US healthcare changes offer insurers opportunities


Allied World says the changing legislative landscape around healthcare in the US means big opportunities for insurers – but only those prepared to innovative and tailor bespoke solutions.

That is the view of John Telenko, senior vice president and the Bermuda healthcare manager at Allied World Assurance.

“It is clear that the US is at the forefront of a changing healthcare landscape,” he said. “Public need, legislative directives and technological advances are challenging the ‘old’ model of how healthcare services are delivered and paid for.

“As this happens in the US – and worldwide – the insurance companies that ‘think outside the box’ and provide new products to meet the needs of their healthcare partners will be successful and viewed as the market leaders in the healthcare insurance industry.”

According to Telenko, Accountable Care Organisations (ACOs) – newly emerging healthcare organisations characterised by a payment and care delivery model that ties provider reimbursements to quality of care metrics and reductions in the total cost of care for an assigned population of patients – will face a host of new exposures on many fronts.

“How they address these many risks will dictate their long-term success,” he said. “Coordinated care is the key and the goal of coordinated care is to ensure that patients, sometimes comprised of an assigned population of previously uninsured individuals, get the right care at the right time, while ensuring wellness and prevention of illness as well as avoiding unnecessary duplication of services.

“The goal of increasing care coordination is to help reduce unnecessary medical care and improve health outcomes, leading to a decrease in utilization of acute care services. When an ACO succeeds both in delivering high-quality care and spending healthcare dollars wisely, it will share in the savings it achieves.”

Allied World Bermuda is the latest insurer to expand into this market. It recently launched a new liability solution product aimed at ACOs. The product is built off a central errors and omissions (E&O) policy where ACOs can select different retentions and can also purchase shared or separate limits between certain coverages.

Last year Allied World launched an ACO product for the US market for companies of any size or make-up. The Bermuda product has been created for Bermuda-centric healthcare clients that plan to maintain the working layer of the ACO risk – at least $1m – and are looking to secure excess capacity in the marketplace.

healthcare, insurance, landscape, coordination, change