Preventative medicine and wellbeing have never been as popular as they are now, in the wake of the COVID pandemic. In fact, with medical services globally undergoing massive transitional shifts and treatment waiting lists for commonplace conditions at an all-time high, private health services, especially those which are delivered digitally, are in demand.
Health insurers around the world are responding by developing rapid digital pathways for customers to access benefits.
Vitality health insurance is one such organisation. An insurance provider that offers a multitude of services and protection products to its customers, it was originally founded in 2004 when a partnership between Prudential and Discovery – a South African insurer – was formed.
Vitality current Managing Director for Health, Dr Keith Klintworth, joined the company in 2010. At that time, Vitality had just acquired Standard Life Healthcare to drive forward the economies of scale and to increase its health membership base. By 2014, Vitality had bought out Prudential and was operating as a composite insurer across Life and Health insurance.
“We've gone from strength-to-strength,” says Klintworth with pride. As a healthcare expert with a 25-year career in medicine – during which he has worked in the role of both a Managing Director for the insurer and as a consultant anaesthetist – it's comforting to see this softly-spoken South African’s enthusiasm for Vitality offerings. After all, this is no ordinary health and life insurance operation: its leaders are doctors and the wellbeing of its customers is considered of paramount concern.
Klintworth explains: “Discovery in South Africa was well known to me as an insurance provider. Their core purpose of making people healthier – which is Vitality’s purpose, too – resonated with me as I spent so many years treating, and not enough on preventing, illness. Prevention is a really complex challenge.”
As part of this they have what they call the Vitality Programme embedded into their insurance products, he explains, an incentive-based behavioural change programme – encouraging personal behaviour change and incentivising people to make healthy decisions through rewards. Launched in 1997, the evidence of the programme’s success spans 25 years.
As a result, the well-structured offering has plenty of data to back up the impact it has in driving positive behaviour change and the significant difference it has made to its members during its quarter-century tenure.
“The Vitality Programme is part of our completely different approach to insurance – the incentive-based programme where, if you get active each week and look after yourself, rewards you with regular treats and discounts from our partners. By sharing the benefits of healthy living in this way, we find members benefit from better health, tangible financial value, enhanced insurance benefits, alongside compelling rewards.”
He continues: “Health is a key concern for us, post-pandemic, which makes our member-led approach, with health and wellbeing at its core, really relevant and empowering to our members.”
Vitality is driven by its member-centric digital functionality, which has been responsible for developing in-depth customer insights to understand their customer needs. More importantly, it is driven by learning from customer feedback and experience surveys across medical pathways and treatment to really ensure that the customer journey being built matches and manages their expectations, while driving excellence in the customer experience.
Klintworth points out that the member-driven healthcare approach is one that responds to the full spectrum of members' healthcare needs. Rather than just focusing on the traditional features that people think of within PMI – specifically, private health insurance – such as in-patient and day patient treatment, Vitality prioritises prevention, primary care, and digital pathways that enable its members to better understand and also navigate the complex healthcare system so that they can access their needs quickly and seamlessly.
“Additionally, our digital experience teams are composed of both UX teams and the customer experience (CX) teams, as it is imperative that they bring together their different skills and effectively collaborate in a way that will ultimately result in an enhanced journey for all our customers,” says Klintworth.
Personalised digital healthcare
The idea is that healthcare and coverage should be as personalised as possible so it can support people throughout all the health changes in their lives, minor or major, to maximise their health. In 2021, Vitality announced its data-driven approach to realise this. Called ‘Next Best Action’, the new initiative brings together Vitality’s data science capabilities with its expertise in understanding individual health risks to provide members with that one action that would have the biggest impact on their future health.
“We all have risks, whether they're lifestyle or they're clinical risk factors. But where do you start? You can take an overweight person and tell them ‘you need to eat healthy’. Well, we all know that. But what is the trigger, the pathway, for that person that would resonate and help them get started on that journey? It might just be, can you do 5,000 steps, four days a week, as a starting point? After that, you can expand your usage of the Vitality Programme.”
Ultimately, it's down to behavioural changes, incentivised by Vitality. Users are encouraged to alter their lifestyles and adopt healthier habits. “I think it is really important to appreciate that Vitality is a behavioural change programme. We're not just telling you you're overweight, you're inactive, or you're a smoker and you need to stop; we give you the tools and support to make that change happen in a way that is sustainable for the long-term.
