DISCOVERY HEALTH DISCOVERY HEALTH MEDICAL - SCHEME UPDATES 2021
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DISCOVERY HEALTH DISCOVERY HEALTH MEDICAL SCHEME UPDATES 2021
Utilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare
sustainability and short-term services leveraging platforms benefit changes to drive expanding access to
affordability and Big Data positive outcomes affordable healthcare
Utilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare
sustainability and short-term services leveraging platforms benefit changes to drive expanding access to
affordability and Big Data positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient Expanding access to
strategy for 2021 the care continuum centric care new markets
COVID-19 HAS CREATED A DISCONTINUITY IN UTILISATION TRENDS
New COVID-19
Demand
140%
120%
100%
80%
60%
40%
20% New
COVID-19 Demand
0%
Pre Covid Mar-20 Jun-20 Sep-20 Dec-20
COVID-19 HAS CREATED A DISCONTINUITY IN UTILISATION TRENDS
New COVID-19 Lower Non- Lower Non-
Demand COVID-19 Demand COVID-19 Supply
140%
120% Non-COVID-19 demand
lower than Pre-COVID:
Pre-COVID-19 Levels
100% Admissions
Out-of-Hospital
Overall non-COVID
demand
80%
Non-COVID supply
60%
Non-COVID-19 supply
lower than Pre-COVID
40%
20% New
COVID-19 Demand
0%
Pre Covid Mar-20 Jun-20 Sep-20 Dec-20
COVID-19 HAS CREATED A DISCONTINUITY IN UTILISATION TRENDS
New COVID-19 Lower Non- Lower Non- Favourable net impact on
Demand COVID-19 Demand COVID-19 Supply scheme reserves
140%
120% Non-COVID-19 demand Reserves (Rand billion)
lower than Pre-COVID:
Pre-COVID-19 Levels 27.5
100% Admissions +36%
Out-of-Hospital
Overall
80% 20.1
60%
Non-COVID-19 supply
lower than Pre-COVID
40%
20% New
COVID-19 Demand
0% DHMS pre COVID-19 DHMS end 2020
Pre Covid Mar-20 Jun-20 Sep-20 Dec-20
ANTICIPATED RETURN OF LATENT NON-COVID-19 RELATED DEMAND
IN 2021
New COVID-19 Lower Non- Lower Non- Return of non-COVID-19
Demand COVID-19 Demand COVID-19 Supply latent demand
140%
120%
Pre-COVID-19 Levels
100%
80%
Higher ongoing healthcare
Demand and supply
funding demand due to:
60% return to pre-COVID
levels July 2021 § COVID-19 Vaccine availability
§ Potential Resurgence
§ Deferred care during pandemic
40%
20%
0%
Pre Covid Mar-20 Jun-20 Sep-20 Dec-20 Jun-21 Dec-21
2021 CONTRIBUTION INCREASE STRATEGY
Contribution increases
10%
8%
6%
Annual CPI
(FL: 2017 – 2020)
4%
2%
0%
2017 2018 2019 2020 2021 H1 2021 H2
2021 CONTRIBUTION INCREASE STRATEGY
Contribution increases 2021 H1 drivers
10% 3.9% -1.6%
8%
-0.8%
6%
-1.5%
4%
2%
0%
Contribution
freeze
0%
2017 2018 2019 2020 2021 H1 2021 H2 Demand-side Supply-side Risk
Tariff Net
inflation inflation management
2021 CONTRIBUTION INCREASE STRATEGY
Contribution increases 2021 H2 drivers
10%
8%
Maximum increase
of CPI + 2% ~ 5.9%
6% 5.9%
+1.2%
-1.5%
+3.9%
4%
+2.3%
2%
Contribution
freeze
0%
2017 2018 2019 2020 2021 H1 2021 H2 Demand-side Supply-side Risk
Tariff Net
inflation inflation management2021 CONTRIBUTION INCREASE STRATEGY
Contribution increases
0% contribution increase
10% from January to June
8%
6%
4%
2%
Contribution
freeze
0%
2017 2018 2019 2020 2021 H1 2021 H22021 CONTRIBUTION INCREASE STRATEGY
Contribution increases
0% contribution increase
10% from January to June
8%
Maximum CPI+2% (5.9%) increase for
July to December
Maximum increase
of CPI + 2% ~ 5.9%
6%
4%
2%
Contribution
freeze
0%
2017 2018 2019 2020 2021 H1 2021 H22021 CONTRIBUTION INCREASE STRATEGY
Contribution increases
0% contribution increase
10% from January to June
8%
Maximum CPI+2% (5.9%) increase for
July to December
Maximum increase
of CPI + 2% ~ 5.9%
6%Utilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare
sustainability and short-term services leveraging platforms benefit changes to drive expanding access to
affordability and Big Data positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient Expanding access to
strategy for 2021 the care continuum centric care new markets
0% contribution increase in H1 2021
Max CPI+2% increase in H2 2021Utilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare services
sustainability and short-term leveraging platforms, Big Data and benefit changes to drive expanding access to
affordability innovative technology positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient Expanding access to
strategy for 2021 the care continuum centric care new marketsINTRODUCING DISCOVERY CONNECTED CARE
