Health insurers: evolving into ecosystem-based service companies

Abstract

Purpose This study aims to investigate whether health insurers are transforming from pure payers into ecosystem-based health service companies. The authors discuss the findings’ impact on health insurers’ business model approach and their sources of competitive advantage. Design/methodology/approach The authors conducted a multiple case study of 25 incumbent and rising health insurers from the USA, Europe and Asia-Pacific. The selection of firms was based on databases from Forbes, S&P Global Market Intelligence and Crunchbase. By performing a review of financial reports, app descriptions, corporate websites and media coverage, the authors analyzed health insurers’ digital service offerings and underlying strategic approaches for providing those services. Findings This study demonstrates that major health insurers are transforming into ecosystem-based health service companies. They expand the traditional insurance value chain by offering value-adding health services along the patient journey. The analysis results are summarized in a table displaying 18 digital service categories along core patient journey phases with corresponding examples of health insurers and underlying strategic approaches. Originality/value The role of digital services and ecosystems has been explored for many industries. This study investigates this subject area with a focus on the health insurance sector, advancing a young field of research. The analysis gives insights into the latest digital service offerings and strategic approaches of an internationally diverse set of incumbents and rising ventures.

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