Thank you for standing by, and welcome to the Medibank Full Year Results 2024. All participants are in listen-only mode. There will be a presentation, followed by a question- and- answer session. If you wish to ask a question, you will need to press the star key followed by the number one on your telephone keypad. I would now like to hand the conference over to Mr. David Koczkar, Chief Executive Officer. Please go ahead.
Good morning, everyone, and welcome to Medibank's 2024 full year financial results presentation. I'm joining you today from Naarm, the home of the Wurundjeri Woi-wurrung peoples. On behalf of Medibank, I'd like to acknowledge the traditional owners and custodians of country throughout Australia and their connections to land, sea, and community. I pay my respects to their elders, past, present, and emerging. I'm joined today by our executive leadership team, including our Group Lead, Chief Financial Officer, and Group Strategy, Mark Rogers. I'll make some comments on our key highlights, and then Mark will take you through the financials. I'll then wrap up with our outlook, and then really happy to take your questions. Starting on slide five, the highlights.
By staying focused on our customers, investing in the health transition, and growing as a health company, we've delivered another solid result. Despite customers feeling under pressure with the rising cost of living, people are continuing to prioritize their health and well-being, with the PHI market remaining with strong growth. We've remained focused on providing our customers with more value and greater support in their health, and we've stuck by our promise to not profit from the pandemic. We've continued to return these permanent net claim savings to our customers, which is the right thing to do. We delivered around AUD 10 million in productivity savings with our PHI management expense ratio , one of the lowest in the industry, and this is a very important position given the economic environment.
While the PHI industry and Medibank both continue to grow, we've been deliberate in our response to the ongoing competitive environment and remain disciplined in how we are managing the business for the long term. We've taken a big step in growth in Medibank Health this year. It's performed very strongly, and our primary care investment in Myhealth is tracking well. Our growth as a health company is a key differentiator. We delivered more than four million health interactions through our multidisciplinary primary care network, which now incorporates Amplify Health and Myhealth services. We remain a strong and resilient business, and we have a long track record of navigating competitive and economic challenges and delivering results. We remain focused on driving sustainable long-term growth and are excited about our opportunities for the future. Now, let's turn to slide six for some customer highlights.
First and foremost, we have continued to work hard to deliver our customers more value. We announced an additional AUD 305 million in COVID give back to our customers, bringing our total customer support to a record AUD 1.46 billion. We are committed to keeping premium increases as low as we can, and this year's increase was below inflation and wage growth, and as I mentioned before, we know that our customers are looking for more value. In the current cost of living challenges, 55% of our customers say their concerns over out-of-pocket costs are higher than they were a year ago, so in response, we've expanded the procedures covered by our No Gap program, now at 35 hospitals, and have seen a 38% increase in the number of customers going through the program.
Our Live Better program has now grown to 823,000 participants, and we delivered more than AUD 25 million in rewards to our customers, including more than AUD 8 million in cover rewards. We saw a 20% growth in the support provided to our PHI customers by our Amplify Health team and their partners. They delivered over 300,000 virtual health interactions and supported more than one in four eligible customers admitted to hospital through our Health Concierge offering. This shows we're making very good progress on expanding our relationship with our customers to a deeper and broader relationship in health, with now almost half of our Medibank policyholders engaging with our health and well-being services.
And our ongoing focus on simplifying and personalizing our customers' experience is reflected in increasing service Net Promoter Score for both ahm and Medibank brands, achieving our best result in the last four years. Now to slide seven and a brief overview of the key financial highlights. In FY 2024, we delivered another solid result. We saw continued growth in both the resident and non-resident health insurance business. Net resident policyholder growth was up by more than 14,000 or 0.7%. Now, this was not what we set out to achieve, but given the competitive market, we remain disciplined about the best way to grow for the long term. In our non-resident business, our strong growth momentum continued growing by 69,000 policy units or up 25% over the last 12 months, continued this result. Management expenses were up slightly by 30 basis points.
Health insurance operating profit was up 6.3% to AUD 692.3 million. And in Medibank Health, our segment profit was up 36.7% to AUD 60.4 million, with strong organic growth and a significant increase in contribution from Myhealth. Net investment income was up by 31.5% to AUD 182.2 million, and underlying net profit after tax was up by 14.1% to AUD 570.4 million. And in line with our strong capital position, we are delivering shareholders a final fully franked ordinary dividend of AUD 0.094 per share. Now on to slide eight.
The investments we are making in our people, our products, and our services, and our partnerships are delivering greater value to our customers and the community, and driving our growth as a health company. We've made it simpler for people to manage their health and well-being needs. For the Medibank brand, our trial connecting customers to local team members has delivered fantastic results in customer satisfaction, employee engagement, and in growth, and we're rolling this out nationally in FY 2025. Our new range of silver and gold hospital covers are one of the only products that ensure customers going to hospital for a no-gap procedure, have no excess and no out-of-pocket costs, which is saving customers undergoing joint surgery around AUD 2,400. The strength of our health and well-being offerings has also helped us win more corporate insurance accounts this year, which were up 9%.
And we're also seeing more corporate customers engage in Live Better and take up our diversified insurance offerings. We extended our twenty-four by seven nurse and mental health support lines to an additional 700,000 of our customers, and continue to grow our expansive Members' Choice Advantage network, which has delivered over AUD 23 million of savings to our customers and which continues to support better customer retention. As our customers for both Medibank and ahm brands continue to preference our digital channels, we've made these more intuitive, integrating more features, enhancing messaging functionality, and continuing to harness our investments in AI to support our people in the conversations they are having with our customers. We've provided more health and well-being support to our customers and the community.
