DATA TOOLS

Standardised, transparent ROI evaluation framework. Calculates ROI outcomes of varying OHSI programs offered by independent services providers. Forecasts the ROI for your OHSI program(s) so you know how much to optimally invest. 

• Know if your fund will reap a positive (or negative) ROI from [X] OHSI program
• Project net outlay savings realisable in FY26, FY27, FY28 and beyond care of X, Y and Z programs
• Know the risks of negative ROI via outlays duplication, program related admin, risk equalisation or hospital replacement supply
• Robustness of ROI and expected $ saving per member over program life from [X] OHSI program
• See 'what-if' we dialled up our OHSI campaign intensity?
• Ascertain how much your fund would need to invest prior to reaping benefits from OHSI activities

Time series analysis of OHSI activity in PHI split by HST Programs, DM Programs, Care Co-ordination and (in time) other innovative and clinically efficacious hospital avoidance programs. This Data Tools is a collaboration between PHInsights and Insight Actuaries.

How you can use these tools

• Determine whether time is right to launch your OHSI campaign and (if so) at what level of intensity. Or should you await market maturity
• Know your Fund's OHSI activity magnitude versus peers regionally and drivers of the difference
• Forward plan to realise optimal optimal OHSI settings in the short term (2 years); medium term (4 years) and long term (8 years)

Guides on options for creation of outcomes based OHSI Provider agreements. Enables transition to a risk-sharing framework with provider incentives aligned to outlay savings and enhanced patient outcomes. 

How you can use these tools

• Identify most effective risk-sharing payment models practical
• Gather an evidence base for how outcome-based payments will reduce outlays 
• Ascertain how to align provider incentives with fund savings goals

Anonymized benchmark comparing your Fund's component ME per policyholder on call centre, claims processing and marketing, etc. Facilitates targeted discussions on improving function-specific efficiencies, driving strategic cost optimizations through robust data analysis. It also identifies where your functions are relatively efficient. 

• Show you Board where your Fund excels in efficiency terms
• Confirm (or challenge) your hypotheses of where efficiencies can be found
• Data leverage to combat year on year cost pressures (supplier negotiations)
• Data to empower meaningful dialogue / planning with operational managers

Time series of the ME Composition Benchmarker. Enables function on function costs growth & inflation check - your fund versus rest of sector. Compare your unit costs base growth versus other funds. If you unit costs or function costs are rising faster than peers, then you can fix it!

How you can use these tools

• Show you Board where your Fund excels in member service and operational efficiency.
• Identify and seize opportunities for performance augmentation.
• Draw inspiration from the triumphs of other Funds to catalyse your own success.

Our quarterly index assesses Policyholder Trust Levels ("PTL") across all Private Health Insurance Funds, enabling benchmarks against peers. Results are detailed by fund, geography, age, income level, and taxation status. This Data Tool is a collaboration between PHInsights and DFA Analytics. 

How you can use these tools?

• Know your PTL compared with other Funds
• Know when your PTLs rise (or decline) in response to your external communications or news on the PHI sector
• See how PTLs in your fund varies by demographics 
• Fine tune your policyholder messaging 

This quarterly index offers predictions on policyholder lapses specific to your Fund, based on weekly surveys with the public about their renewal intentions. Results are benchmarkable versus competing funds. Our extensive dataset helps reconcile the discrepancy between the higher number of stated lapses and the actual lapse rates. The analysis is segmented by fund, geography, age, income level and PHI taxation status. Data Tool is a collaboration between PHInsights and DFA Analytics.

How you can use these tools?

• Know in advance if you are about to experience more lapses than usual
• Deeper insight on what is driving policyholder retention and lapse
• Track changes in retention likelihood over time
• Know to what extent PTL drives Lapse likelihood
• Know to what extent Lapse likelihood drives actual lapse

Customizable model calculates the retention period needed to offset a new policyholder's acquisition cost. It factors in claims rates, servicing costs, premium rates, the likelihood of policy downgrades, and the initial cost of acquisition, allowing for tailored planning and strategy development.

How you can use these tools

• Compare policyholder value from competing acquisition channels aka (a) Intermediaries; (b) Marketing; (c) Word-of-mouth; and (d) M&A activity
• Measure ROI from intermediary-acquired policyholders.
• Understand the significance of policyholder growth for your Fund's success.