Health (health companies)

Market situation

The health market is a dynamically developing and prospective business area. Experts from PMR¹, dealing with market research and analyses in Central and Eastern Europe, expect that in 2020-2025: 

• the growth rate of private health insurance will reach the average annual level of approx. 7.1% for supplementary health insurance and approx. 6.2% for subscriptions; 
• the average annual growth rate of the fee-for-service market will be 5.8%. 

In addition, the following is expected: 

• further intensive development of telemedicine and service opportunities through remote channels; 
• increasing number of persons outside working age and greater need to provide care to senior citizens; 
• increasing public awareness of prevention and periodic examinations. 

According to PMR², the private health care offered under fee-for-service products at the end of 2019 was worth PLN 21.1 billion (up 12.9% y/y). The value of medical subscriptions reached PLN 5.1 billion (up 12.1%), while the value of private health insurance was nearly PLN 1 billion (up 8.9% y/y).

^{1 2} PMR Report entitled “Private Health Care Market in Poland 2020 – market analysis and development forecasts for 2020-2025”

Activities in the health area

The PZU Group's operations in the health area include:

• sale of health products in the form of insurance (life and health insurance and non-life health insurance, and non-insurance products);
• sale of non-insurance products (occupational medicine, medical subscriptions, partnerships and prevention programs;
• development of proprietary, uniform-standard medical infrastructure (medical centers and patient service solutions) to endure the best access to service and the achievement of revenue targets

Development of the non-insurance health offering of PZU Zdrowie

Responding to the changing market environment, PZU Zdrowie adapted its offering to client expectations, introducing innovative solutions: 

• In January 2020, PZU Zdrowie’s own sales network started to sell subscription-based medical care, mainly for strategic corporate clients. Rules for internal communication with other PZU Group companies and for work on the shared portfolio were prepared to generate the best possible synergy, and the following were developed:
• standardized Sales Contacts Report (CRM), 
• uniform documentation necessary for the execution of agreements, 
• rules for cooperation with external sales agents and brokers, 
• promotional and communication materials for the subscription product and occupational medicine;
• Within the structures of PZU Zdrowie, a tender offering area was established. Its key purpose is to align the product offering to the individual expectations of strategic tendering clients, in accordance with the tendering roadmap prepared by the company;
• Pilot sales of a product designed for seniors, named Caring for seniors, were launched. The offer provides for the use of geolocation bands for seniors, which monitor their basic life parameters and help summon assistance in life-threatening situations. The product also includes a medical package enabling prompt doctor consultations and tests – both stationary and remote; 
• In August 2020, the Safe Hotel package was introduced for owners of hotel facilities, increasing the safety of hotel guests and providing telemedical care during their stay; 
• As part of the non-standard subscription offer, the following were implemented:
• update of the subscription for Tauron’s clients – as part of the offer, prepared in cooperation with TUW PZUW, the possibility of concluding agreements for 36 months was introduced and the limits can be set based on the calendar year, rather than policy year, as before, 
• subscription for PGNIG’s clients – comprises a medical package offered in cooperation with TUW PZUW, 
• medical packages (vouchers) for car service garage employees – a solution delivered in cooperation with PZU Pomoc,
• update of additional services, such as:
• telemedical consultations, 
• rental of rehabilitation equipment, 
• hospital consultant, 
• hospital advisor, 
• ambulance transport, 
• ad hoc oral medicine help;
• same-day surgery – scheduled surgical procedures are performed and the patient is discharged from hospital on the same day or within 24 hours of the surgery. The service includes:
• limited qualification consultations by a physician of the relevant medical specialty, 
• anesthesiological consultation, 
• surgical procedure, 
• required diagnostic tests accompanying the procedure and prescribed by the physician during hospitalization, 
• anesthesia, 
• dressing materials, 
• medical care, 
• cost of medicines prescribed as part of the service, 
• post-operation check-up.

The broad range of health products is adapted to the segment’s and clients’ need

Development of the insurance health offering of PZU Życie

• in March 2020, sales of PZU Thinking about Life and Health product for companies employing up to 4 people were launched. Employees may select from among 6 insurance options with different covers and benefit amounts. Each option may be extended to include private medical care. The insurance covers have been prepared to address different needs, depending on the client’s stage in life. Contracts are concluded remotely via the mojePZU portal. PZU Życie can insure even a single employee – also when an employer itself does not take out a cover;
• thinking about children, in the first quarter of 2020 the “P Plus” product was expanded to include three riders with medical services for:
• accidental dismemberment of a child, 
• hospitalization of a child caused by an accident or illness, 
• critical illness of a child.