Our Amplify Health team is delivering around a thousand home care visits a day to people across Australia. And we've just extended our virtual psychology clinic to all Medibank customers, so they can access timely and affordable mental health support from registered psychologists. And our hospital investments have expanded, with our ahm joint venture with Aurora offering innovative mental health approach, opening its second hospital, with a third to open later this year in Brisbane. And the Orthopaedic Institute opened at Macquarie University Hospital in February. Now on to slide nine. People continue to choose private health insurance in record numbers. In fact, the number of Australians who see private health insurance as essential is the highest it's been in seven years, particularly as confidence in the public hospital system continues to decline.
We've also continued to see very strong growth in younger customers, which is important for the longer- term health of the system. With last year seeing another 100,000 people under 30 now covered by hospital insurance, which is the highest rate of growth we've seen in the segment in 12 years. And despite the strong resident market growth, competitive intensity continues in some parts of the market, with some competitors continuing to offer significant discounts and offer through high-cost channels, and more price-sensitive customers shopping around for shorter- term deals. This competitive dynamic is lasting longer than we first thought, and we expect this to continue in the medium term. We've seen similar cycles to this in other industries, where short-term unsustainable activity is at odds with long-term competitive fundamentals.
For us, to remain strong and resilient, we will continue to think about volume and margin, and not just volume alone, as we continue to differentiate offering across both Medibank and ahm. So while our goal is to get back to growing market share in the retail business, we won't be chasing growth at all costs. Importantly, in FY 2024, we saw strong growth in our priority segments for Medibank, including the largest growth in family policies in over six years and strong momentum in corporate joins. With double-digit acquisition growth across customer and product segments of the Medibank brand, and new to industry growth being above market share. Medibank brand lapses remain well below the industry average and continues to improve relative to the industry. While ahm continued to grow strongly above market, with a 3.4% growth in policyholders for the year.
As we move into FY 2025, you should expect to see continued investment in differentiation for both brands, a continued broadening of our customer relationships to drive retention, and maintaining our focus on growth in our priority segments through our direct channels. We are aiming to grow in line with the market during FY 2025, including volume growth in the Medibank brand, and we aim to grow market share in FY 2026. In our non-resident business, our strong momentum continued with standout growth in the student market. This was driven by the enhanced health and well-being support and increased value we're providing to overseas students and our strong university relationships. With Medibank now the preferred provider of overseas student health cover for nearly half of Australian universities. We remain confident about the future growth prospects of our non-resident business and its meaningful contribution to our overall company results.
Now to slide ten. As we've talked about before, the health transition is well underway. We are seeing a shift from overnight stays in extensive acute hospitals to virtual short stay and home care, from treatment to prevention, and from generalized care to personalized health. Consumers are demanding these changes. For example, Medibank customers electing to have their rehab at home after a joint replacement has grown from 5% in 2018 to almost 30% in 2023. Also, the number of people electing to return home on the day of their surgery is increasing, with about 5% more hospital procedures now day cases compared with 2019 numbers.
Our health system needs this innovation, and if we don't act, the government will need to spend nearly 50% more on health as a proportion of GDP in 40 years' time, with hospital spending the fastest growing part. So while there's positive change in some areas, we all need to move faster to respond. The past few years have been challenging for all parts of the health sector, including hospitals. In recent time, inflation has been driving up costs for hospitals, and COVID waves have impacted staffing and operational levels of hospitals. However, despite these challenges, higher cost acute hospital bed capacity in the private sector has been growing ahead of demand, now with only approximately 64% of beds being utilized. So while we're seeing some hospitals closing, we also continue to see hospitals opening and new capacity being built.
Now, we want the private hospital sector to be strong, and we recognize the important role hospitals play in supporting our customers, which is why we continue to support our hospital partners and fund them through the health transition. Over the last two years, our one-off financial support for hospitals has reached a substantial AUD 63 million. This is in addition to higher indexation in hospital agreements and in addition to incentives to accelerate the health transition, where these additional benefits are given to hospitals, where they provide our customers with greater choice, better access, and more value in their healthcare. These new partnership agreements now cover 3/4s of the private hospital episodes experienced by our customers.
And what we continue to think about is how we support the sustainability of hospitals in a way that doesn't push up premiums to reduce affordability for customers and put increasing pressure on an already stretched public system. What we do know is that expecting consumers, insurers, and governments to provide more funding for the status quo is not sustainable. Change in health is never easy, and while there are many vested interests, complex funding models, and regulatory constraints to navigate, these must not be cause for inaction. Instead, we must accelerate the health transition, working together to shift from a hospital system to a health system. And we've been at the forefront of this transition, and alongside doctors, we will continue to make investments in the care models of the future, expanding our business and being a catalyst to change the way healthcare is delivered in Australia.
Let's move to slide eleven. We know people want healthcare done differently, and we know our health system needs change to remain sustainable. And we know this innovation in health is even more important given the current conditions we're seeing play out in the system, as I've described before. So our strategy remains the same. We're investing in the health transition to deliver greater value, choice, and control for our customers, focusing on prevention and accelerating the take-up of other models of care in partnership with clinicians and health providers. And by bringing together our group's established capabilities from PHI to health, we are well positioned to both differentiate our insurance offering and grow as a result of its focus, and be able to continue to support our customers, whether they need to be better or get better. Now to slide twelve.
