Digital ecosystems: health insurers multiply collaborations

In late January, insurers Groupe Mutuel, Helsana and Swica and healthcare groups Medbase and Hirslanden announced the creation of the Bluespace Ventures alliance and the launch of a common digital portal called Compassana. Through networking and information sharing between health actors and patients, the online platform aims to improve the coordination of health providers and the treatment decisions that the patient makes with their doctor. Features and standards that obviously bring to mind the computerized patient file decided many years ago and which is just beginning to be implemented in Switzerland. In an interview with ICTjournal, the CEO of the joint venture Peter Mittemeyer is, however, careful not to create a computerized file of the bis patient: “Compassana is a healthcare ecosystem and we deliberately emphasize integrated care. We want to offer hybrid healthcare services, combining digital and analog services. Our goal is not to replace the doctor or healthcare professional, but to give them digital support”.

The initiative is not isolated. In autumn 2020, health insurers CSS and Visana, telemedicine provider Medi24 (Allianz Care) and online pharmacy Zur Rose also decided to combine their skills on a common platform likely to open up to other players. And, last August, the partners completed their project with the launch of Well, a mobile application that gives access to 24-hour online consultations, electronic prescriptions, health information and recommendations and document management tools. “With our platform, our aim is to connect all the important players in the healthcare system and also to change it in a sustainable way.

This development is in the interest of the entire population with a view to simplified access to health services, but also to more efficient and therefore less costly processes”, explained Alexander Bojer, General Manager of the Well platform operator. Gesundheit AG.

health ecosystems

Several factors explain the emergence of these health ecosystems with a strong digital component developed by and around health insurers. First, insurers want to accelerate the digitization of the healthcare system expected by the population. According to Oliver Wyman’s “Digital DNA of Switzerland” study, a majority of Swiss people believe that the internet and technologies improve health and two-thirds of them trust hospitals, doctors and health insurance when it comes to healthcare. it’s about transmitting data to them. In Switzerland and around the world, this willingness to use health technologies has been further strengthened by the pandemic.

Furthermore, in addition to gains in efficiency and quality of care, the formation of ecosystems allows insurers to associate with actors with credible and complementary skills and services, in order to expand the offer of health care. In a report on the subject published last year (“The Untapped Potential of Health Ecosystems”), BCG distinguishes four delivery strategies that these alliances can develop:

  • Optimizing the treatment of a disease. Strategies may focus on treating and preventing specific indications, such as heart disease or cancer.

  • HAVEimprove life with illness. Strategies can go beyond the narrow framework of health care and include other areas of life, such as nutrition, housing, mobility or well-being, in order to improve the lives of patients with a specific pathology.

  • Improving processes in healthcare. Ecosystem strategies that can be leveraged to make healthcare processes more efficient and effective include electronic records and comprehensive telehealth offerings.

  • Promote a healthy lifestyle. The broader value proposition of a health ecosystem is to cover different areas of life, such as mobility or education, to promote a healthy lifestyle – with or without disease – including prevention and general health.

open innovation

Collaboration with start-ups is another means used by health insurers to inject innovation from outside and expand their offering. Since 2020, CSS has invested in active health start-ups through a specially created fund with 50 million francs. “We seek to bring their innovations to the company and create bridges with the business units”, explains Torsten Butz, responsible for innovation at the insurance company. Four start-ups benefit from the insurer’s support. They work in several fields: remote diagnosis, therapy against depression, health programs or even prevention of premature births.

Grupo Mutual is also interested in startups that develop digital solutions for women’s health (femtech). Rather than investing directly, the insurer launched the Tech4Eva acceleration program with EPFL last year. The 30 startups that participated in the first edition raised 60 million francs. In 2018, Groupe Mutuel also launched Innopeaks, an open innovation platform that combines incubator and accelerator. “We could invest in start-ups or co-opt them to offer new services, but this is not necessarily Groupe Mutuel’s primary objective. For our teams, there is also a common interest in collaborating closely with start-ups to delve into their way of working in order to accelerate internal innovation capabilities,” said then-project manager Nicolas Loeillot.

value-based health

Lyfegen is one of the companies that participated in the Innopeaks program. The Basel start-up, which has raised 3 million since its inception, is active in the field of value-based healthcare (VHBC). The field represents a profound change in the way therapeutic treatments are financed and, as such, is of great interest to insurers. The idea is that a treatment is paid according to its performance and therefore the value brought to the patient. And the approach is also based on collaborations and digital technologies and data.

Proof of this is that the Mutual Group signed a partnership in September to carry out a pilot project in the field with the University Hospital of Basel and the Hospital La Tour, for two types of intervention. “To measure the quality of interventions, project partners will rely, among other things, on questionnaire data related to patient-reported health outcomes. This principle consists of directly asking the patient about their health status and quality of life before and after treatment. The efficiency of the care provided will also be evaluated on the basis of the cost/benefit principle. To the extent possible, data will be analyzed across the entire patient care pathway, because the outcome of a treatment depends on multiple providers as well as their coordination,” the partners explain.

It is precisely to manage this measure and the corresponding reimbursements that Lyfegen’s solution comes into play. “Our patent-pending platform uses algorithms to collect and analyze patient drug cost data to execute complex pay-for-performance agreements between parties,” says Girisha Fernando, CEO of Young Shooting. Lyfegen recently signed a contract with the health insurer Sympany, but also with the Swiss subsidiary of Johnson & Johnson for medical equipment. In addition, the value-based healthcare model and the technologies it is based on can be decisive in reaching reimbursement agreements for expensive treatments with uncertain outcomes, such as certain gene therapies. A new kind of digital collaboration for the benefit of the pharmaceutical industry, insurers… and patients.

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