By Dr. Kelvin Loh, Group Chief Healthcare Officer, AIA and Dr. Axel Baur, CEO, Amplify Health
Asia has made progress in recent years in shifting towards value-based approaches to healthcare. These include bundled pricing, negotiated fees, and other ways of risk-sharing between payors and providers. These changes are necessary to put healthcare systems on a stable long-term footing. But they are just a start if healthcare systems are to evolve to meet the long-term challenge of caring for ageing populations amid rising medical inflation.
Deeper and more systemic change is needed and is possible with better management and analysis of the enormous volumes of data that Asia’s healthcare systems generate. At present, how this data is captured, coded, and used remains sub-optimal and varies widely across hospitals, markets, and payors. Too often it is fragmented, inconsistent, or incomplete. Insurance claims in Asia frequently arrive as high-level summaries, offering little visibility into what treatment was delivered, which makes assessing the cost and appropriateness of care difficult for insurers and other payors.
Change is underway. AIA has partnered with Amplify Health to implement a consistent approach for capturing, structuring, standardising, and enriching data to provide a region-wide view of healthcare costs and patterns of treatment. This approach is enabling a shift from fragmented information towards a more integrated understanding of customers’ interactions with healthcare systems: care received, costs incurred, and outcomes experienced.
Ultimately, this increased visibility has the potential to improve both health outcomes and health system efficiency. For AIA, it will help us fund more affordable, accessible, and effective care for customers. At a system level, it will allow us to work with our healthcare provider partners on a transparent basis to negotiate risk-sharing arrangements based on real-world data—outcomes, quality, effectiveness of care—with the potential to shift care in our markets further in the direction of more sustainable, value-based models.
The impact will be region-wide. AIA has rolled out this data approach across our largest markets with private healthcare systems—Hong Kong, Malaysia, Singapore, Thailand—as well as Indonesia and the Philippines. Through its work with stakeholders across the healthcare value chain—including other major insurers like Star Health in India—Amplify Health is helping to build a modern health information system for Asia that enables payors, providers, and policymakers to understand variation in care, identify drivers of value, and take aligned action.
From fragmented data to actionable Insights
The approach AIA and Amplify Health have developed transforms largely unstandardised data into usable insights. It brings information from claims, underwriting, providers, and wellness programmes into a unified model. It can be used to improve product design and chronic disease management for our customers while giving healthcare providers transparent views on how their own patient populations compare to similar hospitals in terms of complexity, costs, and other outcomes.
At its core is the concept of critical data elements: the specific pieces of information needed to generate meaningful insights. These include everything from basic claims data such as amount paid and date of admission to diagnosis, provider information, insurance product, and drug details. Bill amounts allow us to compare costs. Provider information includes location to allow for geographic analyses. Altogether, we have identified hundreds of critical data elements for over a dozen categories of information.
We capture this data from medical documents, invoices, and discharge summaries and then anonymise, aggregate, and translate it into standardised formats, including clinical codes. We then perform the necessary data quality checks to ensure consistency and comparability. The result is that healthcare data that was once opaque becomes structured, comparable, and actionable.