Our strategy for growth in the corporate health and well-being market is an example of how we're bringing together our capabilities across the group to provide more for customers and grow our business. As one of the market leaders in the corporate private health insurance market, we're now expanding our offering in physical and mental health to grow within a market that is ready to change. We know that workplaces play an important role in people's mental health and quality of life. There's also greater expectation on employers to provide not just safe, but healthy workplaces. And changing regulations are increasing the obligations for organizations to minimize risks to employees' physical and psychological health. But while employees are prioritizing workplace well-being, there's a disconnect between their expectations and their experiences. Worker stress and burnout is rising, and this is costing businesses.
Corporates are looking to us for support, and this year we delivered around 600 health and wellbeing programs to corporate clients, including mental health support, and this demand is just growing. We expect the corporate health and wellbeing market to increase by over 10% each year for the next six years to be around AUD 2 billion. While there's a spectrum of health and wellbeing services currently offered, the market is ripe for innovation. With around 2,500 corporate customers, we are well positioned to drive this shift. What's different in our approach is we want to create the best end-to-end health experience for corporate Australia. Last month, we launched a new range of corporate hospital and extra cover options, which offer employees greater flexibility, preventative health benefits, and dedicated support.
Employers benefit from these, too, as many of the services we offer, like flu vax, skin checks, or health screenings, would typically be services they'd need to outsource at cost for their employees. To support our overall expansion into this market, we are excited to announce earlier this week, the acquisition of the Pinnacle Health Group, a leading provider of workplace well-being services, who bring to us a great team with strong capabilities in operations and service orchestration and established customer relationships. You can expect to see us further invest to grow in this market, including the establishment of our workplace mental health and well-being program. Moving to slide eleven. This year, by bringing together Myhealth, Medibank, and our existing Amplify Health services, we've created one of Australia's largest multidisciplinary primary care networks, delivering services in clinics, virtually, and in homes.
With care from GPs to nurses, psychologists to physios, and other health specialists. Primary care in Australia is a large and growing sector, but it needs investment and innovation to better support the growing needs of patients in both physical and mental health. We're partnering with GPs to take a more proactive, holistic approach within primary care, to prioritize prevention and better manage chronic conditions. This improvement is also a crucial part of the health transition and needed to reduce unnecessary hospitalization. Speaking to our GP partners, they also want this change. They see the potential to deliver a much better experience for their patients, to spend more time on care and less time on admin, and to provide a more coordinated approach to supporting people with chronic conditions by bringing health professionals together as a team, supported by the latest technology.
This is what we're trialing in Myhealth clinics in Western Sydney, and we've committed AUD 3 million to develop prevention programs and help GPs change primary care delivery with support from other health professionals. Already, 600 patients have been through the program, and the feedback from both patients and the health professionals is very promising. Not only is this helping Myhealth to deliver greater value to patients, it's another differentiator for our business, enabling us to grow our health offerings for other funders and for our own customers. Alongside this, we'll also continue to grow our virtual self-service offering, powered by our ventures team, which is enabling us to scale health and wellbeing prevention programs across the country, improving much-needed access to patients, including in regional and rural areas. I'll now hand over to Mark.
Thanks, David, and good morning. The result reflects the continued resilience of the Australian health insurance business, demonstrates the important contribution non-insurance makes to health solutions and fund growth, and highlights both the organic and inorganic growth potential in Medibank Health. With the implementation of AASB 17, we are reporting health insurance performance excluding COVID impacts in group operating profit, with COVID impacts shown separately. Group operating profit was up 7.9% to AUD 699.8 million, and with a significant increase in investment income, profit before tax and COVID impacts increased 13% to AUD 822.5 million.
This included a further AUD 39.8 million of IT security uplift, legal and other costs associated with the cybercrime, which is lower than in the previous twelve months, and we expect similar spend in FY 2025, including investment in uplifting business resilience and customer trust. And reported EPS was up 59.6% to 17.9 cents per share, and underlying EPS, which adjusts for the normalization of investment returns and COVID impacts, was up 14.1% to 20.7 cents per share. Moving to slide 16. While the claims environment has continued to recover, particularly in the last few months, intermittent COVID impacts, changing customer preferences, and increasing economic impacts resulted in resident claims paid for the six months to May, being AUD 104.1 million below our expectation of 2.2% growth per policy unit.
In extras, claims paid were AUD 37.2 million below expectations, with economic conditions impacting demand for all services other than dental. Hospital claims paid were AUD 66.9 million lower than expected, and while private surgical claims have been broadly in line with expectations since January, softness continues across all other claim types, particularly private mental health, rehab, and respiratory claims. FY 2025 will be the last year we separate our COVID impacts from the health insurance result. In extras, this will commence from 1 July, as claims favorability is now largely due to economic factors, and in hospital, where there remains ongoing monthly variability in claims, we will closely monitor trends over the next six months, and we expect to finalize our giveback program in FY 2025, with any remaining COVID savings returned to customers.
Slide 17 covers the health insurance result, which, as mentioned, excludes COVID impacts, which are reported separately and reconciled against the COVID equity reserve. While the economic environment has impacted the resident business over the last 12 months, with inflation remaining elevated and a higher proportion of sales through aggregators, this was offset by lower growth in extras claims and resulted in largely offsetting gross margin and management expense ratio impacts. Revenue increased 4% and gross profit was 7.2% higher. With the improved Risk Equalisation outcome reflecting continued favorable age claiming patterns and benefits emerging from our disciplined approach to growth. Gross margin was 40 basis points higher at 16.5%, including a 10 basis point benefit from strong growth in higher margin nonresident policies.