Access to connected healthcare
across the care continuum
High quality home-based care delivered
through Discovery assets and partnerships
Personalised experience enabled by
a range digital healthcare solutions
Underpinned by DHMS benefitsTRANSFORMING HEALTHCARE DELIVERY ACROSS THE CONTINUUM
For Home | For Work For Chronics For Acute Care
On-demand medical examinations Educational material Sophisticated clinical insights
Virtual consultations Remote monitoring devices Tools for healthcare professionals
E-scripting Personalised coaching consultations Remote monitoring devices
Medicine deliveryENABLING ON-DEMAND OUT-OF-HOSPITAL HEALTHCARE DELIVERY AT
HOME THROUGH CONNECTED CARE FOR HOME
Detailed medical examinations and advanced 24/7 doctor support
virtual consultations Discovery TytoCare Dr NetworkCONNECTED CARE FOR HOME POWERED BY TYTOCARE
Ty t o H o m e b y Ty t o C a r e
§ Award-winning, mobile
medical device enabling
remotely-guided virtual
consults with a GP –
anytime, anywhere.
§ Captures and shares ear,
throat and skin images and
lung and heart auscultations
§ Device includes exam
camera, thermometer,
otoscope and stethoscopeCONNECTED CARE FOR HOME POWERED BY TYTOCARE
Ty t o H o m e b y Ty t o C a r e 20% discount
for all Discovery clients AND
§ Award-winning, mobile
medical device enabling
scheme funding
remotely-guided virtual for qualifying DHMS members
consults with a GP –
anytime, anywhere.
Retail price R7 855 incl. VAT
§ Captures and shares ear,
throat and skin images and
Discovery
lung and heart auscultations
clients and
R 6 284 incl. VAT
DHMS
§ Device includes exam members
camera, thermometer,
otoscope and stethoscope PRE-ORDER FROM OCTOBER 2020ENABLING ON-DEMAND OH HEALTHCARE DELIVERY AT HOME THROUGH
CONNECTED CARE FOR HOME
Detailed medical examinations and 24/7 doctor support End-to-end digital experience
Including e-scripting, same-day medicine
advanced virtual consultations Discovery TytoCare Dr Network
delivery and automatic EHR updatesEMPOWERING PATIENTS AND PROVIDERS THROUGH CONNECTED
CARE FOR CHRONIC ILLNESS
Access to condition- Advanced integrated
DHMS benefits Member support
specific content reporting
Interactive and intuitive 100% funding for remote Clinical and lifestyle metrics Personalised coaching and
digital educational content monitoring devices and apps to to monitor your health consultations with relevant care
support chronic management with automatic triggers team members
to the treating doctorCONVERGENCE OF CLINICAL AND DATA INSIGHTS TO OFFER HIGH
QUALITY CARE AT HOME FOR ACUTE CASES
CLINICAL DATA ANALYTICS TOOLS
CODING
SCHEMAS
CLASSIFICATIONS
AND TOOLS
CLINICAL
GROUPERS
Enables
Clinical criteria for the
safe treatment of low
acuity conditions Home-based care for members who are at risk
of re-admission post hospital discharge
Home-based care for members who are
Identification of risk, discharged early from hospital
complexity and
patient
comorbidities Home-based acute care for members
in lieu of hospitalisation
Criteria for optimal
patient recovery
Home-based acute care for end of life
CLINICALLY APPROPRIATE palliative care
QUALIFYING MEMBERSINTRODUCING CONNECTED CARE FOR ACUTE CARE
24/7 GP-oversight panel for
immediate care and advice
Detailed clinical assessment to
ensure patient safety and
subsequent eligibility
Library with
condition specific
and procedural
content
Integrated management
dashboard for live
monitoring by healthcare End-to-end digital
providers medication journey with
live tracking
Supportive physical and virtual
consultations by specialist care
teamHEALTHCARE DELIVERY TO THE WORKPLACE THROUGH CONNECTED
CARE FOR WORK
The enhancements to the onsite
clinic offering allows:
Advanced diagnostic care with
HEALTHCARE COVER Tyto Care
Digital booking platform and
HEALTH AND
dispensing of medication onsite
WELLNESS
BENEFITS
DIGITAL
ENABLERS
Year round access to complete a
BEHAVIOUR Vitality Health Check
CHANGE
PROGRAMMEUtilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare services
sustainability and short-term leveraging platforms, Big Data and benefit changes to drive expanding access to
affordability innovative technology positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient Expanding access to
strategy for 2021 the care continuum centric care new marketsUtilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare
sustainability and short-term services leveraging platforms, Big benefit changes to drive expanding access to
affordability Data and innovative technology positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient More ways to access
strategy for 2021 the care continuum centric care healthcareENHANCED SUPPORT FOR MENTAL WELLBEING FOR 2021
Intensity of
intervention
High
IN-PATIENT TREATMENT
in optimized psychiatric network
DEFINED DAY FACILITY PROGRAMME
delivered by a multidisciplinary team
COMPREHENSIVE OUT-PATIENT CARE
coordinated by the Premier Plus GP
Healthy Company EARLY INTERVENTIONS AND
Low
OUT-PATIENT SUPPORT
Poor
for members at risk or
between depressive episodes
PROMOTING WELL-BEING
even for those who may not consider
themselves at risk
Excellent
State of mental healthENHANCED SUPPORT FOR MENTAL WELLBEING FOR 2021
Intensity of
intervention
Key enhancements
High
IN-PATIENT TREATMENT
in optimized psychiatric network
New Relapse Prevention
Programme to identify and
support members who are at
DEFINED DAY FACILITY PROGRAMME risk of relapse or recurrence
delivered by a multidisciplinary team
Enhanced out-patient benefits
COMPREHENSIVE OUT-PATIENT CARE
coordinated by the Premier Plus GP
to monitor and manage acute
and/or episodic major depression
Healthy Company EARLY INTERVENTIONS AND
Low
OUT-PATIENT SUPPORT
for members at risk or
Poor
between depressive episodes
Free access to Personal Health
Goals on Vitality Active Rewards
PROMOTING WELL-BEING
even for those who may not consider
for those who are at risk or
themselves at risk diagnosed with major depression
Excellent
State of mental healthSUPPORTING YOUNG FAMILIES WITH BENEFITS FOR INFERTILITY
Cover for Assisted Reproductive Therapies (ART) including In-Vitro Fertilisation
(IVF), Intra-Uterine Insemination (IUI), Embryo Transfer (FET)
and Intra-Cytoplasmic Sperm Injection (ICSI)
Available to members on Cover for up to 2 cycles of ART Benefit accessible at SASREG
Executive and Comprehensive for eligible members, which accredited centres, subject to
plans, minimum of 2 years on includes cover for clinical pathway and protocols
plan, between the ages of the full member journey
25 and 42 yearsIMPROVING QUALITY OF CARE THROUGH NETWORK SOLUTIONS
Success of the Major Joints Centre Variations in quality of care for Variations in quality of care for spinal
of Excellence colorectal cancer surgery surgery
High quality, cost effective arthroplasty Improved survival rates in high volume Improved readmission rates in high volume
network with defined pathways hospitals hospitals
Pre and post surgery education 5-year survival rate after surgery Readmission rate
(2010-2018) Post lumbar fusions
Clinical outcomes measures
63%
Single global fee for all services 11.00%
10.10%
Peer review and monitoring
8.30%
Full cover in network 7.00%
Incentivise highest quality care
58%
• 95 participating Centres of Excellence
• 340 participating surgeons 2016 2017 2018 2019
• Full coverage for over 90% of members High volume hospitals Low volume hospitals
High volume hospitals Low volume hospitals
• Improvements in clinical outcomesIMPROVING QUALITY OF CARE THROUGH NETWORK SOLUTIONS
Centre of excellence for colorectal cancer Enhanced spinal care programme and
surgery quality network
Enhanced reimbursement Out-of-hospital Back Pain care programme
and value-based contracting; Electronic and
Colorectal Cancer Record Spinal Care Network
Opportunity to develop SA’s first Colorectal Cancer Up to 6 consultations with
registry an appropriate alliedOTHER DHMS BENEFIT UPDATES
Improving outcomes for members living
Network changes Other technical updates
with diabetes
§ Day Surgery Network expanded to § Premier Plus GP as Designated § Co-payments for Endoscopic
members on Comprehensive plans, Service Provider (DSP) for Procedures: Reduced co-payment for
to ensure provider and patient safety Comprehensive members scopes performed in day clinics;
increased co-payment for scopes
§ To ensure continued optimisation of the § Premier Plus GP for Diabetes Care performed in acute hospitals
DHMS Hospital Networks, new member’s DSP for ongoing
hospitals will be added to, and some management of diabetes § Chronic Illness Benefit: From 2021,
existing hospitals replaced on, plan and CVD formulary and Chronic Drug Amount
specific networks (for Delta, Smart changes will be applied.
