Transcript Bahrain Health Insurance System in Germany 11th July 2005
Presentation of DKV Deutsche Krankenversicherung AG
Tallinn, 8th September 2005
Bernd Knof
Ich vertrau der DKV
Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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DKV in figures 2004
DKV GROUP *
Premiums Change as against previous year * Including VICTORIA Kranken and foreign subsidiaries.
DKV AG
Premiums Change as against previous year
Ageing reserve
Ein Unternehmen der Versicherungsgruppe.
million euros 4,549.6
million euros 3,325.6
15,260.0
% 2.0
% 1.9
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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New challenges in the health care sector (1) The opportunities:
● The healthcare market is growing worldwide ● Ever higher levels of quality and transparency are expected ● Well-being and aesthetics are new dimensions in medicine ● More and more people are living longer Ein Unternehmen der Versicherungsgruppe.
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New challenges in the health care sector (2) Innovations in products
Innovative insurance and financing products with focus on quality and prevention, products in co-operation with the statutory health insurance.
Today: Financing of the risk of illness Excellent & efficient care
New activities in the provision of healthcare, in areas where there are deficits in quality and coordination.
Health Services: Better medical consulting
New service, support for clients‘ health-related decisions.
Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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Think Healthcare! Our strategy covers all aspects of modern healthcare THINK HEALTHCARE!
INSURANCE HEALTH SERVICES
Comprehensive and supplementary insurance coverage of all types DKV-health hotline DKV healthcare programs Health information via the Internet Publications, Innovative insurance products such as Customer Information and newsletters
Best Care
International Assistance
Optident PROVIDING CARE DKV-Residenzen DKV aims to provide people with convincing health solutions, wherever they may be.
Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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Different types of PHI-Systems *
Eligibility to public health insurance
Individuals have public cover Individuals do not have public cover
Health services covered by PHI
PHI covers medically necessary curative services typically covered under the public system PHI covers cost sharing applicable to public coverage systems PHI covers top-up health services not included in public systems or primary PHI Duplicate PHI Complementary Primary PHI: - Substitute - Principal Supplementary
* OECD classification
Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of
health insurance markets
• DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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DKV‘s experience in different types of health insurance markets (1)
Examples
Belgium
Supplementary market
Europe
Germany
Substitutive market
Asia
Spain
Network and provider steered market
Ein Unternehmen der Versicherungsgruppe.
China
Developing health market
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DKV‘s experience in different types of health insurance markets Germany - substitutive market
Health market DKV 90% of the population are covered by the Statutory Health Insurance system.
PHI - substitutive market
• Private Health Insurance is able to replace entirely or partially the Statutory Health Insurance.
• The PHI represents an important column of the German social security system.
• Also Long-term-care and dental care are part of the coverage. Ein Unternehmen der Versicherungsgruppe.
DKV has almost 80 years of health insurance experience.
• The product range varies from comprehensive to supplementary health insurances and also long term-care products were offered.
• DKV’s core business is to develop comprehensive long-term health insurance products, adequate to German market needs.
• Realistic risk analysis possible, due to an extensive medical data pool.
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DKV‘s experience in different types of health insurance markets Germany - substitutive market Product Principles
• Guarantee of coverage for life • Premium calculation based on underlying risk (gender / age) • Premium adjustments solely due to aging are not exercised • Cost of service principle “Benefit equals service in return” Cash value of expected benefit equals cash value of expected premium Ein Unternehmen der Versicherungsgruppe.
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DKV‘s experience in different types of health insurance markets Spain - network and provider steered market
Health market DKV Seguros 98% of the population are covered by the statutory health insurance system.
Only public servants have the possibility to choose between public or private insurances.
PHI - Network and provider steered market
• Service provided by own or contractually bound networks • PHI-companies offer comprehensive and supplementary products
DKV Seguros offers supplemen tary and comprehensive products
.
• Well-priced / competitive products by building up provider-networks.
