discovery vitality - western cape government · 2011. 11. 10. · sa vitality partner network ....
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Discovery Vitality
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The Economist
“The Discovery story is another reminder of how quickly new ideas are starting to flow out of emerging markets”
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Problem definition and underlying behavioural causes
Modifiable
health risks
Genetic and
age related
risks
Increasing prevalence of diseases of lifestyle
Distribution of healthcare costs
Facilitated access and immediate benefits are required to address behavior tendencies and to motivate long-term health behaviour change
Problem of behavioural economics
Immediate price to wellness,
hidden benefit
Hyperbolic discounting places undue emphasis on the present
Over-optimism of ability to take
corrective action
Access
Behaviour
Behaviour
Under-consumption of preventative care
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Vitality Programme
Complete a Personal Health
Review
Determine Vitality Age and set health goals
Obtain a Personal Pathway
Earn vitality points and achieve a status
Clinical and
scientific basis
Personal Pathway
algorithms
Wellness network
Actuarial points
allocation
methodology
Reward network
Valuable
incentives
On
lin
e c
ap
ab
ilit
y
Assets and
capabilities
Enjoy incentives
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Travel
Integration with store card
Cinema
Retail
HealthyFoodTM
Percentage discount tiered
by Vitality status
Additional benefits on partner
store card tiered by status
Cash back on all purchases in retail
network tiered by Vitality status
1/3 of retail price
available to all members
10% discount on HealthyFoodTM for all
members; 25% if Personal Health Review is completed
Val
ue
pe
r u
se
Frequency of use
Broad Rewards Motivate Differing Aspirations: SA Vitality partner network
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Reward utilisation is high across the benefit spectrum
0
100 000
200 000
300 000
400 000
500 000
600 000
Movie Clubmembers
kulula.comflights
Gym benefitusers
ActivatedHealthyFoods
benefit
Clicks users Vitalitymembers
shopping witha DiscoveryCredit Card
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Frequency of use
Valu
eTangible rewards Self-interest
Charity Noble cause
Lottery Self-interest
Contributions Loss aversion
Nature of reward Motivating factor Example
1. Earn money for a charity of your choice
2. Promotion through social networks
0
20
40
60
80
100
120
Low engaged Moderate engaged High engaged
`
Non-engaged
Employer Employee
Equitable Contribution Manager
1. Points convert into entries 2. Status gears number of entries
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Vitality cross-sectional studies
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VIP Study 1: Vitality engagement is correlated with lower healthcare costs
Risk-adjusted hospital admission costs for engaged vs not engaged
*Categorisation based on diagnosis-related groupers using ICD-10, CPT-4 and local procedural codes
*
Not Engaged benchmark
P < 0.001 for all categories (incl overall result) except cancer where P < 0.01
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VIP Study 2: Vitality engagement reduces the cost of managing chronic disease
P = 0.001 for multiple metabolic conditions, all single conditions are not statistically significant
Risk-adjusted hospital cost for chronic members: engaged vs not engaged
70
90 92 90
79
Multiple
metabolic
conditions
Hypertension Dyslipidaemia Cancer Mental illness
Beneficiaries with single conditions
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100% Hospital cost per non engaged member -
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VIP Study 3: Fitter people spend less time in hospital and incur lower healthcare costs
6.12 5.88
5.38 5.19
4.57 4.0
4.5
5.0
5.5
6.0
6.5
NR INACTIVE LO MED HI
1.57 1.57
1.52 1.49
1.42
1.40
1.45
1.50
1.55
1.60
NR INACTIVE LO MED HI
30 31
30 30
26 25
26
27
28
29
30
31
32
NR INACTIVE LO MED HI
Tho
usa
nd
s
1. Admission per patient*
• 9.6% lower in highly active individuals
vs inactive
2. Length of stay in hospital
• On average 0.57 days shorter for
highly active individuals vs inactive
3. Cost per patient
• Medical costs once hospitalised
R5,052 lower for highly active
individuals vs inactive
*Patients with at least one admission event
Fit people make better patients – admissions, length of stay and costs are risk-adjusted
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Longitudinal Study of Fitness Engagement
• A retrospective analysis of 304,000 adults over the period 2004 to 2008