Habits take a while to change though, explains Klintworth, and all of us frame our habits in different shapes or forms. “We will either minimise it, or we will recognise it as an issue. But we all have another trigger, or incentive, that can help us do something about it. Whether it's suddenly waking up to the reality of your own health and that you won't be a grandfather, or you won't see your kids grow up, or something else, we all need that occasional reality check to suddenly take heed and say, ‘Oh, I need to do something differently’,” he points out.
If customers adopt better habits, not only are they benefitting from being healthier, but their health risk factors are reduced, which is better for insurers and society as a whole. Ultimately, it's what the company calls ‘Shared Value’.
Klintworth says: “Society is demanding that companies have a strong social purpose. By focusing on the creation of a healthier society, we believe we are at the forefront of this. Ultimately, what's good for us is good for our members and thus for wider society – member-led healthcare actually fits into that whole framework.”
A growing customer base
Vitality’s target market is twofold: the first target is made up of individual members who, through accessibility, convenience, and speed of access, drive some of the market’s needs; the second big component is employee health and wellbeing. More and more companies are offering private medical insurance and are aware they need to provide something that’s appropriate for their entire workforce.
“We seek to provide the private medical insurance that is right for each company's circumstances. Some, for example, may for whatever reason not cover all employees. Recognising that these companies often still wanted a wellbeing programme for the wider workforce that could support them to be healthier, we devised a programme that featured key aspects of the Vitality Programme and access to primary care for the whole workforce.”
The Vitality team is increasingly seeing primary care, which would previously have fallen out of the remit of private health insurance, becoming one of the most used services. Klintworth explains that there is much people can now do to understand their own health better. When they have a Vitality GP consultation or see their physio, it's often not just about treating that acute event; instead, it’s a process that informs the member about what their risks are. Understanding risk as a consumer is, Klintworth believes, paramount in the preventative medicine journey.
“As a Vitality memberyou can also do a health questionnaire, get a health check to see where your numbers are sitting, like your blood pressure and your weight, etc. Then, if there are any risks that are identified, you can take action to prevent it. If you add into this our Vitality programme, with what we know about behaviour change and incentives, you have the potential to have a far healthier society.
“While our model encourages members to live a healthier lifestyle, we do attract a healthier client base to start off with, whether that be a 30-year gym member or a 50-year-old cyclist, as the product offering resonates with them.”
In general, Klintworth says that a significant proportion of the Vitality membership base is active, which supports their prevention agenda. The provider’s aim is then to leverage the data they have as part of the Vitality Programme and claims data to make the less active or at-risk more active, thus improving their health.
Technology plays a crucial role in everything Vitality does, with a clear focus for the company centred on using technology to improve customer experience, access and clinical pathways. It is also a powerful tool for their own employees. To empower employees, it is imperative that they have the necessary technology tools to do their job well.
“The key consequence of empowering one’s employees is that it drives service improvement and understanding of our customer’s needs. And why do I think that's important? Well, it's to build advocacy among the actual membership base.”
Klintworth says businesses need to drive scalability, and economies are scaled through different efficiencies of technology use.
“You need to continually invest in technology because it is critical to our offerings. Within the Health and the Life business for example, we need technology to support claim fund management as it relies on technology assets such as rules engines.
“For cyber security, we are duty bound and committed to ensuring our data and our assets are protected from cyber attacks. Our customers rightfully want to know that we govern their data properly, that it's ethically managed, and that it's collated consistently and stored safely.”
Digital diversity and an expanding ecosystem
Working on a core value of promoting digital diversity is another motivating factor behind Vitality. “Digital diversity is an ever-evolving, ever-changing definition as we consider more and more facets. But I think it does include all aspects of technology and its impact on people, whether its a physical, mental, emotional or ethical impact.
“When you're building technology or digital programmes, you have to consider the diversity of your customer mix and the demographic you're targeting. We need that balance of understanding and the conscious and unconscious biases that are at play.”
Digital transformation in the DNA
Vitality is a fairly young company and, as such, may not be as hampered by legacy and multiple technology systems that other, longer established health and life insurance providers have endured. The culture of the company is dynamic, and the teams actively embrace new innovations and solutions as they appear on the market.
“The people who work here know that change happens. To quote my CIO, ‘We look for shiny new objects all the time, and we build and enhance and optimise’.
“Another component is language – consistency of language across your different technology routes, whether app or web, is critical. After that, it's a case of continuing to optimise and use technology to understand and continually improve the customer experience.”
Vitality’s technology integration is complex. As part of the company’s focus on health and wellbeing and the way the Vitality Programme runs, they needed to integrate their technology systems with a range of fitness devices that are essentially wearable data sources. Additionally, the company needs its technology to integrate with the partners it has within the Vitality Programme, such as Caffe Nero, ODEON and Vue.
