Jan 19, 2016
Themes
Create convenient access
Incentivise the right behaviours
Integrate
1
2
3
Themes
Create convenient access
Incentivise the right behaviours
Integrate
1
THE VITALITYHEALTH INTEGRATED MODEL
THE VITALITYHEALTH INTEGRATED MODEL
THE VITALITYHEALTH INTEGRATED MODEL
GPS – GATEKEEPERS TO HEALTHCARE
GP’s are a trusted entry point for healthcare
Doctor
Family / friends
Online forums
Online experts
Online reviews
Health magazines
95%
35%
24%
16%
9%
8%
Sources of advice on health matters
Accessing GP services is getting harder
Patients waiting on average more than 1 week for a non-urgent GP appointment
2014 2015
56%
74%
Target guaranteeing a GP appointment within 48 hours removed in 2010
NHS Direct closed in March 2014
Sources: nVision Research 2013 and Pulse 2014
CONSUMER DEMAND MORE FROM GPS
Consumers desire more choice and access
coordinate with my doctor's office
communicate with my doctor's office
adhere to my doctor's treatment plan
track my health goals
75%
70%
65%
62%
Percentage who would sign up for an app or website that helped them :
Health insurance is all about access and choice
Key drivers of health insurance sales
Sources: nVision Research 2013, Vitality Health
INTRODUCING VITALITY GP
Expert advice on wellness and
illness
“Whether you want to find out what you should do to get healthier or want to discuss a health issue before making a claim, our Vitality GPs can help. You can speak to a Vitality GP face-to-face through video consultations or over the phone 24 hours a day”
! available from Q2 2015
MULTI-CHANNEL HEALTHCARE
24/7 access
advice on health matters
referral to physiotherapist & surgical consultant
Vitality lifestyle coaching GP HELPLINE(reassurance &
advice)
Service Attributes Outputs
GP
+flexible appointment
times(including weekends & evenings)
online booking system(ensuring appointment within 48 hrs)
choice of GP (gender, availability, special
interests, 10 years UK experience, CQC accredited)
medical underwriting (can authorise treatments)
secure upload of images (e.g. for mole check)
secure sharing of records
review & rate facility (member can review & rate
experience)
(diagnosis & referral )
prescribe Vitality
order minor diagnostic tests
order prescriptions
schedule follow-up appointment
authorise referral to physiotherapist
(via Priority Physio network)
authorise referral to CBT therapist
(via CBT network)
authorise referral to consultant
(Alliance Surgical, Oncologist & medical consultant)
referral to NHS GP & A&E
THE COST OF VITALITY GP
£25 (per
consultation)
Actual Cost
GP
FREE
Cost to Member
GP
EXAMPLE SCENARIOS
I am illCan a Vitality GP treat me ?Do I need to go to my NHS GP or A&E ?Do I need a referral ?
I am seeking medical advice for me or a family memberI have a mole / skin lesion I will be travelling Do I need a full medical screening ?My child has a high temperature do I need to take them to A&E ?
I have already been diagnosed – Now what ?What is your opinion ?Can I see my named consultant?Can you refer me for a second specialist opinion ?
I’ve a recurring problem – acute flare upCan you treat me ?Can you refer me ?
I have a chronic condition Can you monitor me ?Can you help me manage my condition ?
1
2
3
4
5
CASE STUDY 1
Reassurance is just a call away
It’s the weekend and Nikki’s son is sick. She doesn’t know what to do. How serious is it? The GP’s surgery isn’t open and Nikki doesn’t know if she should take him to hospitalNikki phones the Vitality GP who advise her on the best course of action for her son and whether or not they need to go A&E.
The Vitality GP consultation
CASE STUDY 2
The Vitality GP consultation
Liz’s arm has come up in a nasty rash. It came on quite quickly and it’s itchy and sore. She wants to see a doctor quickly so they can tell her what it is, but she can’t take time off work at short notice.
With Vitality GP Liz is able to book a video consultation with a GP at a time that works for her. The GP can see the extent of Liz’s rash by video and through additional photos Liz sends him, the GP can assess the rash in more detail. The GP then advises Liz on the best course of treatment and whether or not she should see a dermatologist.