• The analysis was designed to test • For significant changes in engagement with fitness-related activities over
time
• Whether these changes were associated with changes in the probability and cost of hospitalisation
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Increase in Fitness Engagement
21.1
24.8 27.0
31.1 31.8
1 2 3 4 5
Year
% o
f m
em
be
rs u
sin
g th
e gy
m b
en
efit
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90 92 94 96 98 100
Outcomes associated with transitions between engagement levels
Year 1 Hospital cost per member, Year 4 to 5 Year 3
Inactive
Inactive
Active
Less active
Active Active
More Active
6%
8%
9%
Benchmark
Benchmark
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Relationship between increasing activity and the odds of hospitalisation
Number of additional gym visits per week from Year 1 to Year 3
Od
ds
rati
o f
or
ho
spit
alis
atio
n in
Ye
ars
4 t
o 5
0.80
0.85
0.90
0.95
1.00
0.5 1.0 1.5 2.0
13%
10%
7%
3%
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HealthyFood™
16
25% saving on nutritional items purchased at Pick n Pay
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HealthyFood™ structure
Nutrient WHO dietary
recommendations
Saturated fat 10 en%
Trans fat 1 en%
Sodium 1.2mg/kcal
Added sugar 10 en%
Dietary fibre 1.3mg/kcal
61,000 products assessed; 10,000 classified as HealthyFoodTM
Fruit and
vegetables
3,000 products
Grains and
cereals
1,425 products
Chicken, fish and
meat alternatives
479 products
Vegetable oils
and nuts
536 products
Milk and dairy
products
217 products
Lentils and
legumes
373 products
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HealthyFood™ mechanics
18
HealthyFood™ purchases marked
on till slips
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Adoption of the HealthyFoodTM Benefit
Result: Over 240,000 families have activated the HealthyFood™ benefit
-
2 000 000
4 000 000
6 000 000
8 000 000
10 000 000
12 000 000
Mar
-09
May
-09
Jul-
09
Sep
-09
No
v-0
9
Jan
-10
Mar
-10
May
-10
Jul-
10
Sep
-10
No
v-1
0
Jan
-11
Mar
-11
Number of HealthyFood Store Visits
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
pre-launch 2009 2010 2011
HealthyFood as % of cart
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Discovery Healthy Company Index
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Discovery Healthy Company Index
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Healthy Active Kids Report Card 2010
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Physical Activity (Grade D):
• Less than 70% of high school learners report having regularly scheduled physical education.
• Less than 50% participate in enough physical activity for it to be considered ‘health-enhancing’.
Nutrition (Grade D):
• Just over 2 servings of fruits and vegetables per day, with less than 1 serving of fruit per day.
• Over 50% drink sweetened cool drinks more than 4 times a week.
• Nearly 30% eat fast food between 2 and 3 times per week.
Healthy Active Kids Report Card 2010
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Screen time (Grade F): • Nearly 1 in 3 adolescents watch more than 3 hours of
television daily Overweight, obesity (Grade C-) and stunting (Grade D-): • 20% are overweight and 5% are obese • 13% of teens are stunted Smoking (Grade D): • 29.5% of adolescents report having smoked • 21% are current smokers
Healthy Active Kids Report Card 2010
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Vitality Schools Programme
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Vitality Schools Programme
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Developing healthy active kids
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Developing healthy active kids
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Vitality Schools Programme
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Vitality Schools Programme
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Get South Africa walking
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Vitality Healthiest City
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Vitality Healthiest City
2.8
4.7
9.8
12.7
Durban Pretoria Port Elizabeth Cape Town
% Difference in mortality risk, compared to Johannesburg
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2.9
0.9
3.1
1.2
Durban Pretoria PortElizabeth
Cape Town
-2.5
-0.2
-3.2
1.3
Durban Pretoria PortElizabeth
Cape Town
1.5 1.4
3.9 3.4
Durban Pretoria PortElizabeth
Cape Town
-0.9
0.0
2.6
3.9
Durban Pretoria PortElizabeth
Cape Town
1.7 1.8 2.0
1.2
Durban Pretoria PortElizabeth
Cape Town
High Blood Pressure High Cholesterol
Smoking
Unhealthy Weight
Insufficient Physical Activity
Vitality Healthiest City
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Discovery Vitality