and KeyCare)
§ 2021 Benefit Limits, Co-payments
and Deductibles Increases: 3%
increase applied. Some benefit limits
unchanged*
* Oncology Threshold, Specialised Medicine and Technology Benefit, International Travel Benefit, Overseas Treatment Benefit, and the KeyCare Mobility Benefit will all have no increase in
2021Utilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare
sustainability and short-term services leveraging platforms, Big benefit changes to drive expanding access to
affordability Data and innovative technology positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient More ways to access
strategy for 2021 the care continuum centric care healthcareACCESS TO SHARI’AH-COMPLIANT DISCOVERY HEALTH MEDICAL
SCHEME PLAN OPTIONS
Discovery Health Medical Scheme members can elect to have their contributions and claims on any plan option managed in
accordance with Shari’ah principles, through the Shari’ah-Compliant Arrangement
Contributions and balances invested according to
Shari’ah-compliant investment strategies
Independent advisory committee for
ongoing compliance, reviews and audits
Selected on the application form,
on requestDISCOVERY PREPAID HEALTH
AFFORDABLE HEALTHCARE FOR ALL SOUTH AFRICANS
Free-to-use digital platform Affordable prepaid healthcare services
R50 R150 – R200
R250 – R300 R300 – R350DISCOVERY PREPAID HEALTH
AFFORDABLE HEALTHCARE FOR ALL SOUTH AFRICANS
Top up healthcare balance
Multiple top-up options
In-store vouchers In-app debit or credit card
View prepaid
healthcare balance
Discovery Bank Discovery Miles
Use prepaid healthcare
balance
§ Starts at R50
Affordable healthcare servcies § Retail outlets throughout South Africa
Medicine Pharmacy Clinic
Find a contracted healthcare
provider
Medicine + In-
Medicine + Virtual GP person GP
Get regular health
§ Always includes medicine
§ Contracted healthcare providers
& wellbeing tips
throughout South AfricaUtilisation discontinuity:
balancing the equilibrium Technology: Quality care: Access:
between long-term enabling digital healthcare
sustainability and short-term services leveraging platforms, Big benefit changes to drive expanding access to
affordability Data and innovative technology positive outcomes affordable healthcare
Contribution increase Connected care across Focus on patient More ways to access
strategy for 2021 the care continuum centric care healthcareVITALITY 2021 UPDATES
VITALITY HAS NEVER BEEN MORE RELEVANT
The nature of COVID-19 risk Engagement in Vitality is linked to better COVID-19
is behaviourial clinical outcomes
100%
Engaged Vitality
Individuals with 3 or more members have a
co-morbidities account for 37% lower
COVID-19 mortality risk
63%
of global COVID-19 deaths
No Vitality engagement Engaged Vitality2021
Clinical Relevance Physical Activity Enhanced Rewards
Ensuring Vitality remains Encouraging exercise with Dazzling members with
clinically and a broader and deeper exciting new rewards
behaviourally relevant physical activity offering partnerships2021
Clinical Relevance Physical Activity Enhanced Rewards
Ensuring Vitality remains Encouraging exercise with Dazzling members with
clinically and a broader and deeper exciting new rewards
behaviourally relevant physical activity offering partnershipsLOCKDOWN HAS IMPACTED SCREENINGS AND PHYSICAL ACTIVITY,
REQUIRING AN EXTRAORDINARY EFFORT TO KEEP MEMBERS
MOTIVATED
January – September
engagement compared to 2019
Recognise 2019 engagement in 2020 to motivate and support members
ASSESSMENTS AND SCREENINGS
84%
55%
45%
Award the higher of 2019 and 2020 VHC and VFA results
VHC VFA Screenings
WORKOUTS Award 2020 points for 2019 screenings and flu vaccinations
115% completed in 2019 if not yet completed in 2020
90%
34%
Device Gym Steps
Award the higher of 2019 and 2020 physical activity points
for January to September
% HEALTHY FOOD ITEMS
99%
POINTS WILL BE AWARDED IN OCTOBER 2020
2019 20202021
Clinical Relevance Physical Activity Enhanced Rewards
Considering 2019
engagement
Encouraging exercise with Dazzling members with
