance Trends 2018 | December 2017 © 2017 Capgemini. All rights reserved. ‹#›
Health insurers are leveraging wearables to gather
real-time data for enhanced customer engagement
Source: Capgemini Financial Services Analysis, 2017; http://www.marketsandmarkets.com/PressReleases/wearable-electronics.asp
Proactive risk mitigationPersonalized offerings
Timely alert notifications Personalized pricing
$51.6
bn
Estimated size of the
wearables market by
2022

6. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 6© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
Health insurers are using RPA and AI to enhance
operational efficiency and customer experience
Source: Capgemini Financial Services Analysis, 2017;
Applications of
RPA and AI
Health
plan
consulting
Customer
health
management
Claims
management
Streamlined
policy
application
Agent
empowerment

7. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 77© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
Health insurers see strong potential in Blockchain for
secure, transparent, and seamless services
Source: Capgemini Financial Services Analysis, 2017; https://www.newswire.com/files/16/40/321b6089f1b01dfd80433bffb0df.pdf
Patient data security
Lower third-party dependencies
Better availability of health records
Increased process efficiencies
70%
Proportion of surveyed
health insurers that
expect blockchain to
be integrated into
their systems

8. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 8© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
APIs are enabling enhanced data management for
healthcare players by connecting diverse systems
Source: Capgemini Financial Services Analysis, 2017;
Patient Eligibility Verification
HIPAA Compliance
Digital Claims Management
Provider Directory Compliance
Population Health Data Access

9. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 9© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
Predictive and behavioral analytics enable better risk
mitigation, fraud detection, and customer insights
Source: Capgemini Financial Services Analysis, 2017;
Predictive and
Behavioral Analytics
Targeted preventive care
and customer engagement
Anticipating future
customer needs for
personalized offerings, up-
sell, and cross-sell
Mitigating fraudulent
behavior by checking for
patterns and data analysis

10. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 10© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
Shift to value-based payment model will open
up new opportunities for analytics in healthcare
Source: Capgemini Financial Services Analysis, 2017;
Payer and
Provider
Collaboration

11. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 11© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
InsurTech firms are creating a more streamlined,
integrated, and digitized healthcare ecosystem
Source: Capgemini Financial Services Analysis, 2017;
Customers
Providers
Employers
Brokers,
Exchanges
Payers
Connect
 Automated
underwriting
 Digital
enrollments
 Digital
payments
 Network
integration
 Data
aggregation
 Multiple
technology
integration
Streamline

12. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved. 12© 2017 Capgemini. All rights reserved. ‹#›Health Insurance Trends 2018 | December 2017
Cloud is gradually becoming a key infrastructure
component for health insurers
Source: Capgemini Financial Services Analysis, 2017;
Ability to manage real-time data sources
Optimization of operating costs
Efficient regulatory compliance
Flexible computing resources
Easier infrastructure management
Anytime, anywhere access to data from multiple sources

13. Capital Markets Trends 2018| December 2017 © 2017 Capgemini. All rights reserved.
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