Health insurance has progressed continuously over the past fifty years, with significant advances achieved in most areas: 1) in coverage (e.g. in the last decade the introduction of new outpatient benefits such as physiotherapy and alternative medicines), 2) in operational efficiency (e.g. the digitalisation of processes, the development of advanced case management, automated fraud detection), and 3) in the way insurers interact with members (direct and faster communication through phone and then online and mobile services, or the facilitation of corporate/ worksite health services).

We can now see all of these things in IPMI, but, despite the fact that each of the initial pioneers in IPMI (in particular the top players: Cigna, Bupa and Aetna) had driven these evolutions in domestic PMI, there was often a delay before their adoption into IPMI. Some of this is explained by the very different size of the populations involved, the considerable added complexity (and cost) of providing borderless, global healthcare, and the relatively short time frame of overseas assignments.

Occasionally, of course, IPMI has been the pioneer product, for example, initially in international evacuation, and later in risk management. A major advance impacting private health insurers in recent years (outside the US) is a change in paradigm, which sees them leaving their traditional role as primarily an after-the-event payer of medical services, to become a more proactive partner to help members maintain a longer, healthier life. In the US of course, this shift started amongst health insurers, and especially HMOs (Health Maintenance Organisations) as far ago as the 1980’s, when they developed a strongly integrated strategy combining healthcare financing and a managed care approach. At much the same time the concept of ‘corporate wellness’ was also introduced, usually as a stand alone service, supported by specialist care organisations.

But, even more than with the other significant game changers in domestic PMI, we are only just recently starting to see some of the IPMI players communicating and occasionally enacting, an integrated wellness approach.

This insight publication seeks to assess the following questions:
How far has this trend come to date?
What exactly are players saying and doing?
Who are the leaders? And who are the non- believers?
Why has this trend been slow?
Will it speed up or not?

To answer these, McGrigor Group firstly reviewed the products and services of multiple (but not all) players, and then conducted interviews with a range of insurers and brokers including: Cigna, Bupa, AXA Global Healthcare, A+ International, Jelf, Willis/Gras Savoye, MyMatchmaker.