CASE STUDY 3
The Vitality GP referral
Mark has sprained his ankle and needs to see a GP. This is tricky because when he phones his GP’s surgery to book an appointment, the only available ones that week are in the middle of the day. Mark’s busy at work then and doesn’t have time to go during the middle of the day
With Vitality GP Mark is able to book a video consultation with a GP within 48hrs and at a time which suits him. The GP recommends a course of physiotherapy and is able to book Mark’s first session for the next day at a clinic near his work.
PRESCRIPTIONS AND TESTS
prescribes medication
prescription fulfilled by
LloydsPharmacy
pick up from local
LloydsPharmacy or
home delivery
recommends minor tests
full blood count, urea and electrolytes, urine for culture and sensitivity, ultrasound scans or plain X-rays
£100 (per year)
PRIMARY CARE
BENEFIT
Part of Core Cover No impact on No-Claims Discount Not subject to excess deduction
Tests and scans
Tests / scans Average cost
Full blood count £78
Liver function profile £98
Urea and electrolytes
£78
X-ray £109
Chest X-ray £101
Private prescriptions
Prescription Average cost
Amoxicillin £8.15
CASE STUDY 4
The Vitality GP prescription
It’s 8am and Tom has just had a video consultation with the Vitality GP before going to work. The GP has written him a prescription. Normally Tom would take his prescription into a pharmacy in his lunch break and wait while they put together the prescription – this normally takes a while as the pharmacy is always busy at lunchtime
Through its partnership with LloydsPharmacy, Vitality GP sends Tom’s prescription straight to LloydsPharmacy who prepare Tom’s prescription for him to pick up during his lunch break
KEY MESSAGES Clients
Convenience24/7 access to primary care, including payment for minor diagnostics and private prescriptions
Coordinated Carea single point of referral and navigation for your treatment to ensure the best member experience and most appropriate clinical pathway
Prescribe Wellnessa unique ability to combine clinical pathways with wellness interventions to achieve the best health outcomes
Employers
Reduce employee time off work due to time needed to see GP, and minor illness
Rewardemployees with a truly unique, relevant and highly valued new benefit
Remind employees of your commitment to helping them manage and improve their health and wellbeing
TREATMENT
1.Limited clinical and claims information
2.Limited consultant & provider information
3.Size disadvantage for negotiation
Customer
NHS GP
Consultant
Health Insurer
1.Access to clinical and claims information 2.Access to consultant and provider information 3.Size advantage for negotiation
1.Increasingly hard to contact 2.Little or no knowledge of consultant quality and
charging patterns 3.Little or no knowledge of networks and services
available through health insurers Who is best to advise ?
Information asymmetry in the independent healthcare system means that healthcare consumers have little or no informed choice
Real time access to consultants’ & therapists’ profiles
Real time access to consultant and therapists’ diaries
Members able to choose GP according to their selection
criteria
Members able to rate GP according to overall
experience
Continuous feedback loop between insurers and
providers ensuring quality of referrals and outcomes
Quality assured medical access for member
WITH SERVICE INTEGRATION COMES VALUE FOR ALL
GP panel delivers clinically appropriate primary care & wellness services and enabled to authorise onward referral for treatment
Consultants empowered to make treatment recommendations
according to clinical appropriateness and not member’s chosen hospital list
Insurer is able to deliver greater customer and partner value while still achieving cost efficiencies
Member has immediate access to an integrated
healthcare system
GP
feedback loop
direct referral to consultants
consultant refers member
to most appropriate facility for
treating the presenting condition
GP SELECT
Member books video consultation with Vitality GP
Vitality GP can authorise
further treatment
and referrals
prescriptions
minor tests
physiotherapy
cognitive behavioural
therapy
GPA&E
GP
PRICING
BASE
COUNTRYWIDELOCAL
-10%
-15%
GP SELECT
33%( up to)
COUNTRYWIDE PLUS
! available from Q2 2015Pricing is indicative only, and correct as at November 2014
KEY MESSAGES
Empowers GP to make decisions together with the patient without the influence of the insurance company and without the restriction of a defined hospital list
Facilitates access to clinicians with expertise relevant to your condition at the earliest opportunity
Removes unnecessary utilisation in the system by eliminating repeat consultations and diagnostics
Allowsus to pass on efficiency savings to the member, consistent with our shared-value insurance model
OUT-PATIENT COVER
Out-patient Cover
MRI/CT/PET Scans no impact on out-patient limit In-network physiotherapy
Consultations up to chosen out-
patient limits with option to
fully cover consultant referred
diagnostic tests
Diagnostic tests
Out of network physiotherapy
£35 per
session
Core cover
MRI/CT/PET Scans
New Out-patient cover
MRI/CT/PET Scans are only covered when an out-patient option has been selected
1. Including high cost scans in Core Cover inflates the cost of Core
2. Requirement for consultant referral for scans means its counter intuitive to offer this cover without accompanying Out-patient Cover
3. 93% of new business clients opt for Out-patient Cover
Old approach to covering high cost scans
new benefits
Vitality Health continues to offer the most out-patient options in the market
Priority Physio claims DO NOT count towards the overall out-patient limit
Priority Physio Network provides access to over 1,400 physiotherapy clinics nationwide
! available from Q2 2015
WHAT DRIVES HOSPITAL CHOICE?