While the management expense ratio was 30 basis points higher at 7.8%, operating margin was up 20 basis points to 8.8%, and operating profit up 6.3% to AUD 692.3 million. Now turning to slide 18. The private health insurance market remains buoyant, with policyholder growth in the 12 months to 30 June expected to be similar to the 1.9% growth we saw last year. The market continues to be competitive, with customers seeking to offset cost- of- living pressures, resulting in a modest increase in the number of customers both lapsing and switching funds, and a higher cost of acquisition. Over the last 12 months, our number of policyholders increased by more than 14,000, with ahm growing 3.4% and Medibank down 0.2%.
Importantly, growth in hospital lives of 0.9% was 20 basis points above policyholder growth and skewed to customers under 30 years of age. The acquisition rate of 11% was 50 basis points higher, with improvement across both brands and Medibank back in line with pre-cyber levels. However, the cost of acquisition was higher, with an increased use of offers and the percentage of ahm sales through aggregators increasing from 45%- 53%. Whilst lapse was 40 basis points higher at 10.3%, pleasingly, this increase was below the industry average, with the impact greater in ahm, where customers are more price sensitive, particularly if acquired through aggregators.
We aim to grow in line with market during FY 2024, with growth in the Medibank brand by further capitalizing on our dual brand strategy, increasing focus on our priority segments, including the growing corporate market, and adding additional product benefits and further customer givebacks to support retention. Turning to slide 19. Resident claims expense increased 2.8%, and Risk Equalisation provided a 10 basis point benefit to net claims growth this period. Resident claims growth per policy unit of 2.2% was 20 basis points lower, with the 100 basis point decrease in extras partially offset by a 10 basis point increase in hospital. The decrease in extras reflects the impact economic conditions had on the utilization of all services other than dental and investment in additional product benefits in the prior period.
In hospital, higher private indexation was largely offset by lower utilization growth, particularly in nonsurgical claims and the improved Risk Equalisation outcome. Looking to FY 2025, we expect claims growth per policy unit of around 2.7%, with economic conditions impacting extras claims growth, further pressure on hospital indexation being partially offset by a higher proportion of admissions happening on the same-day or short-stay basis, and continued softness in nonsurgical claims growth. Slide 20 details health insurance performance, which shows continued growth in both the resident and nonresident businesses. In resident, gross margin was up 30 basis points to 15.9%, with revenue and claims growth per policy unit of 2.6% and 2.2%, respectively. The growth in revenue per policy unit was in line with last year, and downgrading remained at 50 basis points.
While the economic environment is likely to impact downgrading next year, we expect this will be largely offset by ongoing portfolio management and sales mix activities. Pleasingly, the momentum in non-resident has continued, with policy units and revenue increasing 25.1% and 34.9%, respectively, with strong growth in both the student and worker segments. Gross profit increased 37.3% to AUD 91.2 million, and with stable tenure and mix, gross margin was up 60 basis points to 34.2%. Notwithstanding the potential for lower visa numbers in FY 2025, we've continued to see growth since 30 June, and with potential market share gains in both the student and worker segments, we expect solid policy unit growth to continue in FY 2025.
Non-resident is an attractive market, and we will continue to invest in differentiation through product value and expanding our health offering and increase our focus in the work and business segments to support medium-term growth. Moving to slide 21. Management expenses were up 8.1% to AUD 614.9 million, and the management expense ratio was thirty basis points higher at 7.8%. The major driver of expense growth was higher sales commissions, particularly in the first half, with continued strong non-resident customer growth and a higher percentage of ahm sales coming through aggregators. Operating expenses were up 6.7%, with cost inflation of approximately 5%, volume impacts, particularly in non-resident, and an AUD 8 million uplift in IT, security, and statutory costs, with these partially offset by AUD 10 million of productivity savings.
The major drivers of expense growth in FY 2025 will be inflation, albeit we expect this peak in FY 2024, a further 10 million of productivity savings, and a modest increase in sales commissions, and whilst the management expense ratio increased this period, we will continue to leverage our productivity program and benefits of scale to target a stable to modestly improving ratio, noting that achieving this will be more challenging whilst inflation remains elevated. Turning to slide 22 and Medibank Health. Medibank Health segment profit increased 36.7% to 60.4 million, with strong organic growth and a significant uplift in the contribution from Myhealth. The Myhealth business continues to track well, with increasing consult numbers, improved billing mix, and better operating efficiency.
In the remainder of Medibank Health, revenue of AUD 290.4 million was 4.8% higher, with strong growth in health and well-being and diversified insurances, and home care revenue improving in line with hospital industry activity. Gross profit was up 18.9% to AUD 156.7 million, with the 630 basis point improvement in gross margin, the result of strong growth in higher margin businesses, improved efficiency in home care, and a higher telehealth margin. This was partially offset by a AUD 16.5 million increase in management expenses, reflecting business mix, inflation, and investment in future growth, and whilst the management expense ratio increased, operating margin was up 210 basis points to 18.1%.
Our growing portfolio of strategically important JV short-stay hospitals contributed an AUD 4.8 million loss this period, including expected initial losses from two hospitals opened in the second half. However, we expect financial performance to improve as the portfolio matures. We continue to target, on average, organic profit growth of at least 15% per annum between FY 2024 and FY 2026, with key areas of focus, performance uplift in health services, meeting the needs of more of our health insurance customers, and offering existing services to a broader set of payers. We aim to augment this organic growth by investing between AUD 150 million and AUD 250 million over the same period in healthcare M&A that adds scale, capability, or expands geographic coverage, including in Myhealth's clinic footprint and virtual health capabilities. Moving to slide 23.
Investment income of AUD 182.2 million was 43.6 million higher, with a 43.5 million increase in the defensive portfolio, partially offset by a 6.3 million decrease in the growth portfolio. The decrease in the growth portfolio reflects a lower return in all asset classes other than property, and the increase in the defensive portfolio includes 27.4 million from the higher RBA cash rate and an improved, but still below expected return on international fixed interest holdings. The 60.5 million increase in underlying net investment income resulted in a 188 basis point increase in underlying investment return to 5.77%.