Each of these types of insurance may be extended to cover medical services adapted to the events covered by insurance. PZU Zdrowie organizes, among others, consultations of specialist physicians and rehabilitation, to minimize the risk of complications.

Activities carried out in 2020

Development of medical infrastructure

• PZU Zdrowie became the sole owner of Centrum Medyczne Gamma – one of the leading orthopedic centers in Poland; 
• another greenfield PZU Zdrowie center was opened, introducing a number of innovative solutions aimed at providing better patient service and equipping it with modern equipment. The center is located in the modern office complex Varso at ul. Chmielna in Warsaw;
• as part of PZU Zdrowie’s Tomma Diagnostyka Obrazowa network, new magnetic resonance imaging (MRI) laboratories were opened in Wrocław and Częstochowa; 
• the service provider network was expanded by further centers, thanks to which PZU Zdrowie’s partner network comprises already 2,200 centers; 
• in own centers in Warsaw, Kraków, Poznań and Wrocław, PZU Zdrowie was developing the dental services launched in 2019.

Development of e-commerce and IT infrastructure 

• PZU Zdrowie centers started to provide remote consultations, adapting to the pandemic situation; 
• psychological consultations over the phone were launched; 
• thanks to further development of the tool for booking and purchase of online appointments through a direct connection with the calendars of the medical centers, the number of centers throughout Poland supporting such connections increased to approx. 200. They belong both to the PZU and the partner network. More than 20% of medical services are arranged by PZU Zdrowie patients on their own via the mojePZU portal; 
• starting in January 2020, patients of PZU Zdrowie’s own medical centers obtained access to their online medical documentation on the mojePZU portal. The patients also received an online medical interview free of charge, which allows them to check whether they have COVID-19 symptoms; 
• as part of the phone-based patient service, in January 2020, PZU Zdrowie introduced an IVA voicebot, which supports the medical call center in booking (and canceling) standard medical appointments; 
• in April 2020, PZU Zdrowie opened its own PZU Zdrowie Telemedicine Center; 
• in May 2020, the sales of medical bundles for fee-for-service customers were launched via the mojePZU portal; 
• the service of health products for children was launched on the mojePZU portal, offering the customers the possibility of making appointments and accessing medical documentation online; 
• support for registration of claims for reimbursement for medical services was launched on the mojePZU portal.

Development of innovative solutions

The MedTech and HealthTech solutions market is developing faster than ever and the progress of digitization in health care has accelerated significantly. As a result, remote solutions, in particular telemedicine, will become the most important trend in the coming years. PZU Zdrowie is addressing these needs today, by implementing innovations in its medical centers and in patient services:

• AccuVein vein imaging device designed to support the nursing staff at blood specimen collection points. It uses a laser to display veins in patients whose veins are either invisible or impalpable, thereby minimizing the risk of painful insertions of a needle, which is especially important when the patients are children; 
• StethoMe electronic stethoscope – in combination with headphones, the device may be used as a traditional stethoscope, which additionally recognizes and appropriately amplifies sounds originating in the lungs or in the heart. When integrated with a dedicated tablet app, the stethoscope supports the diagnosis of lung diseases in adults and children using medically certified artificial intelligence algorithms; 
• portable USG Lumify heads are used among others by orthopedists for joint injections. Thanks to this device, in many cases procedures may be carried out without a need for an additional USG test. The device connects directly to a tablet, allowing a physician to perform the test in any location; 
• monitors in doctor’s offices with visualizations of medical models aid physicians in explaining medical problems to patients, thereby allowing the patient to take an active part in the diagnosis process; 
• electronic consents with biometric signature – patients, who visit a PZU Zdrowie center for the first time, may place their signature on a tablet and that signature is as valid as one on a paper document. Biometric signature makes the document circulation easier and helps in the digitization of medical documentation; 
• artificial intelligence in stroke diagnostics – Tomma Diagnostyka Obrazowa SA, which is owned by PZU Zdrowie, cooperated with the Polish start-up by the name of BrainScan, to become one of the first companies in Poland to launch a pilot in August 2020 for a solution, which uses artificial intelligence algorithms to identify strokes in computed tomography tests. This method supports the work of radiologists and helps detect a life-threatening change lesions automatically. Thanks to this cuttingedge solution, the time needed to prepare a description whenever a stroke is detected has been reduced from several hours to just a few minutes, which allows patients to be assisted quickly. This method reduces the likelihood of severe brain damage and increases the patient’s chances of survival;
• tele-rehabilitation – allows patients to perform rehabilitation exercises at home by using controllers connected to a personal computer. The pilot of the solution has been conducted since December 2020 in the PZU Zdrowie Medicus Medical Center in Opole.