• Premium calculation: - without aging reserves - gender, age, geographic region
Provider network of DKV Seguros:
• 280 Hospitals • 22.000 Medical doctors • 500 Out-patient medical centers • 450 Diagnostic centers • 500 Clinical laboratories Ein Unternehmen der Versicherungsgruppe.
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Innovative Health Model in Denia, Spain
02/2005:
DKV Seguros, DKV‘s subsidiary company in Spain, wins the tender of a
public health insurance contract
Region Denia: - 140.000 inhabitants - 68.000 long-term tourists - 350.000 Tourists p.a.
Integrated care business
in the Denia region based on a innovative per-capita insurance model.
Management of
public health services
(medical care, hospital)
01/2007: Business start
Ein Unternehmen der Versicherungsgruppe.
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DKV‘s experience in different types of health insurance markets Belgium - supplementary market
Health market DKV Belgium
•
99% of the population are covered by the statutory health insurance system.
DKV has a very good reputation; brokers recommend DKV-products PHI
• High potential for private supplementary products, due to big gaps within the statutory system.
• Approx. 15% of the population have private supplementary coverage.
LTC – Supplementary market – Substitutive market
• public insurers (mutuelles) and private Insurers operate parallely Ein Unternehmen der Versicherungsgruppe.
• DKV developed cost-effective and competitive supplementary products.
• Main focus on in-patient and long-term-care products. • Premium calculation: - with aging reserves - gender, age, geographic region - long-term-products
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DKV‘s experience in different types of health insurance markets China – developing market
Health market DKV`s experience Only 10% of the population are covered by the statutory health care system PHI – developing market
• PHI was offered by life insurance companies • No comprehensive health insurance products available • Dread disease, critical illness and lump sum products were offered
2004: Foundation of the first PHI company in China (PICC-Health)
• Development of comprehensive and supplementary PHI-products • Support by the government • Close co-operation with supervisory authority • Preparation of risk list for China • Premium calculation: - start with short-term products without aging reserves - next step: long-term-products Ein Unternehmen der Versicherungsgruppe.
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Involvement in establishing the first private health insurance in China, PICC Health
Nov. 2004: Foundation of PICC Health
- DKV has 19% shares of the new company - DKV holds important positions in PICC Health - Agreement of PICC und DKV: Long-Term Strategic Cooperation - DKV project team with 20 persons in Beijing
April 2005: Business license
- Grant of license was politically supported; personal comment by prime minister - First business license for a private health insurance company was granted by CIRC Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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DKV – The No. 1 among private health insurers in Europe Norway and Sweden
Storebrand Helseforsikring
Luxembourg
DKV Luxembourg
Belgium
DKV Belgium
Spain
DKV Seguros Ein Unternehmen der Versicherungsgruppe.
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Excellent position of our foreign subsidiaries Country Company DKV Belgium Position in market No. 1 DKV Luxembourg No. 1 Premium p.a.
Mio. EUR Customers 226 14 1,2 Mio.
18.000
DKV Seguros No. 5 251 1,5 Mio.
Storebrand Helse No. 1* 14 30.000
* in Norway Ein Unternehmen der Versicherungsgruppe.
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We offer insurance, service and healthcare from a single source – worldwide INSURANCE PICC Health THINK HEALTHCARE!
HEALTH SERVICES PROVIDING CARE Norway/Sweden:
Best Care tariff for customers of Storebrand Helse
Belgium:
Second Opinion
Spain:
Health telephone line 24h-Emergency Phone Second opinion
Spain:
Medical Network: Contracts with over 22,000 doctors and over 1,000 hospitals
Denia:
Integrated care business in the Denia region based on a innovative per-capita insurance model Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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Difficulties in different markets
- Political decisions In The Netherlands the announced introduction of the basic insurance for entire population was main criteria for market exit. DKV NL could not reach critical size in near future.
- Legal practice DKV Belgium: A court decision driven by consumer organisation Test Achat intervened in the principles of premium calculation.
Ein Unternehmen der Versicherungsgruppe.
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Opportunities in different markets
+ Political decisions In Spain the Government partly privatised the health care support of the region Denia and tendered a public health insurance contract.