Location most likely to influence hospital choice
Gegraphic location
Previous experience
Waiting times for appointments
Comfort and quality of accommodation
Whether insurance covers cost
Consultant rec-ommendation
48%
36%
36%
33%
32%
32%
Most important reasons for choosing private hospital
Sources: Competition Commission / GFK 2012)
On average patients are willing to travel for 30 minsWillingness to travel to private hospital (average travel time in minutes)
Average London Urban Rural
32 31
25
35
Hospital of St John and St Elizabeth added to Countrywide Hospital List at no additional cost
HOSPITAL LISTS
National
Central London
main independent acute hospitals
main independent acute hospital beds
Countrywide
95%
88%
BASE PREMIUM
Countrywide Plus
100%
100%
33%(up to)
Local
70%+
67%+
-10%
Premier Hospital List renamed as Countrywide Plus
Sources: Laing & Buisson 2014
! available from Q2 2015
‘
over fifty percent of consultants with
admitting rights to Countrywide Plus
hospitals also have admitting rights to Countrywide List
hospitals
Average number of hospital specialists have admitting rights to
London Out of London
3 2
LONDON HOSPITALSMyth busting
67% of SME and corporate customers on the Countrywide Plus coverage live within 2 miles of a Countrywide List hospital
In 71% of cases, the nearest Countrywide List hospital is also the nearest Countrywide Plus Hospital
London consultants tend to only work out of 1 hospital
You have to have Countrywide Plus coverage to get ‘Premier’ consultants’
You have to have Countrywide Plus to get the best care and service
Aspe
n
Other
(no
n – Lo
ndon
)
Nuffiel
d
Spire
BM
I
Other
(Lon
don)
Ram
say
HCA
NHS
9.22
8.11
Vitality Health customer satisfaction scores with hospital
Sources: Competition Commission / GFK 2012) & VitalityHealth data 2014
ABILITY TO MEET CUSTOMER NEEDS
Malignant neoplasm, breast
Low back pain, site unspecified
Malignant neoplasm, colon,
Malignant neoplasm of ovary
Malignant neoplasm of prostate
Malignant neoplasm, bronchus or lung, unspecific
- Other and unspecified abdominal pain
Senile cataract, unspecified
impacted teeth
Pain in joint, lower leg
Unilateral or unspecified inguinal hernia
Intervertebral disc disorder
Injury to multiple structures of knee
Haemorrhage of anus and rectum
Atrial fibrillation and flutter
Sources: Vitality Health data 2014
Looking at the top 15 conditions we most commonly pay for in London, between them all 3 Central London Countrywide hospitals treat these conditions
KEY MESSAGES
Outside Central LondonWhere Central London hospital coverage is not required we believe that in the majority of cases the Local Hospital List offers sufficient coverage with access to high quality facilities and consultants
Central LondonWhere Central London hospital coverage is required we believe that in the majority of cases the Countrywide List offers sufficient coverage with access to high quality facilities and consultants
CANCER
Typical cancer benefits
Quick diagnosis
Rapid referral
Prompt hospital treatment
Radiotherapy
Chemotherapy
Drugs/treatments not covered by NHS
Latest technology e.g. Cyber Knife
Treatment at home
Health insurance offers reassurance in terms of cover
Concerns about NHS cancer provision prevail
HIDDEN COSTS OF CANCER Full Cancer module
renamed Enhanced Cancer Cover module but remains default module for quotes
New benefits added to Enhanced Cancer Cover module
Additional services Monthly
Cost Annualise
d Cost New cancer
benefits
Wigs hairpieces and head coverings £23 £276 £300
Fabric supports e.g. Mastectomy bras £14 £168 £200
Scalp cold capping £50 £200 Covered
Additional services Average Duration
Speech therapy 6 sessions 6 sessions 6 sessions
End of life home nursing care 12 – 14 days 14 days 14 days
available on new Enhanced Cancer
Cover module
Sources: Macmillan – Cancer’s Hidden Price Tag. Public Health England - What We Know 2013
