Reflecting on 2022:
Impact on The Insured and The Insurer
In recent years, fallout from the COVID-19 pandemic and geopolitical upheaval from the Russia-Ukraine conflict resulted in widespread global economic uncertainty. While the insurance industry has demonstrated extraordinary resilience in confronting the challenges of soaring inflation and rising claims costs, growth without sacrificing customer satisfaction and profitability, remains a key issue.
More common than one might think, incorrect diagnoses and treatment plans, and avoidable medical procedures, result in prolonged suffering for the insured and elevated and unnecessary costs for the insurer. That said, correctly diagnosing a medical condition and recommending the right treatment plan can be extremely complex. Even the most trusted physicians can make mistakes, can benefit from, and usually value a medical second opinion (MSO), particularly one provided from the world’s top specialist physicians at world-leading medical centers.
The importance of MSO utilization
Every year, MediGuide’s annual medical second opinion key performance indicators (KPIs) reinforce the fact that an expert MSO is one of the most powerful tools to ensure the correct diagnosis and treatment plan. This is critical, not just for ensuring better health outcomes for the insured but also significantly lowers costs for you, the insurer.
Last year, in 88.23% of MediGuide’s medical second opinion cases there was a treatment change. This means an alternate treatment plan was recommended and/or additional testing was recommended, and/or surgery was avoided. This resulted in significant cost savings, short-term gains such as lower treatment costs, and other long-term benefits such as improved productivity, and reduced absenteeism from work. Studies show that the probability of patients returning to work after a leave of absence due to illness decreases with time with:
To this end, receiving the correct diagnosis and treatment plan, as early as possible, results in fewer disability/income protection claims from prolonged recovery times. All the more reason to ensure the insured is made aware of, and encouraged to utilize, the medical second opinion service available to them.
As we progress into 2023
At our core, much like the insurance industry, MediGuide is about protecting people (the insured) and helping businesses (our insurance partners) avoid unnecessary medical expenses. On top of looming inflation, rising operating costs and slowed premium growth in the insurance industry, managing health risk becomes increasingly important.
In the last year we have had to navigate a complex and changing healthcare landscape, but this hasn’t hampered our ability to create value both for our clients and their members.
Expert MSO services along with telehealth (telemedicine), and preventative health services, all of which form part of our integrated offering, have significant health optimization and cost saving implications. Year on year, our consistently high KPIs reflect this, with major ramifications for insurers particularly when it comes to MSO related changes in treatment and the role this plays in helping to dramatically cut down on claims costs.