The next process has been to integrate the relevant health and wellness data into medical care. Klintworth began working on developing the first virtual GP service back in 2015, at a time when these kinds of appointments were largely unheard of. Yet, now, after the pandemic has caused millions of face-to-face appointment cancellations, the forward-thinking moves Vitality made in this direction are now setting an example to other health providers.
“If I just look back at the GP market that I surveyed at that time, 50% of GPs were against telehealth, 50% were for it. It was age and gender agnostic, which was surprising. Yet, customers recognised it as a really important route of access for GP services. Following a market review, we identified US partner second MD, who did the initial application development for the virtual GP service and outsourced the medical service to a UK GP provider.”
Klintworth says that in continuing to drive scalability, member experience and digital innovation, Vitality recently partnered with Livi, a Swedish-based digital company, to provide its digital GP service. Livi is working with a number of NHS Primary Care Trusts, which ensures they understand the challenge to deliver an exceptional customer experience in digital healthcare.
He then emphasises that it’s about more than having convenient access to a GP. “We devised a new pathway so these GPs could make onward referrals where a member needs it, as well as training the GPs to prescribe ‘wellness’.” GPs, he stresses, need to have visualisation of patients’ health checks, their activity data and their lifestyle and clinical risk factors so that they are not only treating the sore throat, but they're also prescribing wellness.
“Our Vitality primary care digital services also include physiotherapy and CBT services. We introduced the use of smartphone cameras to support diagnosis of skin lesions, for example. Our customers are sent a high-resolution lens that attaches to their smartphone and with which they take a photograph of their skin lesion, upload it, and our partner, Skin Analytics, will use Artificial Intelligence processes to assess it.”
Klintworth, who is passionate about progress, believes the company was well positioned to embrace digital healthcare at the start of the pandemic because it had all the foundations in place. “Recently, we launched the next iteration of the digital care journey for our members – an online Care Hub where our members can start a claim, get authorisation and choose a consultant in one seamless digital process,” he says.
New solutions for healthcare providers
The Care Hub’s includes a Consultant Finder which features a range of different doctors, including Vitality Premier Consultants, a specially designated panel that demonstrates superior performance outcomes. The solution is supported by a Vitality partner, Doctify, and enables members to input their condition(s), bringing up a list of consultants for members to look through so they can choose who is most suitable to treat them.
“People demonstrate different preferences when it comes to choosing a doctor. We provide each doctor's details, such as academic background or specialist interest, as well as patient reviews to support each customer in making an informed choice.
“It's about the journey,” Klintworth continues. “And our journeys in healthcare can be wasteful. The amount of time that is wasted by consumers going to see a GP, waiting for your appointment, being referred somewhere else, and then you wait again. Why do you always need follow-ups to be done in person? They're generally five to 10-minute follow-up consultations. With the current in-person system, customers may find themselves impacted for three hours out of their day. Having a digital process in place is far more efficient for the consultant and the customer and can, for many conditions, still provide a good medical outcome.”
Turning of the tide in healthcare
Despite some initial resistance to the digital healthcare system, both from members and providers, Klintworth says the tide is now turning. People are understanding the value of technology, while also appreciating the convenience and speed at which their medical needs can be met. This is all made possible through the strategic partnerships Vitality operates with.
“We have a very wide partner ecosystem. Not least of all, our external technology and digital companies. One of these is TCS, which is a valued partner of ours and has been since before our Standard Life days. Vitality also has a substantial number of digital wellness, screening providers and reward partners.
“You need the attraction for a broad base of appeal. You're either an Apple Watch lover or you prefer something else, such as your Garmin, your Fitbit, or your Polar. So we have built the capability to integrate with all of these fitness tracking devices within our Vitality Programme.
“Our focus has always been about creating innovative and disruptive products. We work from understanding consumer needs, while also developing products or journeys that people haven't thought about before.”
A bright future for digital health providers
“We have always been known as a disrupter in the health insurance market, approaching things differently. Using the data we collect to develop behavioural change incentives that support better health and wellbeing while reducing health risks will always set us apart,” concludes Klintworth, who goes on to say that, at least annually, Vitality launches new initiatives, product enhancements, and new reward and health provider partners to its programmes and products. Ultimately, consumers and market demand for better services are driving this initiative.
He adds: “Digital healthcare adoption is a revolution. We need to keep driving this revolution because, from a consumer perspective, I do believe it works best for the majority of people – that's really important to us. Concentrating on continuing to reduce future morbidity and mortality, and really giving people healthy life years, remains our key strategic focus.”