Cancer Cover Enhanced
Cancer Cover
Diagnostics
Consultations
Investigations
Surgery
Surgery
Reconstructive surgery
Stem / bone marrow transplants
Oncology
Radiotherapy
Chemotherapy
Chemotherapy at home / work
Biological therapies 12 months
Bisphosphonates full cover if combined with chemotherapy & up to 3
months if used on their own
Hormone therapies
Support
Cash benefits
Dedicated nursing support
Assistance at home
Follow-up consultations 5 years no time limit
End of life care (pain relief)
Hospice donation
End of life home nursing care 2 weeks
Wigs hairpieces and head coverings
£300
Fabric supports e.g. Mastectomy bras
£200
Scalp cold capping
Speech therapy 6 sessions
OUR CANCER OPTIONS
! available from Q2 2015
Themes
Create convenient access
Incentivise the right behaviours
Integrate
2
BROAD RECOGNITION OF NEED TO INVEST IN HEALTHY BEHAVIOUR
‘ There would be merit in extending incentives for employers in England who provide effective NICE recommended workplace health programmes for employees ‘ - NHS – Five Year Forward View ‘
‘If the nation fails to get serious about prevention then recent progress in healthy life expectancies will stall, health inequalities will widen and our ability to fund beneficial new treatments will be crowded-out by the need to spend billions of pounds on wholly avoidable illness’
NHS – Five Year Forward View
2012 2013 2014
INCENTIVES HAVE SUCCESSFULLY ENCOURAGED GREATER AWARENESS OF HEALTH
2011 2012 2013 Q1 2014
Q2 2014
Q3 2014
non-smoker’s cashback
Removed HealthCheck
fee
Average Vitality Age completions per quarter
Average Vitality HealthChecks per quarter
Removal of Healthcheck fee applied to VitalityHealth members only
x3
x10Weekly movies
UNDERSTANDING HEALTH GETS EASIER AND CHEAPER Entry level Vitality Prevention Plus £50
Lifestyle Health Assessment
£122 BMI Essential £84
Mid-range
Vitality Active £64Female Health Assessment
£154 BMI Select £162
Vitality Core £85
Comprehensive
Vitality Executive £125360 Health Assessment
£257 BMI Advanced £246
360+ Health Assessment
£341 BMI Advanced Plus £329
Bluecrest offers health
screening services out of 1,732
locations nationwide
Discount of 50% applied to all
health screenings
Prices include 50% Vitality Discount and are rounded up to the nearest £1 for illustrative purposes
GREATER INSIGHT INTO THE RISK PROFILES AND NEEDS OF OUR MEMBERS
<=0 1 2 3 4 5 6 7 8 >=9
15% 15% 16%13%
11%9%
6%5%
3%
7%
Distribution of Vitality Age Gap
VITALITY AGE – ACTUAL AGE
Vitality Age and HealthCheck data gives us a unique ability to segment our membersand tailor interventions based on individual need
Based on analysis by Vitality
% o
f m
em
bers
<=0 1 2 3 4 5 6 7 8 >=9
15% 15% 16%13%
11%9%
6%5%
3%
7%
Distribution of Vitality Age Gap
VITALITY AGE – ACTUAL AGE
HIGH-RISK MEMBERS NEED TO GET CONTROL OF THEIR RISKS AND CONDITIONSThe least healthy 15% of members have an average of 3.1 risk factors compared to an overall average of 1.8
Based on analysis by Vitality
% o
f m
em
bers
<=0 1 2 3 4 5 6 7 8 >=9
15% 15% 16%13%
11%9%
6%5%
3%
7%
Distribution of Vitality Age Gap
VITALITY AGE – ACTUAL AGE
AT-RISK MEMBERS REQUIRE A REGULAR ROUTINE OF ACTIVITY AND WELLNESS
66% of these members are out of range for each of physical activity and nutrition
Based on analysis by Vitality
% o
f m
em
bers
Walking
Running
Compared with inactive people, those who run/walk for 15 minutes a day have a 14% lower mortality risk, and a 3 year
longer life expectancy
Source: “Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study”, Chi Pang Wen, Jackson Pui Man Wai, et al
SUSTAINED DAILY ACTIVITY CAN DRAMATICALLY IMPROVE LONG-TERM HEALTH
Relatively simple exercise behaviours (e.g. walking, cycling) may more easily
become habitual than behaviours that are rather complex (e.g. attending an
organized fitness program)...
