The doctor of the future will give no medicine

Insurance is the idea that someone can purchase a service that mitigates their risk in the event of an unforeseen problem.

Premiums paid by policyholders are pooled so that the financial impact of a single event doesn’t wipe out a household or organization.

But with health insurance, and unlike insurance that covers risk for catastrophes or big-ticket items, health insurance covers everything from minor cuts and routine visits to organ replacement and accidents. So it’s like a car insurance plan that covers flat tires and petrol refills, not just collisions.

And complicating matters, the employer/company pays the premium so the individual’s share is low and the tendency to overuse health services is high.

When we think about the future of health insurance we wonder about how far into the horizon we are looking.

I believe that very very far into the future health insurance will cease to exist altogether. If we do our work right, members will have control over their own health, educated and aware and their paying for healthcare will be so granular and personalised that they cover it individually without need for pooling money across populations.

Thomas Edison writing in 1903 said that the doctor of the future will give no medicine.

We've had some really interesting discussions around the future of value-based care or pay for quality, and the regulations allowing reimbursement of technological advances. These are certainly in our medium-term future.

But I’ve chosen to speak to you about those technology advances laying the ground-work allowing healthcare insurance to be reimagined.

1. Metaverse to remotely deliver primary care to connected members
2. Blockchain to manage smart insurance contracts
3. Artificial Intelligence to manage claims fraud, waste and abuse

?1.??????Metaverse to remotely deliver primary care to connected members

April 1924 The Radio Doctor

The use of a television, microphone and monitoring devices to communicate from doctor to patient - named the?Radio Doctor

April 2024 The Metaverse Doctor

The use of VR/AR offering an immersive and engaging experience, and remotely connected wearables for diagnostic and digital twin for therapeutic.

Virtual doctor visits

Wearables for continuous health monitoring and diagnostics

Digital twin for therapeautics

2.??????Blockchain to manage smart insurance contracts

Egyptian records reveal that medicine was being practised in its many forms, from surgery to general medicine and even dentistry, more than 4000 years ago

Medical records blockchain will enhance an insurance company’s dealings with providers, intermediaries, and policyholders, thereby improving the customer experience, enhancing product value, and laying the groundwork for greater consumer choice in the market.

• Moving towards interoperable, comprehensive health records
• The added security and ability to establish trust between entities are two reasons why this technology can help solve the interoperability problem better than today’s existing technologies.?
• Supporting administrative and strategic imperatives with smart contracts
• Blockchain could automatically collect records of agreements, transactions, and other valuable information sets, then link together the information and act on the data using smart contracts.
• Improving provider directory accuracy
• Unique provider directories could leverage the technology’s decentralized consensus protocols to allow providers and insurers to update listings more quickly and easily.
• Simplifying the application process by making it more client-centric
• Providing an easier-to-access, more comprehensive set of medical records on a blockchain could infuse comfort and peace of mind into what, for many, is now an intrusive and often discouraging application process.
• Facilitating a dynamic insurer/client relationship
• Electronic health records securely stored on a smart contract could be the foundation for integrating a wide variety of wellness-related behaviors into the insurer/client dynamic.

?3.??????Artificial Intelligence to manage claims fraud, waste and abuse

The foundational infrastructure of healthcare claims system hasn’t been updated in decades. Most insurers’ core operations rely on technology built in the 70’s and 80’s

???????Automate the process of validation

???????Improve the productivity of the team

???????Increase the quality and productivity of the validation process

Artificial intelligence-powered medical claims auditing and reviewing platform, which helps you to adjudicate, audit, and review claims and prior approvals more efficiently, by automating the process and supporting faster and more robust decision-making.

using a hybrid model of continuously evolving rule-based and machine-learning algorithms to detect and analyze each service in the claims

???????Ability to customize the data and filter it before processing and validation.

???????All of that is powered by advanced analytics and AI models.

The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease

1903 Thomas Edison