Athos Rushovich: My wife's cancer-scare hit home how PMI is transforming
After his wife was recently referred for at-home diagnostic technology to get the all-clear, the true value of health insurance was once again revealed to Athos Rushovich, Director of Health Distribution for Vitality.
In the past, the value of insurance was only ever realised when it was claimed on. And let’s be honest: that was never a situation any of us wanted, especially as it usually meant serious illness, or worse.
However, the traditional view of insurance is changing. Gone are the days when private medical insurance (PMI) simply sat in a drawer until you needed private hospital treatment.
Instead, driven by growing demand for healthcare and shifting customer expectations, we’re now seeing people are using their plan much more frequently, often well before any form of secondary care is needed.
Close to home
You may have read about my own experiences of using health insurance and how I needed to have a triple heart bypass back in 2020. The initial consultation with a private cardiologist and subsequent open-heart surgery very much fell into traditional PMI claim territory.
Since then, we’ve seen the healthcare landscape change fundamentally. And when my wife Sam recently had a health scare, it really hit home, personally, how far PMI has come in a relatively short amount of time.
A few weeks ago, Sam noticed a raised lump on her skin. As she’d previously been treated for breast cancer, we obviously feared the worst.
We quickly logged onto the Vitality GP app and used the drop-in feature to get an immediate virtual GP consultation. Incredibly, Sam was on a video call with the GP 45-minutes later.
Using the app, Sam was able to upload photos of the lump for the GP to review, who referred her to Skin Analytics.
She was sent a special analysis kit in the post, which contains a smartphone and dermoscopic (magnifying) lens, to take high-definition photos of her skin. The photos were analysed by an expert dermatologist within 24 hours, and I’m pleased to say she was given the all-clear just two days later.
Everyday care is transforming PMI
Sam’s experience of using her Vitality plan illustrates the speed and ease with which private healthcare can be accessed - a key motivating factor for those considering PMI.
According to a recent consumer survey, concerns around NHS waiting lists still appear as the top reason for customers taking out PMI (50%), with 38% seeking fast access to GP and primary care support1.
We’re also growing expectation among customers that insurers will do more to help people live in better health, prevent illness and intervene earlier, as well as provide access to care when needed.
Healthcare in the palm of your hand
Almost two-thirds of Vitality Health claims are now for Everyday Care services, such as virtual GPs, Talking Therapies, and physio alongside dental, optical and hearing appointments. Vitality GP consultations, meanwhile, have increased sixfold since 20192.
By integrating primary care services into the wider healthcare journey through a digitally led approach, PMI plans are now offering a much more joined up customer experience.
My wife and I witnessed this firsthand. Sam didn’t have to wait anxiously or go through a lengthy, drawn-out process. Instead, she felt much more in control of her healthcare experience.
From Vitality GP consultation to Skin Analytics referral to receiving the results via Care Hub, it was a seamless digital journey.
Fortunately, onward secondary care wasn’t required in Sam’s case. But if it were, she’d be able to book consultants and access appropriate treatment all via the same Care Hub platform.
Delivering sustainable healthcare
Not only is this shift towards integrated primary care enabling people to use their PMI more - while appealing to a new, younger customer base – it’s also key to a more sustainable healthcare system.
As an industry, unprecedented demand is undoubtedly a challenge our industry is grappling with. According to a recent consumer survey, 73% of UK health insurance customers report using their plan in the past 12 months alone1.
With medical inflation also on the rise3, it’s crucial we find ways to manage demand in the most streamlined and efficient way possible.
On one hand, this is about directing patients to an onward care pathway that’s most suited to their needs. For example, more than half of care requests that come through Vitality GP can be managed in an Everyday Care environment. And this was the case for Sam.
On the other hand, it’s also about intervening much earlier to help prevent more severe conditions from developing, or getting missed, which would require extensive and more expensive treatment later down the line.
Perhaps remarkably, Everyday Care claims are not always leading to higher secondary care claims costs, and this is therefore one way of helping to drive healthcare sustainability.
As we explored in our recent Health Claims Insights Report, despite physio claims increasing 35% since 2019, in-patient musculoskeletal claims have reduced 31%. Similarly, during the same period, Talking Therapies claims have risen sharply (179%), but severe mental health claims, which are more costly, dropped 69%2.
But it’s about more than just sustainability. When you overlay this evidence with real-life, everyday experiences like my wife’s, it paints a compelling picture of the truly powerful journey we’re currently on in the PMI market. I’m excited to be part of it.
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2. Vitality Health Claims Insights Report 2024
3. How does medical inflation compare to inflation in the rest of the economy? - Peterson-KFF Health System Tracker.