Source: “Physical exercise habit: on the conceptualization and formation of habitual health behaviours”, Henk Aarts, Theo Paulussen and Herman Schaalma
EMBEDDING DAILY ROUTINES WITH REGULAR, MODERATE ACTIVITY IS KEY TO INCREASING OVERALL PHYSICAL ACTIVITY
Gym
Onl
ine
activ
ity
Scre
enin
g an
d pr
ev...
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Membership Month
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Ongoing pedometer usage (Cohort: Members registered
between Oct 2012 and Mar 2013)
44% usage af-ter 6 months
24% usage af-ter 6 months
Engagement in healthy activities by movie goers relative to non
movie goers:
Vitality members
Non-Vitality members
8.2x
14.1x16.8x
INCENTIVES CAN HELP CREATE NEW ROUTINES, BUT WE NEED TO MAKE IT SUSTAINABLE
Based on analysis by Vitality
Our experience with the cinema benefits have shown the effectiveness of rewards in increasing healthy behaviours
Based on new business 2013
More than one million wearables are expected to be sold this Christmas
Analysts are heralding 2014 as the year the wearable finally fully breaks into
mainstream consciousness
WEARABLE DEVICES TOGETHER WITH INCENTIVES GIVE US A UNIQUE ABILITY TO DRIVE SUSTAINED ENGAGEMENT
MAKING IT EASIER TO TRACK ACTIVITY AND GET ACTIVE Moves:
Free App for iPhone & AndroidNow you can link more activity devices and earn Vitality points with free mobile app Moves
MAKING IT CHEAPER TO TRACK ACTIVITY
50%
50% off selected Garmin activity tracking devices
Includes Garmin Swim, so now swimmers can be rewarded too
One of the largest producers of activity trackers in the market
Each adult member can earn 50% off either a Garmin or Polar device during the lifetime of their plan
REWARDING ACTIVITY THROUGH A NEW REWARDS CATEGORY
We have been inspired by the success of the cinema benefit in increasing Vitality Age completion; can we now use it to motivate regular physical activity?
