How insurer DKV acts as a healthcare partner for its customers
How can an insurer offer customers support and relieve them of worries in their healthcare journey? Hervé Bourel, Chief Commercial Officer at DKV, explains how Belgium's best-known healthcare insurer is adapting to the needs of its customers. He also shares his advice on the evolution of Belgian healthcare.
If you look at a patient's journey, what are the greatest needs in our country at the moment for people who have a health problem?
With health problems, one of the first tasks is to find a suitable doctor and treatment. Which doctor has the right specialisation and experience? Which treatment provides the best proven results? It's not always easy for patients to find answers to these questions.
What's more, the price of healthcare is also evolving. I'm thinking, for example, of the fee supplements charged by many specialists and the additional costs if the patient opts for a single room in a hospital.
Obstacles can also arise after treatment. It has been scientifically proven that patients recover faster and better in their familiar home environment than in the hospital. Despite these findings, a hospital stay in our country lasts longer on average than in other countries. There are all kinds of reasons for this, but one of them is that our healthcare system does not yet pay enough attention to the care and support of patients at home. If you discharge new mothers from the hospital after one night, as is done in many countries, you have to be able to ensure that they and their babies continue to be properly supervised and cared for at home. That's not always possible in Belgium.
How does DKV respond to these needs and how do you want to do more of this in the future?
Our most important role is to facilitate access to the best care for our customers. A large part of the Belgian population has hospitalisation insurance. Those who are insured by DKV simply present their identity card and DKV Medi-Card upon admission to hospital and from then on, they can fully concentrate on their treatment. Our customers' peace of mind is our priority.
On the other hand, it's also clear that healthcare insurers are focusing more on guiding customers throughout their entire healthcare journey. For example, at DKV we work together with Inter Partner Assistance to facilitate access to teleconsultations for our customers. I also see opportunities in services that help patients to identify symptoms themselves or offer them easy access to a network of doctors for a second opinion.
Does this transformation into a healthcare partner also mean that you place more emphasis on medical prevention?
For a health risk insurer such as DKV, with individual customers who remain insured for life, promoting prevention is only logical. The healthier the customer, the less likely they are to need healthcare.
"However, when it comes to organising risk-reducing initiatives, we are very dependent on a health system that spends less than 2% of the national healthcare budget on prevention. Everything else goes to curative medicine."
The situation is slightly different with group health plans. Research shows that the real impact of prevention initiatives only becomes measurable after five to ten years. An insured person who benefits from a prevention programme through his employer but leaves the company after two years for an employer without a prevention plan will very quickly lose the positive effect of such a plan.
Perhaps a bit of a narrow view of a subject that in my view is crucial, but also very complex. I believe more in healthcare prevention that's organised at market level. What's the point of an insurer reimbursing for a certain screening if the healthcare system as a whole does not follow the same logic? That's why social security, healthcare providers and private healthcare financiers should sit down together and consider how they can promote general public health in the most efficient and effective way.
What do you think are the challenges in the shift from healthcare insurer to healthcare partner?
Insurers have to get used to a more service-oriented offering. It requires a completely different mindset, a stronger focus on customer-centricity and a solid operational structure. In a value chain as complex as healthcare, I believe that we should join forces with partners – as we did for teleconsultation with Inter Partner Assistance – who are specialists in their field, to offer our customers the best possible service.
I also see it as a challenge to determine what the actual needs of our customers are and what we think they need. Some assistance services appear to be rarely used in practice. We must not make the same mistake here as the public healthcare systems in many countries, where the supply is no longer dictated by the needs of patients, but by economic potential.
How do you experience the competition from the tech giants that have enormous investment budgets, innovative technologies and masses of data?
Worldwide, the healthcare sector is worth more money than the arms or car industries. It's no wonder then, that the competition is high. Our lifestyle, diet and exercise habits often have a much greater influence on our health than genetic factors.
"With the data that tech giants such as Facebook, Google, Amazon and Apple collect, they are in principle in a position to estimate our health risks and calculate their costs more accurately. They are sitting on a goldmine of data that would be the envy of any insurer. On the other hand, the health sector is also one of the most regulated sectors. So, let's wait and see what the future brings."
We can expect these players to set a new standard for healthcare. What is DKV doing to make health insurance more accessible, easier and more customised?
We've worked hard in recent years on better processes and easier access to our services. Firstly, it has become much easier to take out insurance, thanks to a significantly shortened medical questionnaire. Submitting a claim for damages is also very simple: simply upload a photo of the costs via the DKV app, and if they are covered by insurance, the money will be deposited into the customer's account a few days later. We should consider offering our policyholders simple services throughout the rest of their healthcare journey. I'm thinking here about scheduling doctor's appointments or finding a specialist. I'm an expat and have a 'lazy eye' condition for which I can only go to an orthoptist with the necessary specialisations. I would find it very valuable if my healthcare insurer could provide me with a list of doctors in the region who are able to treat my problem. And I'm sure that many customers feel the same way.
How do you rate the offer of Belgian healthcare insurers compared to what's available in other countries? What do you like about the Belgian offer and what can insurers in our country learn from their foreign colleagues?
In Belgium we have compulsory health insurance, supplemented with private insurance. What strikes me about the Belgian system is the strong focus on hospitalisation coverage, while in other countries, people are also more concerned about dental care and outpatient costs. Although the cost per hospital admission is high, the frequency (on average once every seven years) is many times lower than the number of doctor visits (on average once every two months). And if you know that a consultation usually entails additional costs for medication or additional tests, the average Belgian pays 567 euros in outpatient medical costs out of pocket.
"Belgians need to become more aware of the spiralling outpatient costs and opt for health insurance that offers more holistic protection."
How do you see the role of a healthcare insurer evolving in general? Will the insurer become a health manager?
We absolutely want to do even more for our customers and guide them in every phase of their healthcare journey. Of course, with respect for data privacy and legislation. With partners such as Inter Partner Assistance, we have now taken steps in that direction in Belgium.
At the same time, I think insurers can also play a role in the evolution of our healthcare system towards a better quality, fairer and more affordable model. Currently, the system depends heavily on the mechanisms and decisions of the INAMI/RIZIV (National Institute for Health and Disability Insurance). We want to evolve towards the status of 'player' in order to actively participate in the debate on access to healthcare. How can we ensure that a doctor applies the best possible treatment methods or prescribes medications according to the standards that are scientifically considered safe for health? Why should a patient buy a box of 24 antibiotic pills if he only needs to take three pills for five days? There's a lot of waste in our current system and medicine is constantly evolving.
Although these issues are politically sensitive, I'm convinced that a new dynamic between regulators, healthcare providers and financiers is in the interests of the patient and will result in healthier healthcare.