Effectiveness of 'wellness programmes' evaluated at conference

In a workshop session titled Wellness programmes and private medical insurance, Institute of Actuaries Fellow Emile Stipp spoke about the data from studies into the programmes used by private medical insurers in the UK and South Africa.

The risk-adjusted studies revealed 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, which offers rewards for health improvements such as weight-loss and quitting smoking.

The study revealed:

• Fitter people engaged in the programme had 9.6% fewer hospital admissions and stayed in hospital 0.57 days less than inactive patients, and
• Medical costs once hospitalised were R5,052 (£391) lower for highly active patients than inactive patients

Mr Stipp said: “Our statistics showed 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.”

A UK study of 200,000 members of the PruHealth Vitality Wellness Programme received similarly positive results.

Mr Stipp said: “Using similar risk adjustment techniques as for South African studies, we have seen in-hospital private medical insurance costs are lower by between 30 per cent and 45 per cent, depending on engagement. Out of hospital costs are lower by between 2 per cent and 40 per cent, depending on engagement.”

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 and 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 and the success of incentive-based programmes in promoting healthy lifestyles.

The conference for Health and Care insurance actuaries is at the Glasgow Hilton between 13 and 15 May.

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Enquiries: Tel. Fleur Morrison on 020 7632 1453 or email fleur.morrison@actuaries.org.uk

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