This is a 150 basis point spread to the average RBA cash rate, which is the bottom of our target range of 150- 200 basis points. While cuts to the RBA cash rate are possible in FY 2025, we expect any impact will be largely offset by improved returns on international fixed interest holdings. Now, slide 24 covers capital. The business continues to be well capitalized, with health insurance capital at 1.8x the PCA and unallocated capital of AUD 186.2 million. The health insurance capital ratio of 14.1% is also strong and above the target range of 10%-12% of premium revenue, with additional capital held to offset the AUD 250 million APRA supervisory adjustment.
The increase in other capital employed includes the further investment in Myhealth and fit-out costs for our new Melbourne head office. Despite this, unallocated capital increased in line with the business's strong capital generation. Consistent with the strong capital position, the board has declared a final dividend of AUD 0.094 per share, which brings dividends for the full year to AUD 0.166 per share, which is a 13.7% increase and an 80.1% payout from underlying net profit after tax. With the level of unallocated capital, we are well placed to fund our M&A aspirations and raise Tier 2 debt if further attractive investment opportunities become available. To finish, a few comments on our financial priorities for FY 2025.
In the Retail health insurance business, our immediate imperative is to improve revenue momentum by increasing policyholder growth in a disciplined way, continuing to leverage our portfolio management capabilities to manage downgrading, and increasing our focus on customer lifecycle management. Balancing the need to manage margins in our business with our desire to keep premium increases as low as we can for customers remains top of mind. Our partnership approach to hospital contracting, investing in prevention and chronic condition management programs, and the shift to more contemporary models of care at scale will help offset inflationary pressures, and our approach to managing claims during COVID provides capacity to invest in additional product benefits and to further support hospitals that are embracing care models for the future.
We must also maintain our disciplined approach to cost management, leverage our scale, investment in digitization, and next horizon of productivity initiatives to improve efficiency, and use our direct distribution strength to manage the cost of acquisition. Maintaining strong growth in non-resident customer numbers remains important to overall health fund growth, and we must deliver on Medibank Health's strong organic growth potential and look to augment this with further M&A, particularly where this accelerates Australia's health transition. I'll now pass back to David to make some closing remarks.
Thanks, Mark. Turning to our outlook, just to reiterate, any permanent net claims savings due to COVID will be returned to customers, and we expect the finalization of our customer giveback program to be announced in FY 2025. In resident private health insurance, we anticipate moderating industry growth in FY 2025 relative to FY 2024, and we will remain disciplined as we aim to grow in line with the market during FY 2025, which includes volume growth in the Medibank brand and aim to grow market share in FY 2026. We expect claims for the policy unit growth of 2.7% in FY 2025. For the resident business, we are targeting AUD 10 million of productivity savings in FY 2025. In our non-resident business, we expect solid policy unit growth to continue in FY 2025.
In Medibank Health, we are targeting average organic profit growth of 15% or more per annum between FY 2024 and FY 2026, plus a 12-month contribution from Myhealth in FY 2025. And we aim to invest between AUD 100 million and AUD 250 million through further M&A between FY 2024 and FY 2026. So finally, turning to slide 28. So in summary, we remain a resilient and strong company with a track record of navigating competitive and economic challenges. Our unique combination of two brands, our products and services, and our network of partners, and the service provided by our amazing team, is what differentiates us and positions us to deliver on our growth strategy in health insurance. We're at the forefront of the health transition in Australia.
We have meaningful foundations in markets that are transforming and growing, and we'll continue to invest with our clinician and provider partners to grow our Medibank Health business, to both expand in health and to support the needs of our Medibank and ahm customers. We will also continue to strengthen our foundations to build further resilience and customer trust, and we will remain disciplined about the best way to grow for the long term. Lastly, I'd just like to recognize the wonderful team of people who are the driving force behind the results we've shared today. They're inspired by our vision, and they continue to work together to create the best health and well-being for Australia. Thanks for listening. Now we've got time for some of your questions. Over to you.
Thank you. If you wish to ask a question, you will need to press the star key followed by the number one on your telephone keypad. If you wish to cancel your request, please press star two. If you're on a speakerphone, please pick up the handset to ask your question. Your first question comes from Andrew Buncombe with Macquarie.
Hi, guys. Thanks for taking my questions. The first one is in relation to the 2.7% claims growth target. Can you just give us some context around whether that includes any additional charges from the proposed New South Wales private and public change? Thanks.
Yeah, Andrew, thanks for your question. Yes, when we struck the 2.7%, that's one of the factors that's been considered, noting that at this point in time, that's a risk rather than a certainty.
Excellent. And then the other question that I had was, you've obviously changed the way that you're providing policyholder growth guidance for FY 2025. What do you think FY 2024 industry growth was, to give us some context around where that moderated number could get to? Thanks.
I think I said in the presentation, we expect growth to be broadly in line with the 1.9% we saw in the previous 12 months. Andrew?
Excellent. And then the final one, if you're expecting to go to that sort of level from the 70 basis points that you did this year, how should we be thinking about the Management Expense Ratio and reinsurance in FY 2025? Thanks.
Yeah. So the biggest opportunity, I think, for us as a company, is growth in the Medibank brand, and that largely comes through direct channels, so off a fixed cost base. And then there's also opportunity for ahm, but we'd like to see a skew in the sales back to direct channels at the expense of aggregator. So I don't expect that growth, that increase in growth, Andrew, will have any material bearing on the MER expense for 2025.
