PMP, partner of the Cercle LAB Master Club, has contributed to BADASS, a production resulting from the work of exchanges, sharing and prospects.
Our partner in charge of the Insurance, Banking and Health Pole, contributed to the work of the Health Club, whose godmother was Isabelle Hébert, Managing Director of MGEN, as partner of the Cercle LAB, and alongside Mariona Vivar.
The theme of the 2019 Club was: “What profession for the complementary health insurer of tomorrow”?
In the BADASS, Marie-Sophie wrote an editorial in which she shares her vision on the possible evolution of the promise of health insurers, from a position of funding to an ambition of a health actor.
The tremendous promise of a healthy life
Supplementary health insurance has developed by making health expenditure not financed by Social Security financially. Over time these expenses have increased very significantly creating a very attractive market for insurers. But the cost of health care has reached a level requiring collective attention to the question of its control.
Initially, measures were devised by the public authorities to reduce the coverage by the OR, inducing a transfer of load to the RC. The cost of complementary health insurance having naturally increased significantly in line with these transfers and more generally with the growth in health expenditure, it has become essential to maintain the complementary coverage which was “universal” in fact (more than 95% of people covered) by forcing insurers to follow OR risk management policies in order to have an impact in terms of empowerment of both policyholders and healthcare professionals.
For complementary insurers, this induces a double strategic issue:
- Continue to be able to manage the framed complementary offers under viable financial conditions while bringing customer satisfaction to the customer,
- Contribute to imagining and embodying a new health model, by participating in its financing but also in its implementation.
Challenge n ° 1, ensure and manage additional health benefits
Health insurers, gradually reduced to delegated management, must develop treasures of inventiveness and performance to design offers that display some elements of differentiation, to make their financing possible and to win the battle for overall performance: to produce at best cost and offer the best customer experience. Digital and more generally new technologies are valuable tools to achieve this objective.
The contributory CMUc model should be viewed with extreme care as it could foreshadow a more general model.
Challenge n ° 2, design and make possible a new promise of “Healthy Life”
At the same time, it remains to imagine how to transform our health system, based on the freedom of health professionals and insured persons and on the obsession with the curative, towards a more sustainable and more efficient model. The prevention and organization of a more “continuous” health response in the territory between hospitalization and city medicine are at the heart of the debate.
Yesterday it was a question of financing the expenses of care of a sick person within the framework of an economy of “means”, tomorrow it will be necessary to organize a better management of health within the framework of an economy of “results “.
A great challenge for complementary insurers, optimizing the old model and contributing to the creation of a new system.
Marie-Sophie Houis Valletoux
