EIT Health drives plan to pay for health, not illness

Stockholm Region pioneering health bond scheme to support people in preventing type 2 diabetes

A start-up launched through an EIT Health Innovation Project has signed a five-year agreement with the Stockholm Region to help people at risk of type 2 diabetes stay healthier, while leading a revolution in the way we think about paying for healthcare.

Instead of asking healthcare to pay when people get sick, the health bond originally envisioned by the Health Integrator start-up provides pay-outs when people improve their health through preventative measures. This approach can ultimately reduce illness and the cost of healthcare.

The Stockholm Region is now pioneering the new model in partnership with the Swedish bank SEB and the insurance company Skandia, who provide a unique financing instrument, and Health Integrator, who are responsible for the initiative and the development of the digital platform.

EIT Health support launched the start-up

A two-year EIT Health Innovation Project called the Health Movement was started in 2017. It involved EIT Health Partners RISE, Stockholm Region, Karolinska Institutet, IESE Business School, West Midlands Academic Health Science Network, Semmelweis University and City of Rotterdam, as well as commercial partners MSD and Apoteket. As part of the Innovation Project, the spinout company Health Integrator was launched, with the aim of strengthening the conditions for healthier individuals and preventing non-communicable diseases.

Work was begun on an investment model to provide financial rewards for good health results, resulting in the model now launched.

“This system transformation would never have happened if we had not received support for our innovation project through EIT Health at an early stage. They dared to invest in something innovative that was based on future systems,” says Fredrik Söder, CEO, Health Integrator (pictured, right).

How the system facilitates sustainable change

Initially, up to 925 Stockholmers at risk of developing type 2 diabetes will be offered the use of Health Integrator’s digital health platform and app for five years. With the support of a personal health coach and tests, participants can buy preventative health services and products through the Health Integrator platform. Each user gets a “wallet” loaded with money to shop for selected health services. They can also pay by credit card or use their employer’s healthcare allowance. In the short term, this leads to better health, and in the longer term, changed lifestyle habits can prevent them from developing type 2 diabetes and other chronic diseases. The increasing burden of type 2 disease, for individuals and for society, can be prevented.

“With Health Integrator, we want to give individuals the right conditions to succeed in changing their living habits in a sustainable way. With health tests, support of coaching conversations – together with a health pedagogue and a tailor-made ‘basket of solutions’, based on the individual’s conditions and needs – the chances of success increase to consume health,” said Health Integrator’s Fredrik Söder.

Unique financing model

The project is financed through a SEK 30 million loan (Health Impact Bond) from Skandia, an insurance company. If a participant develops type 2 diabetes, Skandia covers part of the cost, but if the participant is found to have reduced the risk of diabetes, Skandia receives a return of up to 10% percent of the investment. One unique aspect of the solution is that the Stockholm Region does not incur any costs in the first few years. After five years, the region would pay around SEK 23-33 million, depending on outcomes. There will also be savings if people stay healthy and do not require expensive care. Stockholm Region expects to receive up to 100% return on investment.

Proven effectiveness

One reason why Stockholm Region has confidence in the Health Integrator is that it has been proven effective in a clinical study.

“Few apps have been scientifically evaluated, but the Health Integrator app has been tested in a randomised controlled study of just over 200 people,” says Ylva Trolle Lagerros, Chief Physician at the Overweight Center in the Stockholm Region, a researcher at the Karolinska Institute and leader of the pilot study. “After three months we were able to see statistically significant differences in health variables such as waist size and blood pressure between the group that used the Health Integrator app and the group that did not receive the app.”

EIT Health Partners ‘driving development’

“It is fantastic to see how EIT Health’s Partners, through Health Integrator, a project we have supported for several years, are now driving the development of health bonds. It is an exciting development that shows how social value can be created through disease prevention and provide significant cost savings for healthcare,” said Erik Forsberg, Managing Director of EIT Health Scandinavia (pictured, right).

Last year, Health Integrator participated in EIT Health Headstart, an EIT Health Accelerator programme that assists start-ups with product and service verification. With Headstart support, Health Integrator was able to refine the packaging of its service and develop a digital health platform for consumers. In the long term, the solution can be made available in other regions and reach a wider group that is ready to pay for itself.

“In a next step, we think that our service will be paid directly by the user or through the employer’s health care allowance and insurance. By offering different arrangements and payment solutions, we can make it easier for users to consume health and thereby avoid healthcare consumption” said Fredrik Söder.