That's it for me. Thank you.
Your next question comes from Vanessa Thomson with Jefferies.
Good morning, David and Mark, thank you for taking my questions. I just wanted to ask about hospital claims. I think in the first half, you mentioned that some 72% of admissions were same day, and that was up 2%-3%. I just wondered how that was for the full year. I'm not sure, sorry if you did disclose that.
Yeah, thanks, Vanessa. So that trend of shift from the acute overnight procedure to same-day continues. Hasn't been material in six months, but that trend is definitely continuing.
And so then when you think about hospital claims, which surgical claims are now back to expectations, however, there's the lower overnight, and you mentioned that hospital indexation was part of the offset. I just wondered, given all those kind of drivers, how that informs your hospital negotiations, especially in light of the government review of private hospitals? Thank you.
I think firstly, you know, we've approached hospital discussions as we always have, which is to think about what our customers need to preserving access to quality care, but also thinking about short-term and long-term affordability. So there's no doubt that the trends continue, as I said before, there's 5% less overnight procedures done this year than five years ago. So that trend has continued, and look, there's no doubt been a challenging environment coming out of COVID-19 with inflation, but no one's been immune to those pressures. We've, as you've heard, delivered, continue to deliver on our productivity program. So really the conversations are around, well, how do we address and help support unknown and material cost increases? But also how do we help invest in the health transition?
We've outlined some one-off support, AUD 63 million, that we've provided over the last two years, but also, you know, working with hospital partners to help them maintain access, particularly where our customers, need access. The hospital review that's going on is a welcome review. It's good to get the facts on the table. The facts around cost, the facts around capacity, the facts around locations of services. I think all of those things factor into our hospital negotiations, and what we said today is that now 75% of all of the hospital episodes that our customers experience are now covered by these partnership agreements, which have those elements of indexation but also investment in the future.
Thank you. That's all.
Your next question comes from Andrew Goodsall with MST Marquee.
Oh, good morning, and thanks for taking my questions. First one, just on the non-resident health insurance growth outlook, solid policy unit growth. I was just wondering if you could unpack that target a little bit, just because I'm just sort of thinking through with the caps that have been put on international students and so on.
Yeah, Andrew. So I think I mentioned earlier that we're very strong in the overseas student part of the market, and particularly more through first-year universities and less reliant on vocational visas, so vocational courses. So we suspect that that being in that particular part of the segment, obviously student segment will be helpful because I think the visa restrictions are more likely to be in the vocational part of the student market. And bearing in mind, it's going to be a political issue and suspect there's more to play out here going into the election. It's a very important. The student market is a very important, student education is a very important part of GDP, so I think it could be problematic if that was disrupted significantly.
The only thing to add, Mark, on that is that we are still slightly underpenetrating the workers segment. You know, there are a lot of students that become workers. So our life cycle management approach here will also help us grow in this worker market and potentially visitor market that new avenues for growth within that non-resident that we haven't really tapped into before. So I think, as Mark said, a lot to play out, but we have multiple avenues even in the non-resident business.
Got it. That makes sense. Thank you. And then secondly, just the private health check, the federal review is getting a bit of profile. Just interested in any commentary you might have on that or any sort of potential outcomes you think might come from that?
Yeah, as I said before, look, I mean, the review is good to get the facts on the table, and we know private hospitals are critical to private health. We want them to be strong and resilient. We want the sector to be strong and resilient, but we also want to maintain affordability because if we don't, then we will put even further pressure on an already stretched public system, so yeah, we're actively involved in the review, participating, getting the facts on the table. You know, I think it's about cost growth, but it's also about capacity growth, where locations of services need to be and how we transition from a high percentage of care delivered in acute hospitals to embracing our care models for the future.
I think it's too early to speculate what's going to come from it, but you know, it's good that we can get the facts on the table.
That's great. Thank you.
Once again, if you wish to ask a question, please press star then one on your telephone and wait for your name to be announced. Your next question comes from Nigel Pittaway with Citi.
Good morning, guys. I wanted, first of all, if I could, to explore the extent to which you think your customer givebacks are actually aiding your policyholder retention. Is it the sole reason why your increase in lapses is less than market? Or what dynamics do you think are at play there?
I might start, and then maybe hand over to Mark. I think we've shown today that our overall fund lapse growth has been lower than the industry, and for the Medibank brand, where a significant amount of the giveback was apportioned and now is even growing by less. In fact, the Medibank brand lapse rate within the year is now significantly lower than the rest of the industry lapse rate. There are multiple drivers there. I'd say, Nigel, you know, giving more value back, as we've outlined. You know, a broader relationship. Now, almost 50% of our Medibank customers have a relationship in health. Each time we have that broader relationship, that improves retention and loyalty, but there's no doubt that giveback has been, one of the drivers.
Yeah, and a good point, David. And I think the most important part for us is the most recently announced giveback hasn't yet of AUD 290 million landed in our customers' bank accounts. So I think that there is a lag between the announcement and the benefit. It's when the cash is actually received in the customer's bank account, so that will be around the September, October timeframe. What I think is important to call out, though, is that you can't separate the premium increases that funds are getting with the way in which they've treated their customers during COVID. So, you can see a big stratification between the larger health funds and what premium increases they've got through and will probably get through in the future.
The fact that we continue to meet our customer promise and return all permanent claims savings to customers is an important contemplation as part of the premium round conversation.
Okay. Sorry, I just cut out there, but yeah, I think that's finished. So next question is just on the structural savings taken into account in the 2025 growth of 2.7%. So I guess I'm interested in particular, what structural savings you still think you're seeing that you've been cautious on and not locked in your 2.7% growth?
