ITIC Global 2021: Cost containment challenges and solutions

AP Companies Global Solution’s Weigall begins with a discussion on the developments of the cruise industry, and how to best support it coming out of the pandemic. In 2019, 27 million passengers went on cruises, the industry was becoming more popular until the pandemic. Although 2020 saw seven million, that was effectively the first months and the industry effectively ‘shut down’.

However, passenger estimates for 2021 are 13.5 million, and more positive about 2022/23. Weigall asked how best to can we make boats as safe as possible. Some core techniques include passenger numbers are still reduced, mandated vaccination, pre-boarding testing and regular onboard testing, and stringent protocols for positive cases. Polling suggests 81 per cent of cruisers will do so again.

Butakova, also from AP Companies, outlined the advancements in medical provisions, including ICU, isolation zones, and other containment measures. Medical care onboard is more expensive, and Butakova stated that insurers may be hesitant to pay out in these instances, as they have less choice.

ITIJ’s Ian Cameron queried that the first port of call for cost containment is the equipment onboard. How exceptional is equipment such as incubators and ventilators? Weigel states that ‘as digital health becomes more robust, remote doctors and services can enable more’. However, during a discussion with the audience, it was queried whether this was conducive on cost containment. New Frontier Group’s Rob Upton stated: “The issue with cruise cases is you have so many options taken away from you. But regarding the insurer, their priority is always the best treatment for the passenger, regardless of the cost.”

In his presentation, Upton noted that one of the most significant challenges during the pandemic was the assessable provision of primary healthcare, ‘and the obvious solution was telehealth’. Upton stated that New Frontier Group has already explored telehealth prior to the pandemic, and these efforts were accelerated by the spread of Covid. But one of the core issues was the difficulty in prescribing medication outside of the jurisdiction of the physician.

There is an increase in mental health and anxiety treatment for international students, and telehealth can provide access to specialists that might otherwise not be accessible. Sixty-five per cent of callers are female. Upton stated: “When there was a propensity for female callers, when we explored that, it turns out there were a lot of calls about family planning.” The vast majority of callers requested an ‘immediate’ response, with an average waiting time of four minutes.

As the use of telehealth rose during the pandemic, user familiarity has led to a prolonged interest in telemedicine, and Upton predicts patients will prefer providers that offer telemedicine services. When asked about whether telemedicine providers themselves form a part of the cost that could be contained, John Spears, Global Excel Management, said: “We evaluate whether the cost comes from offering our service compared to attending the emergency room. But there is an additional benefit, which is our experience, that is tough to calculate.”

Spears rounded off the presentation with a strong statement: “People have told me it’s the US costs that made cost containment essential.” For each solution that was established, the provider side would increase costs. “The US system, specifically, is about anticipating costs.” But Spears stated that the number of entities entering the healthcare service have become increasingly convoluted.

Some of the most prominent challenges Spears highlighted include the persistently escalating costs around the world, technology and pharmaceutical costs, and opaque mergers and acquisitions. But a number of cost avoidance strategies employed by Global Excel Management include the gradually evolving plan design and policy wording, creating networks that suit client profiles, and preventative and predictive measures. Among cost containment strategies include the use of risk scores, which allow pre-negotiation in advance.

Spears stated: “Telemedicine is great, it provides a better experience, and these things save money,” and argued that the cost containment attitude, led by a reactive nature, and is antiquated and flawed compared to pre-empting costs.