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ANALYSIS

Five PMI trends based on Vitality claims data

Demand for private medical insurance (PMI) has risen sharply in recent years, driven in part by the ongoing pressure on the NHS.
At the same time, an ongoing decline in overall health and wellbeing in the UK is impacting people’s care needs in the UK.
Based on our latest Health Claims Insights Report, these are the main trends currently impacting a rapidly changing healthcare market, which will need to continue to evolve if it is to meet shifting consumer demands over the coming 12 months.
1. The case for prevention has never been clearer
PMI is particularly well positioned to help people to live in better health and prevent illness from occurring in the first place. Vitality data shows that a combination of nudges and incentives can be a powerful way to help people improve their lifestyle, both before, during and after a claim.
Lifestyle-related disease is placing a huge burden on healthcare services and costing the NHS billions each year. In the UK, 88% of preventable illness is down to lifestyle risks such as poor nutrition, lack of exercise and poor mental health.
Positively influencing behaviour change across both mental and physical health is therefore having a significant impact. For the most active Vitality members, for example, there is a 29% reduction in the risk of hospitalisation.
It can also play a major role in someone’s recovery. Analysis of Vitality member data shows that those who were less active before a variety of healthcare claims went on to increase their weekly activity by around 50% in the three months after their initial claim.
By focusing on the prevention – not just treatment – PMI plans have the power to help to reduce healthcare costs and ease the overall burden on the NHS.
2. Everyday care is now an integral part of PMI
In recent years, we’ve seen shifting consumer expectations and attitudes to health insurance, with more people turning to PMI for everyday healthcare needs.
Vitality claims data highlights that services such as Vitality GP, Talking Therapies, physiotherapy and Optical, Dental and Hearing benefits now account for almost 60% of all health claims.
Since 2019, Vitality has seen a three-fold increase in Vitality GP consultations, with over 10,000 consultations per month and, according to recent Vitality research, ease of access to GP appointments is now the second biggest factor for those considering PMI.
Primary care services, such as virtual GPs, are also being integrated with onward care as part of a more joined-up, end-to-end healthcare journey. Through Vitality GP, members can obtain a GP referral and immediate claims authorisation. They can then immediately choose a consultant and book onward care through Care Hub.
3. Talking Therapies are making a meaningful impact
Demand for mental health services in England has risen sharply in recent years, with a record 4.6 million referrals in 2022, up 22% from 2019.
Between 2015 and 2022, claims for Talking Therapies have increased significantly. Yet, despite this, we’ve seen a reduction in out-patient, in-patient and day-patient claims for mental health conditions. And, according to our claims data, 99% of members that access Talking Therapies require no further mental health treatment within the following three months.
Overall, we’ve also seen a 32% reduction in medical inflation-adjusted mental health costs between 2019-2022. This suggests is that when it comes to mental health, earlier intervention – through access to Talking Therapies such as CBT and counselling – is actually reducing overall claim costs.
Underwriting and pre-existing conditions can sometimes represent a barrier to people accessing mental health treatment through their PMI. That’s why, in 2022, Vitality became the first insurer to disregard underwriting for Talking Therapies, to help ensure the growing mental health burden in the UK can be more effectively managed.
4. Earlier cancer detection and diagnosis is needed
With one in two of us developing cancer during our lives, it’s understandable that many people want access to rapid diagnostics and treatment for them and their loved ones.
Our recent data highlights the risk for people of all ages, including younger clients, with one in four cancer claims now made by members under the age of 50.
Broken down by gender, the picture differs dramatically based on type of cancer. 33% of breast cancer and 65% of cervical cancer claims are now for women under 50, whilst skin cancer is the biggest cause of cancer for men under 50.
This need for earlier cancer screening – to ensure more effective diagnosis and enable faster access to treatment – underpins Vitality’s recent enhancement to cancer risk assessments.
Members can now carry-out an online risk assessment for five of the most common cancers – breast, bowel, cervical, prostate and skin – through Care Hub. The personalised assessment guides them onto the next steps, including discounted screenings where appropriate.
5. Digitisation is delivering better outcomes
Like all walks of life, digital technology is changing the way we live in profound ways and this is also having huge implications for healthcare. Innovation – in PMI too – is redefining the customer experience and helping to offer more seamless care journeys.
We’re seeing significant benefits to consumers across diagnostics, claims processing and in the way data is being harnessed. Vitality’s Care Hub for example enables members to start their claims journey online, receive immediate authorisation and book a consultant of their choice. Just under half of all claims are now started online.
Diagnostic tools, such as Skin Analytics, utilise tech-based solutions to deliver certain test results remotely, with a much quicker turnaround time compared to traditional diagnostics. The average time from initial referral to receiving results is just four days.
Elsewhere, data insights are being leveraged offer a more transparent, patient-centric healthcare journey through our Premier Consultant Panel. People are experiencing shorter lengths of hospital stays, lower re-admission rates and less chance of changing consultants as a result. This we see as the next generation of health insurance.

A version of this article originally appeared on VitalityAdviser Insights Hub

Vitality recently unveiled a range of product enhancements and claims insights