21st century healthcare challenges

ITIJ 212, September 2018
We want people to be healthy and when they are not, we want to get them back to full fitness as soon as possible
Phil Austin

ITIJ spoke to Phil Austin, CEO – Europe at Cigna in the UK, about the challenges of 21st century healthcare provision, the impact of technology and the importance of prevention over cure

How did you first get started in the international health insurance industry, and how did you progress to your current position of CEO – Europe at Cigna?
I started my career at Cigna back in 2002 as Partnership Director for Cigna International, and apart from a few years when I briefly left the business, I’ve been with the company ever since.
I have enjoyed working across a mix of international and European business lines, from being the European Sales and Marketing Director and the Head of the Global IPMI Business, to MD of UK HealthCare Benefits and General Manager of the Domestic Health and Travel Business.
As part of Cigna’s International Health Solutions leadership team, I oversee strategic market development to drive accelerated growth in Europe. We intend to grow the business and bring our expertise to a much wider European audience so it’s an exciting challenge at a time when global mobility and demand for health benefits are increasing. 

How has the global health insurance marketplace changed over the years you have been with Cigna?
The biggest change is the impact that technology has had. Of course, you’d struggle to find an industry that hasn’t been impacted by technology but the implications in healthcare are really quite fundamental. Technology has allowed us to move into a space where we are not just treating conditions but helping to catch them earlier or even prevent them developing in the first place. 
From a strictly business perspective, technology is the key to cost control in terms of helping to provide more accurate diagnoses, leading to fewer unnecessary procedures. It also enables earlier intervention to minimise the need for costly treatments in the first place. I read a report from McKinsey recently which predicted that clinical solutions and healthcare value services, such as medical cost and population health management solutions, are likely to grow rapidly due to concerns around cost. By using data to inform our decision making, we are starting to tame that medical cost trend. 
In your view, are health insurers keeping pace with new technology and effectively leveraging it to improve their proposition for customers?
Insurance in all its forms is a very traditional industry but the pace of technological change over the last five years or so has been really exciting to watch and be a part of. I would say that some of the healthcare providers out there have struggled to keep pace with this change – many have been unable to develop the capabilities, acquire the talent, and transform their organisations at the pace required.   
At Cigna, we’ve invested heavily in our digital capabilities such as our online member portal and also in new integrated digital health and wellbeing solutions, using app technology to allow customers fast access to telehealth medical consultations and lifestyle coaching tools to support preventative care and behavioural change. 
It meshes perfectly with the time-poor tech-enabled lifestyles of the 21st century workforce and is a great demonstration of the power of technology to help us meet client needs in fresh new ways.
How can companies like yourselves help employers to manage costs without impacting on customer care?
We want people to be healthy and when they are not, we want to get them back to full fitness as soon as possible. But we don’t want to do that at any cost or compromise the experience that our customers have during and after treatment.
To that end, we are collaborating with primary care groups and multi-speciality groups to provide a range of reporting and analytic mechanisms to better measure the approaches healthcare teams take in caring for patients and improving the experience and outcomes for patients. Fundamentally, it’s about improving our customers’ health whilst minimising the length of time and waste that often occurs in delivering healthcare. 
What do you see as the biggest challenges facing international health insurance providers? And is the industry ready to tackle them?
The twin linked challenges of medical inflation on one side and cost containment on the other continue to be major issues for the industry. But although rising medical costs are obviously a big concern, they really are a catalyst for change. It forces the industry to look at new ways of doing things and of improving the services we provide. 
The need to maintain affordability of cover, for example, is one of the main drivers behind the focus on wellbeing – keeping people healthier for longer is a win-win, not only in terms of managing medical costs but also in better quality of life and higher productivity. Prevention is better than cure, so what looks like a negative factor when viewed in one light can actually yield positive outcomes if we approach it in the right way.
It’s also important that insurers respond to the changing nature of the workforce and develop the agility and flexibility required to meet the needs of all types of workers – from self-employed and remote workers to the globally mobile and those working in challenging environments, for example.
What is the biggest ‘health’ challenge facing business today?
Our recent global survey revealed that unmanageable stress is one of the top wellbeing issues facing employers today. But the good news is that employers are beginning to recognise the cost of poor mental health at work and the impact this can have on their employees and business, and are starting to do something about it.  
In fact, we were one of the first healthcare companies to introduce self-referral for any mental health or emotional wellbeing concern with employees not needing to talk to a GP or their employer first. Early intervention is proven to enhance and speed up recovery, getting people back to work faster and with less risk of relapse. We offer ‘Living Life to the Full’, a digital CBT-based life skills tool to all our members. These courses can effectively support people with managing everyday low mood or stress as well as helping people to cope better if they’re living with a health condition. 
We also recognise the intrinsic link between mental health and physical health and all members receiving psychotherapy treatment are offered free gym membership to aid recovery.
In addition, another challenge facing employers globally is helping their employees to manage chronic and complex conditions such as hypertension, diabetes and so on – conditions that are known to be increasing in prevalence in our population as it ages. Again, insurers like ourselves are well placed to provide support to employers.
Are these ‘health’ challenges the same for companies with employees working abroad in different locations around the world? Absolutely, international exposure is often a significant draw to working overseas. Our own research shows that globally mobile individuals often experience anxieties related to macro-economic factors. They are particularly worried about the medical care available and the financial consequences of falling ill. They face additional challenges due to a higher level of insecurity and pressure from working outside their home country. And they are concerned about illness. Cancer and the fear of accidents are the main worries, followed by mental illness, including depression.
We put as much emphasis on pre-assignment work with our clients as well as supporting their employees when they are on the assignment, and we advise clients that it is critical to ensure that employees returning home from an international assignment continue to have that support while back in their home location – when they may experience difficulties settling back in.  
What are the most challenging aspects of your job?
Quite simply put, ‘regulation’. Regulation continues to change at pace around the world. It is vital as an organisation that we continue to keep abreast of all regulatory changes, and the impact and advice that we need to give to our customers and members. 
What are your proudest achievements, both professionally and personally?
Professionally, building and developing Cigna’s Global IPMI Business, and more recently building a new Cigna European organisation. Personally, my four children – they continue to remind me what is important in life and give me a great balance between work and family life.
If you could do any other job in the world, what would it be and why?
Bearing in mind how much I travel for work, I could definitely have been a pilot for BA! ■

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