Chatswood serves the life and health insurance sector in New Zealand with market intelligence, data, and bespoke consulting services. Some of these are provided in conjunction with Quality Product Research Limited - a subsidiary that brings you Quotemonster.
We believe that good decisions are more likely to occur when we have good information about the market environment in which we operate. Intuitive leaps and creative decisions are always required, of course, but the more they are based on a firm foundation of observation, the better they tend to be.
Southern Cross Health Society Group annual results released
Southern Medical Care Society Group has shared their annual results for the year ended 30 June 2024.
Southern Medical Care Society Group has shared their annual results for the year ended 30 June 2024. By the numbers:
Group deficit of $88.2 million after tax. $43.1 million of the deficit is attributable to a change in international financial reporting standards introduced this financial year. The balance of the deficit is driven by higher claims costs from a high inflationary environment combined with high member demand for private health services, particularly in the second half of the financial year.
Group reserves of $470.7 million.
Claims paid at a rate of $6 million per business day (up from $5.2 million in FY23).
15,196 net new members, with total membership now at 955,301.
This represents 60% of the New Zealand health insurance market by customer numbers but 71% per cent of the value of all health insurance claims paid.
99% of claims were submitted electronically.
Southern Cross Health Insurance
Reported a deficit of $99.1 million.
Paid $1.498 billion in claims from $1.605 billion received in premiums.
Claims costs increased 15% on FY23 (up 13.9% when adjusted for member growth).
Premiums increased 9% on FY23 (up 6.6% when adjusted for member growth).
93.4 cents paid in claims from every dollar received in premiums (compared to an industry average excluding Southern Cross) of 73 cents.
Operating costs grew by 4%, less than inflation.
3.2 million claims in FY24
50% of members claimed over the financial year.
39,326 virtual GP consultations with Care HQ.
4,635 annual health check-ups with MedPro.
4,016 online mental health sessions with Raise.
Net promoter score of 53.7%.
Nick Astwick, Chief Executive for Southern Cross Health Society said
“We have never been in more demand by our members as they prioritise their health needs, largely in the private system. In 2019 33% of our membership claimed, last year it was 50%.”
“The cost of claims in 2024 was steep and rapid, driven by a combination of price, volume, and the mix of claims. The growth in the volume of claims results from an increase in the number of members claiming, the frequency, and claims being made for more expensive procedures.”
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Southern Cross Health Insurance unveils policy updates
From October 22, Southern Cross Health Insurance (SCHI) is ushering in a series of policy updates.
From October 22, Southern Cross Health Insurance (SCHI) is ushering in a series of policy updates. In addition to adopting plain language in some of it’s policy documents in an effort to improve clarity, the updates include enhanced allowances for breast reduction and breast symmetry; expanding coverage for treatments such as unilateral and bilateral TMJ, periurethral injection for incontinence, cochlear implant receiver/stimulator prosthesis and minimally invasive glaucoma surgery; lifting the excess requirement on certain benefits under plans with an excess e.g., surgical allowances, obstetrics and the GP minor surgery benefit; broadening member access to mental health care; increasing the number of healthcare services that must be accessed through Affiliated Providers.
SCHI is also changing the way it communicates changes to some documents that form part of some policies – listing them on the SCHI website and updating them regularly.
Regan Savage, Chief Sales and Marketing Officer for SCHI says,
“Healthcare is dynamic and fast-changing. Health technology, drugs and healthcare services are constantly being improved, so Southern Cross regularly reviews its policies and the way we engage with members, with an aim to remain sustainable and affordable.”
Our research team are looking at the pack of documents that will be considered together and include sub-limits and eligible procedures in this online document alongside the policy wording in our review of the rating of the product.
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Rob Hennin talks about nib's Toi Ora dedicated iwi programme
nib launches an AI-driven symptom checker
nib has launched an AI-driven symptom checker, to help direct kiwis to the appropriate treatment, based on their needs.
nib has launched an AI-driven symptom checker, to help direct kiwis to the appropriate treatment, based on their needs. The symptom checker is available to all nib health policyholders through the my nib app.
Users input their symptoms and the symptom checker gives information on possible conditions as well as when and where to seek care. For a limited time, users advised to book a telehealth GP appointment will be able to get an appointment with Tend’s nationwide online GP service, at no additional cost.
nib New Zealand Chief Executive Officer, Rob Hennin, said
“It’s part of nib’s mission to help Kiwis take a more proactive approach to their health and wellbeing no matter where they are… AI-powered health tools, such as symptom-checkers, can help keep non-urgent medical cases out of hospital emergency departments, relieving some of the pressure on hospitals and emergency department staff, and help ensure people get the right level of medical attention.”
The symptom checker platform was developed by Infermedica and has been used in more than 30 countries, reaching more than 17 million users internationally.
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Te Whatu Ora to roll out 24/7 telehealth primary care service in rural areas
Te Whatu Ora are rolling out a new telehealth primary care service aimed at supporting rural health staff and improving access for patients living rurally.
Ka Ora Telecare, a partnership between Reach Aotearoa, Practice Plus and Emergency Consult, is partnering with general practices in rural areas to deliver the telehealth service. The aim is to support practices by creating extra capacity, including providing overnight support and taking on overflow patients during usual hours. The service should also help redirect patients from emergency departments outside of practice hours.
The service is subsidised by Te Whatu Ora, with free nurse consultations and co-payments for GP consultations.
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Public health systems globally are under pressure
We’re seeing more and more stories of people unable to get the treatment they need from the public health system in a timely manner resorting to fundraising through sites like Givealittle to try and raise money to go private. Whether that’s raising funds to travel overseas for treatment or more recently a family waiting more than 10 months so far for what most people would consider a fairly common childhood surgery. Tauranga Hospital has been unable to provide a timeline for Natália Ferguson’s tonsil and adenoid removal surgery, saying that workforce shortages in the ENT department have impacted on both the number of patients waiting for treatment and the time spent on the waitlist. With Natália’s quality of life deteriorating and health declining, the family are trying to raise the funds for treatment themselves. I wonder, if there was capacity elsewhere in the system, could the family have not travelled to another region to get the surgery, especially given it’s usually an outpatient procedure? The creation of Te Whatu Ora was premised in part on upon removing the post code lottery, but how much progress has been made on this in the 12 months since establishment?
New Zealand isn’t the only country whose health system is stressed. The Economist has a story investigating why healthcare services globally are creaking under pressure. The article cites an Ipsos survey that questioned respondents about the quality of local health care; in almost all of the wealthy countries surveyed, people were less likely to say the service was ‘good’ or ‘very good’ than in 2021. The article has statistics from a broad array of countries illustrating how dire health services provisions have become, from waiting times in Canada reaching an all-time high (median delay of half a year between referral and treatment) to patients in Singapore waiting 13 hours to be seen at the average polyclinic (up from 9 hours in 2021).
The flow-on effects of the decline in health care are easy to see with ‘excess deaths” (those above what would be expected in a normal year) rising in many countries, for example, Germany is running about 10% higher than normal.
OECD countries are spending more on health-care as a percentage of GDP than before, but productivity has fallen. Why? The Economist points to several things that could be impacting the quality of care – burned out health care workers; exploding demand for services partly due to the delay in diagnosis due to lockdowns; sicker patients needing additional care because they weren’t treated in a timely manner; skyrocketing cases of endemic pathogens such as respiratory syncytial virus; and, of course, the ongoing additional burden on services that Covid imposes.
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