Across Asia, health insurers are repricing policies in response to rising medical costs – but without a clear picture of what is actually driving those costs at the claim level. That is the central argument of a paper published by AIA Group and Amplify Health, co-authored by Dr. Kelvin Loh, group chief healthcare officer at AIA, and Dr. Axel Baur, chief executive officer of Amplify Health.
The paper contends that the region’s cost management problem is, at its root, a data problem – and that without addressing it, the tools needed to manage health costs structurally remain out of reach.
The paper identifies a fundamental gap in how claims reach insurers across Asia. Claims, the authors write, “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.”
The paper added: “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.”
Without line-level data – covering diagnosis, provider identity, drug details, and itemised bill amounts – insurers cannot determine whether care was clinically appropriate, whether billing was accurate, or whether a particular provider sits outside regional benchmarks.
The result, the authors argue, is a cycle of reactive repricing: premiums rise because costs rise, with limited analytical basis for understanding why. Clients absorb those increases regardless of their own claims experience, and brokers enter renewals with limited grounds on which to negotiate.
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In response, AIA and Amplify Health have developed a standardised data model across six of AIA’s largest markets with private healthcare systems: Hong Kong, Malaysia, Singapore, Thailand, Indonesia, and the Philippines.
The model is designed to extract hundreds of data elements from medical documents, invoices, and discharge summaries – the line-level information the paper’s authors argue is currently missing across the region.
According to the paper, the structured approach enables three things that fragmented claims data cannot support: provider benchmarking, fraud detection, and the payor-provider data sharing that risk-sharing arrangements require.
The longer-term goal the paper sets out is enabling value-based care – where provider payments are tied to outcomes rather than activity. The authors acknowledge that Asia has made progress in this direction through bundled pricing and negotiated fees, but argue those represent a starting point rather than a solution. Without data capturing outcomes, quality, and cost at a granular level, value-based arrangements cannot function.
Beyond AIA’s own markets, Amplify Health is also working with other insurers across the region, including Star Health in India, with the stated aim of building shared health data infrastructure across Asia.
The context in which the paper is published matters. Asia Pacific is facing another year of double-digit medical cost increases. WTW’s 2026 Global Medical Trends Survey, based on responses from 346 leading health insurers covering 82 countries, projects medical costs in the region to rise 14% in 2026, up from 13.2% in 2025 – the highest projected rate among the regions surveyed.
Mercer Marsh Benefits puts Asia’s average medical trend rate at 12.5% for the same year, nearly six times the region’s 2.1% inflation rate. In individual markets, the pressure is sharper: 17.8% in Indonesia, 16% in the Philippines, and 14% in Singapore, according to Mercer Marsh Benefits.
The affordability pressure is already reshaping market behaviour. Mercer Marsh Benefits’ 2026 research found that 76% of insurers globally are concerned that inefficient and wasteful care is driving unaffordability. In Asia, that concern is even higher, with 85% of insurers saying inefficient and wasteful care could make plans unaffordable over the next three years.
Regulators in two major markets have moved to mandate claims data standardisation – and what those mandates have already produced is instructive.
Bank Negara Malaysia established a central medical claims data platform as part of its reforms to the medical and health insurance and takaful sector, requiring insurers to submit claims data for industry-wide analysis. A World Bank report published in April 2026 used de-identified claims from that database, covering 2022 to 2024, to provide what it described as a first empirical look at the drivers of costs in Malaysia’s private health insurance market.
The findings were significant. Utilisation – the volume of services consumed – accounted for approximately three-quarters of all claims cost growth. Potentially preventable inpatient admissions made up 23.6% of all admissions in 2024. The World Bank also found suggestive evidence that moral hazard among patients and providers may be contributing to utilisation, noting that claim amounts were substantially higher when moral hazard was present.
That analysis was only possible because Malaysia’s centralised claims database existed. Without it, the country’s MHIT claims inflation of 21.6% in 2024 – which outpaced premium inflation of 13.2% – would have remained an opaque aggregate with no actionable decomposition.
In Singapore, the Ministry of Health introduced revised Integrated Shield Plan rider requirements from April 2026, citing over-servicing, rising claims, and escalating premiums as pressures on the private healthcare system.
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The AIA and Amplify Health paper does not frame claims data standardisation as a marginal efficiency improvement. It presents it as a prerequisite for the payor-provider collaboration needed to put Asian healthcare systems on a more stable long-term footing.
“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,” the paper states.
For insurance professionals operating in markets where premiums are rising and benefits are narrowing, the argument is direct: the tools to manage costs structurally – provider benchmarking, value-based arrangements, fraud detection – require data that, across much of Asia, does not yet exist in usable form. Until it does, the cycle of reactive repricing is unlikely to break
