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The Actuary The magazine of the Institute & Faculty of Actuaries
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Effectiveness of ’wellness programmes’

The effectiveness of insurers’ ‘wellness programmes’ to improve health was evaluated in new studies presented at the Profession’s Health and Care Conference in Glasgow. In a workshop session titled ‘Wellness programmes and private medical insurance’, Emile Stipp FIA spoke about the data from the programmes used by private medical insurers in the UK and South Africa.

The risk-adjusted studies reveal that the programmes had reduced costs of healthcare for both the well and the chronically ill. Data from more than 900,000 members of the Vitality Wellness Programme in South Africa was used to determine the effectiveness of the lifestyle programme.

The study revealed that fitter people engaged in the programme had 9.6% fewer hospital admissions and stayed in hospital 0.57 days less than inactive patients. It also showed that medical costs once hospitalised were R5,052 (£391) lower for highly active patients than for inactive patients.

Mr Stipp said the results of the studies show that wellness programmes have a positive impact on health costs. “Our statistics show that engagement with the programme correlated with lower healthcare costs and costs of managing chronic illness. It also showed that fitter people spent less time in hospital and had lower healthcare costs,” he said.

A UK study of 200,000 members of the PruHealth Vitality Wellness Programme received similarly positive results. “Using similar risk adjustment techniques as for the South African studies, we have seen that in-hospital private medical insurance costs are lower by between 30% and 45%, depending on engagement. “Out-of-hospital costs lower by between 2% and 40%, depending on engagement,” Mr Stipp said.

“On a risk-adjusted basis, well-designed wellness programmes improve health and reduce claims. Increasing engagement leads to a significantly lower claims trend over time. Well-structured rewards and personal communication lead to increasing engagement.”

Mr Stipp attributed the value of the programmes to the prevalence of lifestyle-related illnesses and their associated healthcare costs, as well as the success of incentive-based programmes in promoting healthy lifestyles.