A new approach for the life-insurance industry

High blood pressure and high blood cholesterol were first identified as major risk factors for cardiovascular disease in 1948 by a landmark long-term study (known as the Framingham study) in Massachusetts, USA. But many people are unaware that the study was preceded by research led by insurance companies, which have a vested interest in keeping their clients in good health.

“The study built on years of research in the early 1900s by US insurance companies, who were the first to recognize that high blood pressure is associated with higher mortality rates,” says Daisaku Kato of the Meiji Yasuda Research Institute, based in Tokyo, Japan, which is overseeing the study with the National Cerebral and Cardiovascular Center (NCVC).

“Insurance companies have largely moved away from basic research. But considering societal change in Japan, we’re in a time when basic research will inform the new services that insurance companies offer,” Kato notes.

Meiji Yasuda Research Institute — along with parent organization the Meiji Yasuda Life Insurance Company — became the first financial company in Japan to partner with the Osaka-based NCVC on joint research. In 2021, they struck a three-year agreement to transfer talent between institutions, develop education materials for the public, and create new tools for predicting disease. The institutions anticipate this collaboration will advance non-medical approaches to preventing cardiovascular diseases.

A new role

The outputs from the research collaboration inform Meiji Yasuda Life’s Wellness for All Project, one of two major initiatives aiming to promote the health and wellness of customers.

“Insurers and consumers around the world have begun recognizing that health promotion and early prevention of disease are new services that life-insurance companies can offer, in addition to giving payouts for illness or death,” says Hideki Nagashima, president and group chief executive officer of Meiji Yasuda Life.

In Japan, medical costs are controlled under a universal health-insurance system, and it is logical for insurance companies providing private medical insurance to emphasize preventive care. Nagashima likens this to health maintenance organizations (HMOs) in the US, in which insurance companies build their own hospitals or healthcare networks to provide health services for a fixed annual fee.

“For HMOs, it makes more economic sense to invest in preventing disease than to pay for disease treatment. The entire country of Japan functions like a giant HMO since medical costs are controlled centrally. It makes sense for the country and its insurance providers to invest in preventative medicine,” says Nagashima. “We add incentives in our plan to motivate customers to live healthily.”

The Wellness for All project offers a combination of services that help customers with health literacy, maintenance and improvement. For example, Meiji Yasuda Life’s flagship product offers medical-checkup results augmented with health advice and hospitalization-risk predictions based on big data. The results are evaluated in three categories; customers who satisfy certain criteria are given a cashback on one month’s insurance fees.

The company also hosts walking events — sometimes in collaboration with athletes in the Japan Professional Football League — to promote the value of exercise. The project has more than 3 million participants and nearly 600,000 customers have received cashbacks amounting to 7 billion yen (roughly US$49 million). “We see signs that the programme is contributing to our customers’ health. Compared to general data from all over Japan, the percentage of those who have reduced their obesity and blood glucose levels is higher,” says Nagashima.

Backed by evidence

The team at Meiji Yasuda Research Institute is currently based at the Open Innovation Center in NCVC, performing research on the prevention or early detection of cardiovascular diseases and their risk factors, such as hypertension and diabetes. Ultimately, they hope to create evidence-based services and initiatives that will enhance the value of the Wellness for All project.

Heart disease and cerebrovascular disease account for one fifth of the country’s healthcare expenditure. “While insurance companies have offered a variety of services for cancer, this has not been the case for cardiovascular diseases,” says Nagashima. “As we shift towards a business model that emphasizes disease prevention, we believe that cardiovascular disease is a new frontier that we can help our customers with, as lifestyle habits are thought to play a significant role in disease onset.”

Drawing on results from NCVC’s longitudinal study in Suita, Osaka, which began in 1989 and is the first cohort research undertaken in urban areas in Japan, the research team and collaborators are developing models that help predict the onset of cardiovascular disease, as well as hypertension and diabetes.

Development of new products and improvements to existing services are also underway. “The hospital at NCVC cares for many patients with cardiovascular diseases, but also conduct research on their lifestyle and prognosis prior to disease onset. We’re working with NCVC doctors to explore new areas in which insurance companies could offer meaningful services to these patients,” says Kato. “We’re also gaining insights for service improvement. For example, some people have genetically high cholesterol levels, and when such NCVC patients were studied, it was found that with continued treatment, their risk was at the same level as others.”

Connecting the dots

Nagashima believes that catalysing stronger community ties is essential for new findings and improvements to benefit a wider range of customers. In April 2022, the company expanded the role of their agents to include tasks undertaken by community workers, in which they match customers to locally available public services. “We’ve seen elderly customers living alone in Japan. These people might have drugs prescribed to improve sleep and mood, but in that kind of situation, non-medical support has tremendous potential in helping these people lead healthier lives,” says Nagashima.

Municipalities in Japan offer various services and resources to residents, and Meiji Yasuda Life has formed comprehensive partnership agreements with 800 municipalities for promoting health and wellness.

“A common challenge is that residents don’t actively seek and use these services. But are these people fit enough to do so? This is where we hope our agents will make a difference,” says Nagashima. “Technology can help, but it’s people with empathy who can create value. Now is the time for organizations like ours with a spirit of mutual support to contribute to the wellbeing of people and communities.”

Meiji Yasuda Life is seeking to expanding this initiative in collaboration with many scientists and healthcare start-up companies around the world. Anyone interested in this new initiative, should contact us.