Discovery Vitality

The Economist

“The Discovery story is another reminder of how quickly new ideas are starting to flow out of emerging markets”

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

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

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

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

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

Vitality cross-sectional studies

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

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 -

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

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

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

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

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%

HealthyFood™

16

25% saving on nutritional items purchased at Pick n Pay

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

HealthyFood™ mechanics

18

HealthyFood™ purchases marked

on till slips

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

Discovery Healthy Company Index

Discovery Healthy Company Index

Healthy Active Kids Report Card 2010

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

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

Vitality Schools Programme

Vitality Schools Programme

Developing healthy active kids

Developing healthy active kids

Vitality Schools Programme

Vitality Schools Programme

Get South Africa walking

Vitality Healthiest City

Vitality Healthiest City

2.8

4.7

9.8

12.7

Durban Pretoria Port Elizabeth Cape Town

% Difference in mortality risk, compared to Johannesburg

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

Discovery Vitality