MEIR – Nextcare Christian Gregorowicz interview

The health insurance sector in MENA is ripe for growth. Speaking to Middle East Insurance Review, Nextcare CEO Christian Gregorowicz attributes this potential to two main factors.

Firstly, there is still a significant uninsured and underinsured population in the region, and with legal and regulatory reforms making health insurance compulsory in certain markets, he expects the health insurance business to grow substantially.

Secondly, there is an opportunity for health insurers in the region to enrich their offerings. Mr Gregorowicz made a point to emphasise the idea of ‘enrichment’ as insurers will need to bring more value to their core product by providing additional covers and expanding the services they provide, rather than just improving on the main product itself, to meet the needs and demands of customers.

“While we have focused a lot on health insurance in the past year, you now see the rise of digital wherein customers are requesting for more services to be involved. They want to have access, for example, to consultation and lifestyle changing services,” he said. “They want you to support their experience across the value chain. Therefore, you need to add more and more tools. All of these represent an opportunity to grow our region’s health insurance space.”




Health insurance becoming more about lifestyle


With more healthcare services expected to be incorporated into health insurance, it then moves more towards helping customers manage their health. Remote delivery of these services and ease of access will be critical to ensuring they reach a much wider population.

“It’s about lifestyle, engagement, health coaching and potentially around nutrition and support. And on the other end, after you get treated, it’s about disease management programmes and how to maintain your condition better,” he said.

Some of the services he foresees becoming a bigger part of health insurance include teleconsultation, drug delivery and the ability to make medical appointments for consultations or lab services remotely, through the use of mobile apps.

He added that integrating all these services digitally would create a much better overall experience for customers.

With regard to the lifestyle aspect, there is a growing school of thought that health risks are related to a customer’s behaviour and lifestyle choices, and that insurance should be working to influence that to mitigate health risks.


Nextcare has also taken this on board but while the idea is sound, Mr Gregorowicz pointed out that potential implementation poses a number of challenges. “When you’re implementing that from a public system perspective, you have the government and you have the budget. Implementing that from a private system perspective is different. You need to make that budget available, and you need to make sure that that budget is sustainable,” he said.


“You also have to consider that when a customer buys an insurance policy from you, they might opt for a different insurer when it’s time to renew.  This lifestyle behaviour change is a five-year cycle, not a one-year cycle. So, while it looks positive on paper, when it comes to actual implementation, it’s not always 100% [effective].”





Doing things right to keep costs down


Behaviour that can be influenced is not just limited to that of customers – the way health insurers and healthcare providers go about their business can bring significant improvements to the whole system.

“Managing costs is a very important topic, and both insurers and healthcare providers play a very important role in that,” said Mr Gregorowicz. “Implementing best practice on both sides of the of the spectrum, and following international guidelines on treatment, claims and benefits helps a lot in keeping the cost down.”

He also said that the sector needs to start looking more and more to alternatives to manage costs. For example, using generic drugs instead of brand name drugs.

“In some markets you see more reliance on brand name drugs. In other markets you see a much greater acceptance of generic drugs because they’re much cheaper and they have the same impact,” he said.

He also pointed to how even in markets that in the past have subsidised drug costs, there are now fewer subsidies as governments are trying to push the cost of the drugs to the customer.

“For many drugs, specifically over-the-counter ones, I think generic drugs would really help to bring the cost down. And if we were to buy more and more generic drugs, you will see also them reducing in cost as well,” he said.




Data issues


Creating an ecosystem that integrates healthcare and insurance requires multiple parties to have access to customers’ private health data – typically sensitive information.

“As much as I want to have access to the private health data at the tip of my finger, I’m not sure I want many parties touching that data. And you also have a lot of regulation locally in different markets around that data,” said Mr Gregorowicz.


 “Consolidating patient data with centralised access is not easy to manage in practice. When a patient has a lab test or x-ray, the result is shared on a one-gigabyte CD – so how can that data be made easily available elsewhere?”

And while there are today more and more apps and tools that allow such data to be stored and then accessed from different locations, it needs to be fully integrated into the whole system. “That is for me, what we should be working towards, specifically now with blockchain technology that allows us to have access to that data in a very secure way,” he said.

However, he does not see this happening anytime soon as it will require a lot of work around different public systems and regulations in each market. Blockchain allows data to be accessed from almost anywhere but there are some places where certain types of data may not be allowed to be brought out of the market.

Asked how long it might be before we see such an implementation of blockchain, he said it will vary by market, but would overall take more than five years. In the meantime, he said the sector needs to work on making digital data more readily available to the various stakeholders, with their consent.




Positive outlook


Looking ahead, Mr Gregorowicz is bullish about the prospects of the health business in MENA. “With the pandemic, we have gone through a lot of ups and downs. This is normal – you have a pandemic affecting the world and it affected the region. But health still represents 50% of premiums in this part of the world and we still see a lot of opportunity to grow go to the next stage in our markets,” he said.

And while there has been a shift away from a reliance on public health systems, he said there are still markets in the region where the public system plays a very big role, and that the private sector can work together with these systems to create more opportunities for growth.

“We will see growth in our markets in the region and we’ll see more and more services and digital services coming to all markets,” he said.


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