Health Insurance

Vuorinen (2016) conducted an exploratory study into the four leading insurance companies, Aetna, Oscar, Bupa and Ping. The empirical research supported the established theoretical framework and succeeded with regards to providing a strong narrative of a changing industry. However, the case studies suffer a bit from limited data quality. Of the four cases studied, all had schemes for Hitachi Content Platform (HCP) management API and navigating their customers toward value-based healthcare. They also drove the adoption of digital patient empowerment tools such as electronic health records and remote doctors, and have established programs and incentives to identify customers at health risk, to whom preventive healthcare is targeted. However, it was evident that none of the companies have found the ultimate mechanisms by which the prevailing paradigms of healthcare and behavioral constraints can be overcome. It was noted that new digital healthcare technology is a facilitator of a changing healthcare market, not a driver itself. The findings imply that while great potential exists and bold strategic steps have been taken, it will still take time before the insurer can reach a central role in organizing healthcare. In contrast with Saudi Arabia, according to Jedidia & Medhioub (2015), none of the insurance companies in Saudi Arabia is fully efficient over the period 2009 – 2012 under the author review. This suggests considerable efforts in the insurance industry like banking to improve their stability and to enhance further the effectiveness of the monetary system in the kingdom. Further, according to the author, another important result suggests the negative relationship between size and efficiency, i.e. performance of smaller Saudi insurance company is better than larger company. Apparently, healthcare in Saudi Arabia needs to be organized by using the same coding system and adopting electronic health records to ease the flow of information between insurance companies and healthcare providers.