9 points unlock a weekly reward
WEEKLY REWARDS
1 movie AND 1 drink per week
40 points unlock a monthly reward
MONTHLY REWARDS
Minimum of 1 song per month
Active Rewards
How it works:
INTRODUCING FREE PASS FOR VITALITY GOLD AND PLATINUM MEMBERS
To recognise the efforts of our Vitality Gold and Platinum members, we are giving these members immediate and ongoing access to Active Rewards, regardless of their weekly
and monthly points earning
<=0 1 2 3 4 5 6 7 8 >=9
15% 15% 16%13%
11%9%
6%5%
3%
7%
Distribution of Vitality Age Gap
VITALITY AGE – ACTUAL AGE
REGULAR ENGAGERS NEED SUPPORT TO SUSTAIN ENGAGEMENT
The challenge is to keep these members engaged in their health on an on-going basis %
of
mem
bers
Bronze Silver GoldPlatinu
m
10% 20% 40% 50%
£250 £300 £400 £500
£50 £75 £100 £125
25% 30% 35% 40%
50%
Rewarding ongoing engagement for the attainment of health goals
STATUS REWARDS
25%
Maximum cashback:
Maximum cashback:
Subject to terms and conditions
0
1,200
2,400
3,600
0
1,600
3,200
4,800
0
2,400
4,800
7,200
Reduced Status Requirements
0
800
1,600
2,400
Single
Unchanged
Couple Couple and family
Family1
1 - Couple with 18+ Dependant , 2 – Available from Q2 2015 for new business and renewal
CHANGING THE VITALITY POINTS STRUCTURE TO ALLOW EASIER PROGRESSION FOR FAMILIES
CASE STUDY - COUPLE WHO BOTH WALK 7,000 STEPS A DAY
It took 267 days for them to reach Silver:
Before: Silver status = 1,600pts
Now: Silver status = 1,200pts
It takes 200 days for them to reach Silver:
They get to Silver over 2 months earlier
Making moderate engagement more achievable for couples and families
Time taken to reach Silver:
CASE STUDY – RECOGNISING AND DRIVING MORE ENGAGEMENT
Wife goes to gym 3 times a week, but husband is un-engaged:
Wife Husband0
200
400
600
800
1000
1200
1400
1600
1800
Wife Husband0
200
400
600
800
1000
1200
1400
1600
1800
Wife Husband0
200
400
600
800
1000
1200
1400
1600
1800
Bronze status Silver status Gold status
Before wife’s effort was not recognised:
Couples joint status:
Now her effort is appropriately recognised:
If husband walks 7,000 steps
a day they can get to Gold:
Our new approach is designed to help get less active partners engaged, so couples and families can enjoy more rewards
Old thresholds: New thresholds:
Domestic European
ANNOUNCING AN EXCITING NEW STATUS REWARD PARTNER
Up to 40% off return flights including taxes and charges, to more than 70 destinations within UK and Europe
Vitality StatusDiscount off total fare*
Number of return flights per life per
annum
Bronze 5% 1
Silver 20% 1
Gold 30% 2
Platinum 40% 2
Number of flights per annum applies to each life named on the planThe discount applies to return economy flights and is subject to a minimum stay depending on the day of departure.2 nights stay needed for Sun to Thurs departures, and 1 night overnight stay needed for Fri and Sat departures.
WORKINGS OF THE BRITISH AIRWAYS BENEFIT
SUMMARY OF PARTNER CHANGES
Our new partners Withdrawals
We are removing some of our less used partners to make way for even more partners
Our new partners will become available for new business from end of January 2015
New business: These partners will no longer be available for new business from 1 January 2015:
Existing business: Bookings for Mark Warner and Merlin are available up to renewal after 1 Feb 2015.
Ticketmaster and buymobile.net are available for new contracts and activations up to 1 Feb 2015. Existing phone contracts will be honoured until the end of their term..
Themes
Create convenient access
Incentivise the right behaviours
Integrate 3
STATUS LINKED EXCESS ADDITION
A non-discriminate way of sharing cost with employees and driving engagement
Vitality STATUS
£250 Max
£150 Max
£250 £150
£100 £100
£0 £50
£0 £0
Reduced excess for low status
employees
ENHANCED PERSONAL HEALTH FUND
Vitality STATUS
Annual Contributio
n
£75
£125
£175
£225
Service
average cost of a private sight test
£78
average cost of a private dental check-up
£30-£60
Bluecrest Vitality Executive Screening
£125*
Annual cost of a chronic prescription card
£104
Garmen Vívofit£44.50
*
Omron Elite Blood Pressure Monitor
£102.95
Betterlife Digital Tens Unit £25
50% towards indicator measurement devices/products, including blood pressure cuffs, cholesterol and blood glucose testing kits etc.
50% towards medical aids, including hearing aids, tens machines, first aid kits, dressings and medication
+
* Includes Vitality discount
INTELLIGENT INCENTIVES CAN CUT COSTS AND DELIVER GREATER VALUE TO EMPLOYEES
Status Linked Excess
£75
£125
£175
£225
Personal Health Fund
£60
£90
£120
£150
Non-smoker’s Cashback
£150
£100
£50
IN SUMMARY GP embedded in our product
Launch of new product
Introduction of Active Rewards
Powering our Status Rewards
INTRODUCING VITALITY INSIGHTS
visit vitalityinsights.co.uk
Reports & articles
Case studies
Regular insights, research and case studies showing the value of Vitality’s shared value approach