Yes. So, Nigel, I might start with what's the biggest driver in the claims guidance. I'd call out extras as being the most significant driver of FY 2025. We have already reduced the utilization expectation during FY 2024, but we still came in significantly below that expectation. So extras is gonna be one of the major drivers of claims trajectory into FY 2025. We're still seeing notwithstanding the fact we've dropped our expectation for mental health, physio, and rehab claims, we're still seeing in the last six months, claims being about 8% below that expectation. We're taking a cautious approach to how we monetize those. That's probably more a contemplation for FY 2025 in the second half, and more likely FY 2026.
Okay, thank you. And then just a couple of quickies. Just firstly on policyholder growth and the system slowing. I mean, do you expect that to be a slight slowing or a material slowing? And then just secondly, obviously, you are flagging the cyber costs to go on next year, so how long do you think they'll go on for?
Yeah, thanks, Nigel. Look, I'll borrow your crystal ball, but, you know, when I see you next time. But, look, I think if you look at the fundamentals of what's going on in the market. I mean, although the consumers are under pressure with cost of living, you know, we're doing a lot to provide more value. The number of people who see PHI as essential is the highest it's been in seven years. There's an increasing awareness and reducing confidence of the challenges of the public system. That's making our PHI appeal remains very strong. The most recent premium round, as you know, was below inflation, and we've still got relatively low unemployment and population growth.
So I think the fundamentals are still very strong, notwithstanding some of the pressures on the consumer. So whilst, we do think it will moderate slightly, I don't think we see right now any conditions that would talk about a significant moderation. But, you know, as we move through the year, you know, your guess is as good as mine of how the economic environment unfolds. But at this stage, we'd be saying it's a slight moderation.
And on the cyber costs, Nigel, we're expecting a similar amount in FY 2025, so around AUD 40 million as we saw in FY 2024. Around 60%-65% of that spend in FY 2025 will be in the actual IT security uplift component of the program. We expect by the end of 2025, the vast majority of the work we need to do in that program will have been complete. So then looking into FY 2026, the costs will continue, but the majority of those costs then will be associated with the litigations. So 2025 is about completing the technology uplift. There still will be some uplift costs in 2026, but largely the 2026 costs will reflect the cost of defending the litigations that we've got on foot.
Great. Thanks very much for that.
Your next question comes from Julian Braganza with Goldman Sachs.
Good morning, guys. Thanks so much for taking our questions. Just following up on the spec claims inflation guidance of 2.7%. Can I just clarify just what you're assuming there in terms of one-off hospital benefits? Are you expecting that to continue, just given what you've seen over the last two years? Yeah, just maybe that first. Thanks.
Yeah. Hi, Julian. Yeah, we have made some assumption on further benefits paid, but that's not a material contemplation in that guidance.
Okay, so what you're saying is the costs are probably stable in terms of what we've seen in prior periods, not increasing?
No, not materially increase.
Okay. Okay, no, thanks for that. And then maybe just a question on your margin trajectory. Based on, I guess, your claims inflation of 2.7% and downgrading of about 50 basis points, and also just the rate increase you have approved, sort of calculating margin expansion in the vicinity of around 10-20 basis points. Just want to understand, is that the sort of margin we should be expecting to come through, or will that be used to sort of fund elevated expenditure over FY 2025?
Your math's pretty good. So we've got a 3.31% premium increase for the nine months that end 1 April. We obviously don't have our FY 2025 premium increase yet approved. We've signaled around 2.7% of underlying claim strength. So providing the underwriting position doesn't deteriorate significantly, you'd expect a flat to flattish dollars outcome in the resident business. And I'd probably direct you to think about the trajectory in the non-resident business as the major driver of margin trajectory across the whole health fund next year.
Okay, excellent. And then just in terms of the growth that you're pitching into FY 2025 back towards market share, I'd just be interested in how you're thinking about the competitive intensity, because you made it clear your focus is around disciplined growth and not paying, overpaying for growth. So I just wanted to understand, are you therefore anticipating a reduction in the competitive intensity into next year? Yeah, any color around that?
Yeah, I think, Julian, I might tend to answer that one. Look, I think, you know, what we see in these cycles is normally a sort of two- to- three-year cycle, where given different settings in markets, some competitors can chase short-term growth. And then the reality starts to play out, you know, where the more competitive long-term fundamentals, you know, return. I think, yeah, we're already seeing signs of increasing lapse in the rest of the industry compared to us. You're seeing cost to acquire new customers is significantly higher than it was. And as the impacts of COVID sort of unwind, I think that then starts to, sort of unwind over the medium term.
We expect to see that some of that will start to normalize during FY 2025, but really, we're saying it might be another one to two years till we sort of see that fully, you know, play out. So, you know, whilst we don't really know what that will look like, what we are very focused, and when you see these sort of markets, it's really important to focus on what works for the long term. So it's really about, for us, growing, particularly for Medibank, in our target markets, which are, generally, lower lapse, lower cost to acquire and have better retention rates, and further strengthening our distribution strength for direct channels in both ahm and Medibank as Mark had said before.
And Julian, one final point. I guess the approach we've taken to managing claims during COVID means we've got capacity to invest in additional product benefits, and that's not a capacity we think is available to most of the other players in the industry, given a lot of other players have actually just banked any permanent claim savings in existing gross margins. So I think that's going to be an important factor for us as we think about retention during FY twenty-five.
Okay, thanks. But just to be clear, so your guidance for the policyholder growth, that's premised on a continuation of the current competitive intensity that you're seeing in the market?
It doesn't rely on any significant reduction in the competitive environment. That would be upside. Yeah.
