Can Augmented Intelligence improve Health Fund loyalty and profitability?

Houston We Have better health fund member profitability

It is estimated that at about 10% of members of Australia’s private health (insurance) funds switch to another provider each year, placing more than $2 billion of annual income at risk.  Health funds know that it costs 2-3 times more to acquire a new customer than retaining an existing one, but when a member’s policy cancellation comes “out of the blue” there’s little they can do.

Or is there?

Houston We Have is a technology company that already works with a significant number of Australia’s health funds.  Its Prometheus division helps funds gain insights and value from their existing membership and claims data through a portfolio of specialist reporting modules.   Houston We Have also specialises in helping organisations make better strategic decisions through Augmented Intelligence – an approach powered by the company’s patented software deployed across sectors from defence and national intelligence to natural resources and financial services.

One of the company’s health funds clients recently tasked Houston We Have with an interesting challenge.  They asked if the team could develop a model that could predict which specific fund members were most at risk of leaving the fund, and whether we could enhance this further by identifying those most like to leave for a competitor.

We knew we could.

Once we had framed the specific problem, we worked with the fund’s domain knowledge experts to identify the data indicators that might correlate highly with intention to leave for another fund.   Indicators included classical data points as well as more human insights – a clear distinction between artificial intelligence and Houston We Have’s augmented intelligence.     By testing the model’s “prediction” against actual outcomes of a specific group of members, we could see strong correlation between those predicted to leave and those who actually did.   Whilst a strong majority of those included in the “top 100 at risk” list actually did leave the fund, this list also included a good portion of those members who left specifically to join another fund.   When the at risk list was increased to 300 members, it included almost every single member who left to join a competitor.

The impact of this is significant.

Normally a health fund (or one of a number of other subscription businesses for that matter) will deploy a “salvage” team to try to re-recruit a member once the decision to leave has already been made and communicated.   The Houston We Have model allows funds to take small, well targeted steps (acts of protection) before that decision has been made.   Members feel valued, churn decreases, and lifetime customer value is enhanced.

Houston We Have a solution.

 The model developed is in its early stages.   Our next step is to refine it further, increase reporting capability, and operationalise the information into the client’s systems.

Houston We Have is a boutique technology business that combines data science, software and artificial intelligence to deliver the kind of information that allows its clients to make better decisions and thrive.  Its patented software was initially developed for military intelligence agencies where it is still very much in use.   Gartner has identified the company as a Cool Vendor describing the value proposition as “unlike that of any vendor we have seen.”

Houston We Have is currently engaging with a number of leading companies across sectors where its technology and approach can be deployed in the advancement of that business sweet-spot; improved efficiency, lower risk, and enhanced user experience.


For information:

Bill Beedie
Head of Sales Australia & New Zealand
+61 411 759 457 ​

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