In the latest instalment of iFHP’s Meet the CEO series, we speak with Philomena Colatrella, CEO & Chair of the Executive Board, at Swiss health insurer, CSS.
Name: Philomena Colatrella
Country/Region: Lucerne, Switzerland
Appointed: 2016 (having previously served as Secretary General and Group General Counsel)
By bringing both population health and sustainability together, our aim is to create the most compelling case possible for positive change and the investment needed to realise it.
Tell us about CSS Health Insurance
As CEO of CSS Health Insurance (part of the CSS Group), Philomena Colatrella leads an organisation that is nearly 125 years old. Founded in 1899, the group has its headquarters in Lucerne and today insures around 1.7 million people.
The Swiss health insurance system has both mandatory healthcare insurance (also known as basic insurance) and voluntary supplementary insurance. For basic health insurance alone, CSS insures 17% of the population.
What topics are most pressing for the health insurance sector?
Philomena cites Michael Porter’s 2006 work “Redefining Health Care: Creating Value-Based Competition on Results” as an important reference point, and value-based healthcare is high on the agenda for CSS.
A question that Philomena returns to over and over is, “How can we make the outcomes measurable?” This is important as CSS is currently developing a network of health providers, physicians and payers that is rooted in Porter’s vision of value-based healthcare, delivering better health outcomes for its members while fairly compensating those involved in providing care.
Two pilots have been running in Switzerland with several hospitals and physicians. One has created a reimbursement fee that includes an outcome-related payment. The second involves creating a sustainability and health framework. The intersection between sustainability and health is sometimes overlooked, but it is critically important, and the goal of the pilot is to ensure everything that contributes to improving the health of population also contributes to sustainability. Bringing the two together should make the most compelling case possible for positive change and investment needed to realise it. It is Philomena’s hope that this will create both the positive sustainability impact as well as system savings in the longer term.
What are the biggest opportunities for health insurers?
For Philomena, the biggest opportunity lies in changing the perception and business model of health insurances from simply paying invoices to becoming a healthcare partner and a shaping force in the healthcare system.
CSS tries to capture this opportunity along the three episodes of “leading a healthy life”, “regaining health” and “developing a mindful approach to illness”. Philomena explains what each of these means:
For a healthy life: By providing information and advice on all kinds of health-related issues, the health insurer helps its members to stay physically and mentally fit. For example, with the app active365, members benefit from a large library of fitness and wellbeing sessions including video coaching. In a fun way, they can collect points and hereby reduce their insurance costs. On the other hand, enjoy365 is a store full of health-related products to a reduced price. These are only two of many preventative initiatives that CSS is offering to its members, motivating them to look after their health on a day-to-day basis.
Regaining health: CSS helps the members who are ill or have medical questions to find their way through the maze and quickly get the answers they need. Integration, quality, and transparency form key words in this episode.
With WELL, CSS created a navigator for members to find their way through the complex healthcare system. The app guides, helps and gives a peace of mind with a symptom checker, a doctor’s appointment tool, medication ordering system and much more. It is a first step towards an integrated healthcare system in Switzerland that connects what is important in healthcare: doctors, pharmacies, insurance companies, and everyone’s own health.
Next to that, CSS also wants to make outcomes more transparent and costs more quality based. This cannot only be achieved through the above-mentioned value-based pilots, but most also be promoted on the political agenda. With its health policy team as the driving force, the country’s largest health insurer, takes responsibility and advocates for an attractive and efficient healthcare system on behalf of its members.
For a mindful approach to illness: CSS assists its members through care management and partner programmes that supplement their medical treatment, thus helping them to cope with chronic diseases.
Here, mental health has become an important area of health that CSS supports for its members. The insurer has invested in Flow, a Swedish start-up that offers medication-free treatment for depression. Flow is a brain stimulation headset and therapy app, approved for medical use in Europe and the UK in 2019. Research has shown the positive impact for patients is high; as Philomena explains, “you don’t have to visit a psychologist or psychiatrist, instead the therapy is programmed with the patient and the patient then follows it autonomously. It can reduce the therapy time, help to break the stigma of seeking mental health support and also connect mental health support with coaching.”
In short, there are many and equality important innovations along those three episodes which provide immense opportunities for CSS and other health insurers to elevate their business model!