'Right care, right time': How PMI is delivering more streamlined care pathways
With growing health challenges facing our country, PMI is expanding to deliver the right care at the right time in a more cost-effective way, writes Arun Thiyagarajan, CEO Vitality Health
Given wider pressure on healthcare services in recent years, private medical insurance (PMI) has evolved to ensure people get timely access to primary care.
Over and above the provision of GP access, prescriptions and broader everyday care services like talking therapies and physio, delivering the right care at the right time has never been more vital, especially in light of our nation’s declining health.
In recent years, we’ve seen the utilisation of these services snowball. In 2023, 64% of all Vitality Health claims in 2023 for everyday care – an 83% increase since 2019 1.
With this increased utilisation has naturally come cost pressures, but we are seeing now, more than ever, that clients are expecting to use their PMI plan, rather than just when they need treatment.
Access to primary care now ranks as one of the top reasons for people taking out private medical insurance (PMI), almost 40% of people citing fast access to GP and primary care support as their top reason for purchasing cover 2.
This also reflects a wider shift in consumer attitudes to PMI, at a time when products are evolving to deliver better access to a broader range healthcare, whilst also playing a crucial role in the prevention of illness.
This shift, alongside more holistic support for health and wellbeing, has offered a key opportunity for insurers to provide a more comprehensive product which helps customers navigate the healthcare system, effectively placing healthcare in the palm of their hand.
More sustainable delivery
Significantly though, by intervening earlier we are able to manage demand in a more sustainable way whilst improving patient outcomes.
We see, for example, that despite claims for Talking Therapies usage rising by 179% since 2019, in-patient mental health claims decreased by 69%. Meanwhile, claims for physiotherapy were up 35% but in-patient musculoskeletal claims decreased by 31% over the same period.
Key to this is also harnessing technology to deliver a more effective triage and onward referral process, whilst giving patients better digital access to services through a more joined-up approach.
Our Care Hub, for example, provides a one-stop-shop where members access everything they need from their healthcare plan, along with instant digital authorisation to speed up onward diagnostics and treatment. This is empowering your clients to get the support they need when they need it.
Enhancing our mental health cover
Especially concerning is that conditions typically diagnosed and managed within a primary care setting are projected to increase at the fastest rates 3.
Poor mental health in particular has been on the rise in the UK, particularly amongst younger people and children. Recent findings from Britain's Healthiest Workplace showing a staggering 75% increase in rates of anxiety and depression between 2014 and 2023 4.
As we continue to innovate our PMI proposition in light of the changing health landscape, there’s perhaps no better demonstration of what I’ve described than our recent mental health cover enhancements.
Our new app-based digital mental health support powered by Wysa provides members with less severe mental health concerns - where a referral for Talking Therapies, out-patient or in-patient care is not needed - a new pathway giving access to over 150 evidence-based exercises designed by psychologists. Once triaged and registered, clients can access these exercises on demand, 24/7, empowering them to manage their mental wellbeing on an everyday basis.
And by enhancing the Care Hub experience, we can recommend the most appropriate mental health support for every member in minutes, whether that’s Talking Therapies, guided digital self-management or Headspace.
Clients with more severe symptoms will be signposted to more urgent support, including SOS/Crisis line support services as well as to A&E if needed.
Right care, right time
To cater for growing demand, this approach is helping to deliver a far more complete end-to-end healthcare solution.
Vitality was the first insurer to bring primary care to PMI, with the launch of Vitality GP in 2015. Since then, we’ve expanded the range of services to include app-based self-care support, physiotherapy and Talking Therapies, as well as digital diagnostic services.
Such treatments give members access to vital support when they need it, to prevent and manage health conditions. By cutting out the need for GP referrals, we can also speed up access, while the removal of underwriting for mental health means all clients with a VitalityHealth plan can now utilise Talking Therapies regardless of medical history.
Not only does this mean we can deliver more, much-needed support to your clients at a time they need to most. We can also ensure this is delivered in the most streamlined way possible to help avoid unnecessary costs later down the line. This way, everyone wins.
1 Vitality Health Claims Insights Report 2024
2 Private Healthcare survey of 1000 UK adults, Opinium, Vitality, May 2024
3 'Health in 2040: Projected patterns of illness in England', The Health Foundation 2023
4 '10 years of Britain's Healthiest Workplace: The changing face of the UK at work', 2025
VitalityHealth Claims Insights Report 2025
In our 2025 VitalityHealth Claims Insights Report, we consider how consumer needs are changing, and how insurers - and advisers - are adapting to deliver the best possible outcomes for our clients, within a fast-changing environment.
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