Okay, perfect. Thanks so much for that.
Your next question comes from Siddharth Parameswaran with JP Morgan.
Good morning, gentlemen. A couple of questions, if I can. Firstly, Mark, I wonder if I could just ask a question on slide 16. You show there that the cash claims on hospitals are coming back to basically having no difference to your assumptions. I was hoping you could just help us understand if there's any impact from those one-off payments. I think you flagged the AUD 63 million to hospitals in any of these numbers. Where does that actually come in? And also, if there's any impact from the big changes you've flagged around contracting. So, you know, I think you've said you've changed a lot of the contracting to partnership approaches. What has been the impact of that in these numbers, where the cash claims have really just tracked back to your assumptions?
Yes, thanks, Sid. So, any hospital hardship payments are excluded from this. That just comes off and reduces the dollar value of the giveback to customers. When I look at the chart on the top right-hand of slide 16, Sid, there's an important timing thematic part playing out here. We had the COVID wave that started in November and then went through to January. There were a very, very soft environment for surgical claims. But while we're back since January to being in line with expectation, we believe some of that reflects recovery of surgeries that didn't occur November through January. And then in terms of how hospital contracting outcomes are being reflected, you'll note that our second- half underlying claims are higher than the first half.
That, in part, reflected the unwinding of some of the Risk Equalisation benefit we had in the first half, but also the progressive, higher indexation we're paying to hospital, to hospitals as part of contract renegotiations.
Okay. I'll think through that to work out what it means. Thank you. Can I just ask about the corporate market as well, just in terms of the growth that you're targeting there? Could you just comment on a couple of things? Firstly, what percentage of the market are you? I think you flagged as a billion-dollar market. Just what percentage of the market are you today? And I think you flagged some legislation changes, which were potentially driving rapid growth. I was hoping you could just flesh that out as well.
Yeah, sure. Thanks, Sid. Yeah, I might start. So this is the corporate health and well-being market. So for us, we've got about two and a half thousand corporate insurance accounts, so we're probably in the corporate space have a higher share in that space than our average resident share. I think the corporate health and well-being market is quite disaggregated at the moment, and we've got a reasonable share, but not material. So what we're looking to do is to you know, disrupt that market from what is a traditional, sort of, poorly serviced market by some traditional players into a much more proactive solution health and well-being platform that focuses both on mental and physical health solutions. And the second part of your question, sorry? Can you say it again?
I think it was just what share of the market you were, I think, and what the. Oh, sorry, the legislation. The legislation that was-
Legislation. Yeah, that's right.
Yeah.
I think if you look at the increasing requirements of boards in corporate Australia to provide not just physical, safe environments, but psychologically safe environments, and some of that regulation is progressing, it's putting more and more onus on employers to create safe, both physical and mental environment for their employees. That's one driver that's increasing in terms of regulation. I think the other is that the employees are wanting a greater support from their employers. They want to have a workplace that their employers are providing that's making them, you know, feel energized and balance their work and life a lot more differently. And actually, it's part of the EVP for employers now. If you don't have a corporate health and well-being program, it's very hard to retain their good people.
So there's multiple drivers in this market, in addition to the services that are already there, that are really not performing.
Okay, great. Okay, and just one final question. Just the outlook on pricing from here in the industry. We've heard some, varying comments on what's happening with inflation in claims. I was wondering if you could just flag how you're seeing things now. You know, there's quite a difference between yourself and your other listed peer in terms of calling out underlying inflation before. You've given us an outlook for this year, but as we look from here, are we likely to return to that 4%-6% level, which has been the normal level of inflation, you know, over an extended period of time?
Or are there any features of your contracting, et cetera, which you think might keep that number lower?
So let me just touch on the 4%-6%. I'm not sure that's a number we recognize. I think over time, claims inflation has been variable, but particularly driven by particular events such as CC reform not working, or low value orthopedics, or the advent of a higher use of rehab referrals. So the 4%-6% really isn't a long-term average. So just be really, really clear on that. Where we go from here is going to depend on a whole series of factors, both short term, whether it be hospital ask for indexation based on their inflation, but probably more importantly, the shift in new care and contemporary care models.
So I think the biggest driver we saw in FY 2024 in our claims line was softer utilization growth in non-surgical claims, offsetting inflation in--t he cost of inflation in surgical claims, and then the more prevalent use of day versus overnight. So I don't think you can just look at the headline rate we're paying the private hospitals. They're only 48% of our claims. You need to look at the utilization and where that care is being delivered as really good deflationary impacts on our claims line. David, what did I miss?
Oh, Mark, I wouldn't ever second-guess you, but I think the only other thing that, you know, may be worth contemplating is that maybe different insurers approach this differently. Certainly, for example, our hospital contracting approach, we've been quite transparent here about the multiple limbs of that approach. The size of our book and the way we attract younger customers and growing in new to industry above share, all these factors actually also help, different, you know, insurers have different results. So whilst we don't work for other companies, I think there may be some points of difference there.
Yeah, and just to finalize a comment I said. So when I think across the industry, there are a number of players that actually have banked their COVID savings, not returned them to customers, and elevated their gross margin. If you think about those COVID impacts starting to unwind, well, those companies are actually having to grow their claims expense off an artificially deflated cost line, expense line, claims line. So it's. We had AUD 219 million of permanent claims savings during the period. We didn't take that to gross margin or to profit, so we're growing off our expected claims, not our artificially deflated claims line. And I think that's really important when you think about an apples-to-apples comparison.
Okay, great. Thank you very much.
There are no further questions at this time. That does conclude today's conference. Thank you for participating. You may now disconnect.