+ Legal practice Both political and economic development in China gave us the opportunity to enter the market with a joint venture.
Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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Market opportunities from PHI view (I)
Legal / Regulatory aspects:
- Legislation opens the market for PHI and sets clear regulations for the development of PHI - Definition of the level-playing field for both the public and the private insurers (as private insurers often have disadvantages regarding taxes, solvency requirements, …) - Legislation supports ans sets rules for provider market - Stable political environment (as PHI is heavily politically influenced) Ein Unternehmen der Versicherungsgruppe.
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Market opportunities from PHI view (II)
Macro-economical aspects:
- Limited quality and/or service of statutory health care system - Waiting lists in statutory health care system - Problems of funding statutory health care system and/or funding of medical infrastructure - Spendable income of (parts of) the population is present Ein Unternehmen der Versicherungsgruppe.
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Market opportunities from PHI view (III)
Attractive market conditions:
- Medical infrastructure is present and can offer adequate provision of care - Existing private Life- and/or P&C market has established understanding and acceptance for private insurance activities - Information on medical treatments are present or can be build up to allow data-based actuarial calculation Ein Unternehmen der Versicherungsgruppe.
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Summary
• DKV in figures • New challenges in the health care sector • Think Healthcare! Our strategy • Different types of PHI systems • DKV’s experience in different types of health insurance markets • DKV’s international activities • Risks/chances of DKV in different markets • General market opportunities from PHI view • Conclusion Ein Unternehmen der Versicherungsgruppe.
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Conclusion
- Every country or market is different regarding • development, • statutory health care system, • affinity and reliance to insurance in general and PHI in particuar • legislation • competition
In-depth market analysis is obligatory
Ein Unternehmen der Versicherungsgruppe.
Thank you for your Attention
Ein Unternehmen der Versicherungsgruppe.
Ich vertrau der DKV
Ein Unternehmen der Versicherungsgruppe.
Back-up
Ich vertrau der DKV
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Providing care
Business model
Quality oriented out-patient treatment
with focus on evidence-based and dialoguing medicine, prevention Physicians as
health-manager with network-know-how
, attendance to patients throughout all stages of care provision – based on tried & tested high quality treatment-methods (cross-sector )
Savings in treatment of patients with chronic diseases Status
Location Cologne: Successful beginning
with excellent utilization (currently 2.000 patients)
Conceptual enhancement
Aim „Integrated provision of care“
2 other locations
currently being planned Ein Unternehmen der Versicherungsgruppe.
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DKV is a key stakeholder in the hospital market
• 24 own hospitals, 4,900 beds • 33 managed hospitals, 8,100 beds • 2 own senior residences • 17 managed senior residences • 13 service companies • 18,830 employees • 1.4 billion Euro turnover • Share DKV: 20.3% Ein Unternehmen der Versicherungsgruppe.
• 33 hospitals, 7,800 beds (acute care, rehabilitation) • 1 own senior residence • 6,900 employees • 360 Million Euro turnover • Share DKV: 12.47%
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Innovative insurance product
Best Care 15.08.04
8.30 am Phone call:
Diagnosis slipped disc
, heavy pains + crippling Staff
health-hotline
verifies diagnosis per fax, names different BC-experts
Customer choose BC-expert
in Aachen 9.30 am
Appointment at
11.30 am, bank transfer of 500 € allowance 11.30 am
Extensive examination
by BC-expert
Successful surgery
4.30 pm Ein Unternehmen der Versicherungsgruppe.
•
patient discharged 4
•
days after surgery. now 2 weeks of physiotherapy
•
patient is satisfied and wants to start working very soon.
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Involvement in establishing the first private health insurance in China, PICC Health Business launch within only 7 months
Organization
- Personnel: 100 employees - Actuarial responsibility with DKV
Products – 1. generation
- Health insurance: comprehensive and supplementary products / daily allowances - Individual and group products - Accident products
Sales
- Beijing branch is operative; two further branches are planned for 2005 - Sales begin: 05/2005 Ein Unternehmen der Versicherungsgruppe.