PZU Zdrowie’s involvement in health protection activities

PZU Zdrowie’s social activity in 2020 focused on supporting the health care system and the patients in combating the COVID-19 pandemic: 

• The PZU Zdrowie support hotlines gave 20 thousand pieces of free advice associated with COVID-19, which included medical and psychological consultations. From the beginning of the pandemic, PZU Zdrowie provided:
• a psychological support hotline – offering free-ofcharge psychological counseling for physicians, nurses, paramedics and lab technicians involved in the fight against COVID-19,
• the NFZ [National Health Fund] Patient Information Hotline – a free hotline for all citizens, supported by consultants, physicians and psychologists, who provided consultations related to COVID-19, 
• free telemedicine advice – offering consultations with a PZU Zdrowie physician and expert information about COVID-19;
• PZU Zdrowie is an operator in the Health Ministry’s Home Medical Care program. Within this program it provides internal medicine support and psychological counseling, but also provides remote monitoring of the health condition of those who are isolated due to COVID-19, among others by checking their oxygen saturation level, pulse and temperature as well as the severity of their symptoms of the illness. The program utilizes a pulse oximeter as a diagnostic tool and an application to transmit and monitor data; 
• For its customers, PZU Zdrowie additionally launched a Remote COVID Care program, in which patients receive pulse oximeters to monitor their blood oxygen level. They also benefit from the remote internal medicine and psychological care.

Promotion of health also included:

• continuation of PZU Zdrowie’s partnership with the “Large Family Card” program (extension of the 2018 contract) – in 60 own locations, PZU Zdrowie offers discounts on doctor consultations and laboratory diagnostics tests, imaging and exercise diagnostics); 
• a series of free health education webinars organized in cooperation with the Her Impact internet platform; 
• PZU Zdrowie also partnered in creating the first “Top Disruptors in Healthcare” report in Poland on innovations in medicine prepared by the Polish Federation of Hospitals and Young Managers of Medicine; 
• PZU Zdrowie assumed the patronage of a charity concert for the Children’s Transplant Center at the Children’s Memorial Health Institute; 
• PZU Zdrowie also assumed the patronage of the “I, the Patient” debate held by the Medical National Interest Group think tank at the Polish Academy of Sciences on the occasion of the World Day of the Sick. 
• participation in the “Action Defibrillation” educational project in the świętokrzyskie voivodship, which promoted the use of devices, which can restore normal heart action in the event of sudden cardiac arrests.

PZU was the first insurer in Poland to appoint a Health Ombudsman. The PZU Health Ombudsman is a unique function, which has no equal in the entire private medical care and insurance market. The main responsibility is to carry out a dialog with patients and to support them on every stage of interaction with health care operators – from the moment of purchase to visits or examinations in a medical center. The Health Ombudsman will maintain impartiality when reviewing patient cases, assessing the quality of service and procedures in an objective manner. Close contact with patients will allow him or her to have real impact on the development of new solutions and health products. In addition to contacts with customers, the Health Ombudsman also promotes health and prevention activities undertaken by PZU.

Factors, including threats and risks, that may affect the operations of the Health Area in 2021

• changes in fertility, mortality, and morbidity rates, as well as the health consequences of the fact that during the pandemic treatments for certain conditions (e.g., cardiovascular and oncology) were postponed, may affect the value of sales and the loss ratios (e.g. in subscription plans or in health insurance); 
• changes in trends and behaviors displayed by clients, who will start searching for customized offerings – clients’ new expectations may bring about the need to change processes and systems, which in turn may affect the business results;
• an increase in unemployment and uncertainty on the labor market may reduce sales growth of new insurance and medical subscriptions for corporate employees; 
• continued pressure on the prices of group insurance products – the market for health services remains very competitive both in terms of prices and the range of available services; 
• the demand for specialized doctors exceeds the supply, which may slow down growth and affect margins; 
• salary pressures exerted by doctors and other personnel serving patients in medical centers may affect our financial performance in the Health Area;
• relatively high saturation of the market in larger cities and also staff shortages and lack of customer potential in smaller towns may reduce our growth rates; 
• potential modification of the National Health Fund’s contracting rules may cause significant changes in the financial results generated by medical centers.