a broader and deeper exciting new rewards
physical activity offering partnerships
2019 2020 2020 adjusted
VHC & VFA
Other screenings & flu vacs
Physical activity (Jan – Sept)KEY TRENDS SHAPING THE PHYSICAL ACTIVITY LANDSCAPE
Proliferation of exercise Attractiveness of Importance of
formats and facilities high-quality home exercise (virtual) communitiesKEY TRENDS SHAPING THE PHYSICAL ACTIVITY LANDSCAPE
1 2 3
Providing unrivalled access to Recognise and reward members for Continue to build the largest and
facilities members desire their workouts everywhere most inclusive exercise community
4 Equip members with the best fitness gear, equipment and technologyBROADENING THE PHYSICAL ACTIVITY OFFERING
Augmenting the highly successful … by enabling members to get fit at over 300
Vitality gym benefit … Vitality-enabled fitness facilities
Earn Vitality points Spend Discovery Miles
Yoga &
Pilates
Functional
Fitness
75% 100%
Club
membership
Dance
50%
National
membership Digital
FitnessCONNECTING AND EXPANDING THE TEAM VITALITY COMMUNITY
: the new home for our community
Be part of the TEAM VITALITY
community on for free
Discounted training kit 50% discount on STRAVA Summit
Earn achievements through tracking activity Access suggested routes, analyse
performance and compare results
Chance to win quarterly and annual prizes Cashback on race event entries
Connect and compete with friends VIP hospitalityREDESIGNING HEALTHYGEAR FOR A MORE REWARDING EXPERIENCE
HealthyGear 25%
Up to 25% back Up to
25%
upfront 10%
15%
Activate benefit
Complete Vitality Age Activate Complete Complete
benefit Vitality Age VHC
Complete Vitality Fitness Assessment
10% 15% 25%INTRODUCING | ACTIVE GEAR
25%
Up to
25%
upfront 10%
15%
Activate Complete Complete
benefit Vitality Age VHC
10% 15% 25%EXTENDING THIS EXPERIENCE TO DEVICES
25% 75%
10%
Up to Up to
15%
25% 75%
upfront 10% upfront 25%
15% 50%
Activate Complete Complete Meet Active With Discovery
benefit Vitality Age VHC Rewards goals Bank
Earn an additional 5% for every
10% 15% 25% 5 Active Rewards goals met 50% 75%ACTIVE GEAR
25% 75%
10%
Up to Up to
15%
25% 75%
upfront 10% upfront 25%
15% 50%
Activate Complete Complete Meet Active With Discovery
benefit Vitality Age VHC Rewards goals Bank
Earn an additional 5% for every
10% 15% 25% 5 Active Rewards goals met 50% 75%ACTIVE GEAR
25% 75% 75%
10% 10%
Up to Up to Up to
15% 15%
25% 75% 75%
upfront 10% upfront 25% upfront 25%
15% 50%
Activate Complete Complete Meet Active With Discovery
benefit Vitality Age VHC Rewards goals Bank
Earn an additional 5% for every
10% 15% 25% 5 Active Rewards goals met 50% 75%SUMMARY | GETTING MORE MEMBERS MORE ACTIVE IN 2021
Providing unrivalled access, recognition and sense of community to encourage members to get active
P H Y S I C A L V I R T U A L
GYMS BOUTIQUE FACILITIES RUNNING & CYCLING HOME WORKOUTS DIGITAL FITNESS VIRTUAL COMMUNITIES
Rewarding members with the best fitness gear and equipment2021
Clinical Relevance Physical Activity Enhanced Rewards
Considering 2019
engagement
Dazzling members with
exciting new rewards
partnerships
2019 2020 2020 adjusted
VHC & VFA
Other screenings & flu vacs
Physical activity (Jan – Sept)VITALITY
GET HEALTHY 2021 GET REWARDED
GET ACTIVE EARN DISCOVERY MILES SPEND DISCOVERY MILES
Exercise and Drive well Vitality Mall 20% Online Shopping 20%
4,000 700
Vitality Active Rewards
Prepaid products 20%
EAT WELL Travel
Spend and Invest
Exchange Convert Transfer
TAKE CARE
plus much, much more…Hotels and car hire benefits are Vitality members get early booking Priority Fast Track at OR Tambo and
now open for bookings access when domestic flights reopen Cape Town International Airports
International arrivals fast track available from
November 20202021
Clinical Relevance Physical Activity Enhanced Rewards
Considering 2019
engagement 20%
2019 2020 2020 adjusted
VHC & VFA
Other screenings & flu vacs
Physical activity (Jan – Sept)VITALITY 2021 UPDATES
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