As medical costs continue to soar, traditional approaches to medical management are quickly becoming unsustainable. For many insurers, they already are.
A few US carriers in the approximately $60 billion workers’ compensation market are bucking the trend. They are taking advantage of digital technologies, analytics, and evidence-based decision-making tools to recoup some of the profits lost to medical inflation. By focusing on minimizing waste in six areas of medical management, these insurers are poised to reclaim economics, grow market share, and win over customers with better service. Others would be wise to follow their lead.
Accenture Strategy analyses have found that carriers that apply digital innovations and healthcare best practices can drive greater efficiencies, better outcomes and better financial performance. Specifically, they have the potential to:
Use analytics to embed code-driven, digitally automated medical necessity reviews.
Apply digitally enhanced procurement practices and a holistic approach to ecosystem management to optimize the network.
Use analytics, artificial intelligence and machine learning to eliminate provider fraud.
Adopt digital tools to improve administrative fee review processes.
Introduce or strengthen e-bill and electronic payment capabilities.