Health Insurance

Reconfiguring health insurance in a new world

The pandemic has taught us dramatic lessons about the fragility of our workforce, supply chains and health care system. It has also reminded us how difficult it is to accurately predict the future - something health insurers have until now relied on being able to do, to a point, using algorithms to determine risk.

This is exacerbated by longer-term challenges facing the industry, including changing consumer expectations on how care is delivered (e.g., virtual care), mounting sustainability concerns, rapid digitisation and a renewed focus on productivity.

Many insurers are taking bold steps to capitalise on structural changes in the marketplace, technology trends and evolving customer behaviours. To continue nurturing buyers’ trust, insurers are being forced to diversify and take risks - or risk falling behind.

At PwC, we are helping health insurers succeed during this period of evolution. Via our collective ingenuity and suite of human-led and tech-powered health and wellbeing services, we are helping insurers achieve their business goals despite it all. 


Looking at the challenges ahead for health insurers 

Emerging challenges that health insurers will likely face:

  • Increased demand, severity and complexity of mental health services

  • Backlog of surgery delayed due to the pandemic 

  • Changing consumer expectations on how care is delivered including virtual care and in-home care

  • COVID-19 related claims will increase as Australia opens up

  • Potential for vaccine mandates in the workplace, and what this means for insurers

  • The costs of managing COVID-19 are unlikely to continue being borne by the government indefinitely

  • The long-term health burden of COVID-19 as a chronic condition

  • Shortcomings in IT infrastructure and data quality will need to be addressed

Reconfiguring health insurance in a new world

Our solutions to navigate the future of health insurance

We lead the market in identifying and assembling the right mix of advisors, subject matter experts and technology, to deliver the innovative solutions our clients need to strategise, mitigate risk, focus on growth plays and build for a better future. 

These are the several key ways that our passionate community of solvers can help you succeed with your health insurance vision:

Assurance services

Our assurance team gives you the confidence you need when making the big decisions about the future of your health insurance organisation - confidence that the decisions you are making are the right ones for your organisation, your stakeholders and the community more broadly.

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Health service consulting

Our industry-focused consulting business is designed to anticipate and address your business needs as a health insurer of the future. Informed by our deep industry expertise, we combine strategy, technology and management consulting expertise.

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Expert deals services

From corporate value advisory, to moving mergers and acquisitions, to debt and capital advisory, our 500+ Deals partners use data-fuelled insight to help you tackle the big problems and transform your ideas for better health insurance into reality.

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Legal services

Our legal expertise team will not only help you predict the impact of regulatory, economic and political shifts on the health insurance industry, but help you to understand how to future-proof your strategy.

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Environmental Social Governance (ESG) consulting

Our human-led, tech-powered ESG consulting services will help you look for win-win opportunities to reduce costs in a COVID-normal world whilst also delivering improved patient and staff outcomes (e.g. virtual care) and achieving your ESG goals.

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Cybersecurity and digital trust

Digital identity, data trust and privacy issues are becoming increasingly problematic for health insurers and will continue to do so with the growth of virtual care models. Let us help you create more secure digital experiences. 

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Integrated infrastructure for health insurance

Let our digital specialists help you deliver more resilient solutions in IT infrastructure and data quality, such as implementing real-time data tools to inform decision making on COVID-19 care, service model planning and responding to insurance claims.

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Future of work

Prepare the insurance system for future health crises by improving supply chain resilience to future global shocks and constraints. Let our community of solvers help you drive innovation through enhanced technology, a future-focused workplace strategy and adaption solutions.

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Contact us

Kerry Murray

Partner, Assurance - FS, PwC Australia

Tel: +61 408 165 076

Nick Kotwal

Nick Kotwal

Partner, PwC Australia

Tel: 612 8266 4725

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