What is Sympany doing to counter rising health costs?
The rise in health costs is relentless. We know that many policyholders are finding it increasingly difficult to pay their premiums. Sympany is working hard to counter the rise in health costs and premiums by joining forces with industry association santésuisse and other partners.
We use strict invoice verification procedures to identify invoicing errors. Thanks to digitalisation, these are now more efficient, comprehensive and cost-effective.
Invoice verification prevents unjustified payments, thereby making an important contribution to curbing rising costs. This verification process carried out by health insurance companies results in premium savings of around CHF 3.5 billion for policyholders.
► Tip: You can also make an important contribution by checking your medical bills. You can find out how to do this on the page Checking medical bills made easy >
The charges applied in the healthcare system are the result of regular collective bargaining between health insurance companies and the service providers such as doctors and hospitals. In its negotiations with the service providers, Sympany is committed to ensuring that services are provided efficiently and that charges and prices for treatments represent value for money.
tarifsuisse ag often conducts tariff negotiations on behalf of numerous health insurers to ensure that the interests of premium payers are fairly represented. Our industry association santésuisse is also involved in the policy for fair tariffs, flat rates and medication prices to avoid misguided incentives being created within the healthcare system while maintaining the high quality of healthcare provided in Switzerland.
Sympany is committed to high-quality, low-cost basic healthcare. It is a joint owner of Sanacare, which manages group practices.
All of Sympany's alternative insurance models offer affordable and professional primary care. Insured persons receive medical advice and treatment at one of the contact points, which vary depending on the model. These so-called managed care models contribute to cost savings. This means that policyholders receive discounts on their premiums within these models.
Sympany strives to be a fair and reliable insurance partner for its customers when they fall ill. For example, Sympany supports its customers by contributing to preventive measures, such as vaccinations, check-ups and courses or activities in keeping with the principles of getting fit (recognised health-promoting courses such as smoking cessation, back training, nutritional advice) and staying fit (gyms, sports clubs, sports associations).
Sympany has a lean structure: with around 550 employees (as of July 2024) and 247,000 policyholders with basic insurance cover, we are among the top ten largest providers in Switzerland. These employees also look after our supplementary insurance policyholders and corporate customers. Streamlined decision-making processes, efficient systems and largely digitalised and automated processes enable us to focus on what matters most: our customers.
Effective outsourcing and productive partnerships also keep our administrative costs low. Partners and associations such as santésuisse and tarifsuisse handle some core administrative tasks (such as tariff negotiations, invoice verification, insurance medical advisory services and IT services), meaning that we and other health insurers do not need to handle each negotiation separately or introduce technical solutions.
For quite some time, Sympany has predominantly processed invoices and receipts automatically upon submission, triggering reimbursements. Over the past few years, we have automated many other processes and tasks that previously had to be carried out manually – which took longer and resulted in more errors.
Digitalisation is also helping us to offer our policyholders a better service. Customers can now make many changes themselves, for example to their personal data or insurance cover, in mySympany. The changes are then transferred automatically to our database and new policies are sent out.
Artificial intelligence (AI) has also arrived at Sympany: we are currently testing a telephone voicebot, which is able to understand customer requests and forward them to the appropriate team for processing. In future, policyholders will be able to use our chatbot to obtain immediate responses: the chatbot is trained on an ongoing basis, enabling it to respond to many queries itself.
As a fair health insurer, Sympany believes in the importance of offering affordable premiums. As a result, Sympany is taking advantage of a voluntary reduction of reserves wherever possible to return unneeded reserves to customers in basic insurance. No further reduction of reserves is currently possible.
