Trends Shaping Health Benefits Today | Digital Report

Trends Shaping Health Benefits Today - Mercer U.S.

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2018 Medical Trends Around The World

 


Why Health Care Affordability, Accessibility and Quality Should Matter to Organizations

 

 

The data from this year's survey reflect a slight decline in the actual medical trend rate

experienced by insurers in 2017, just 0.4% below the average reported in our report last year.

However, the average global medical trend rate of 9.5% remains close to three times that of

economic inflation.

 

Projections for 2018 reflect the potential for a 9.1% global average, with most countries reporting they expect the trend to remain consistent from last year.

 

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2017 Medical Trend  Rate Experienced 2017 estimated inflation rate 2018 Projected Medical Trend Rate 2018 forecast inflation rate
Global (average) 9.5% 3.4% 9.1% 3.5%
North America (Canada) 6.2% 1.6% 5.6% 2.2%
Asia (average) 10.4% 2.3% 10.0% 2.7%
Pacific (Australia) 4.4% 2.0% 3.8% 2.2%
Europe (average) 7.6% 2.8% 7.5% 2.8%
Middle East & Africa (MEA)
(average)
12.5% 4.7% 11.9% 6.2%
Latin America
(LATAM) (average)
12.7% 5.9% 11.5% 4.7%

Throughout the data collected in this year's survey, it is evident insurers have balanced well-being investments with an increased focus on managing behaviors and costs of health providers (for example, managing high-cost treatment and care via approaches like pre-authorization and hospital length of stay reviews), tightening their use of preferred health provider networks, negotiating fees/bundle packages and managing fraud. In addition, digital approaches to healthcare management continue to be pursued. Such solutions offer promise to enhance affordability, access and quality of care.

 

Managing/ Influencing the Components of Cost

CONDITIONS IMPACTING COST

 

Non-communicable diseases continue to be the leading claims across all regions of the world and reflect great opportunity for all players in the benefits ecosystem to intervene, improving quality of life and sustainability of programs. In addition, there is greater acknowledgement of the role insurers can play in influencing health providers and making employees smarter consumers of health care.

 

Based on (dollar) amount claimed, what were the top three causes of claims cost in 2017 based on your book of group or overall business?

Cancer continues to be number one component of cost.

Select another region to learn more
Cancer
Diseases of the Circulatory System
Gastro-Intestinal Diseases
Respiratory Conditions
Osteomuscular Diseases
Infectious Diseases
Endocrine and metabolic diseases
Obstetrics and pregnancy
Accidents, Conditions derived from violence
Other (not classified in another group)
Mental conditions

Health Providers Impacting Cost

While there is incredible gratitute for new diagnostics and treatments, the following items do increase cost, and their impact on outcomes are not always clear.

What are the top three supplier-driven reasons for cost increases?

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Global Asia Europe LATAM MEA
New and expensive technology, such as biodegradable cardiac stents 28% 30% 24% 39% 19%
High cost pharmaceuticals and biologics 27% 29% 13% 39% 38%
Overprescribing of low value health tests and procedures 15% 10% 22% 8% 25%
Other (not described in another category) 8% 3% 16% 0% 13%
Extensive hospital inpatient lengths of stay 8% 9% 6% 11% 6%
Limited access to high quality care resulting in limited payment competition in the market 6% 7% 10% 0% 0%
Regulatory environments that limit hospital payment competition 4% 6% 3% 3% 0%
Regulatory environments that limit preauthorization or physician management 3% 6% 3% 0% 0%
Poor quality of care 1% 0% 3% 0% 0%

Leveraging Medical Networks to Increase Efficiencies

A perspective from Italy

Insurer Cost Management Approaches

Insurers’ focus on managing provider delivery of services is evident in the data:

To what extent does your organization perform the following to help manage plan member health and/or contain medical costs for employer-sponsored medical insurance?

Please select three interventions to view:

Strategies to Support Mental Health in the Workforce

A perspective from the United Kingdom

Strategies for Improved Health

KEY RISK FACTORS

 

Globally the top three risk factors remain metabolic and cardiovascular risk, dietary risk and emotional/mental risk.  We are seeing employers taking control of these issues not just to influence cost but to improve quality of life and organizational performance.

Globally Metabolic and Cardiovascular Risk Retains Top Spot

Insurers were asked: What three risk factors do you think influence employer sponsored group medical costs the most?

Select another region to learn more
87%
83%
86%
95%
88%
Metabolic and cardiovascular risk
High blood pressure, high cholesterol, high blood glucose, overweight/obesity, physical inactivity
56%
56%
46%
81%
38%
Dietary risk
High carbohydrates consumption, low fiber and vegetables
43%
31%
60%
41%
19%
Emotional/Mental risks
Stress, sleeping disorders
40%
44%
44%
32%
25%
Occupational risk
work related risks, ergonomics, and occupational carcinogens
30%
51%
21%
11%
31%
Environmental risk
Urban indoor/outdoor air pollution, ozone, water sanitation, climate changing

The Importance of Managing Absence

A perspective from Canada

Health Accessibility

It’s not enough to simply say healthcare is accessible — rather, what type and what quality of healthcare? And are the benefit policies responsive to the needs of the modern, more diverse workforce? Modern employers are increasingly dismissing market practice as the guide and, instead, are asking whether benefits align with minimum essential care standards for a 21st century workforce and whether those standards are clinically sound.

Health Status Impacted by Basic Access Issues

To what extent do plan members covered under your medical insurance plans have high quality and comprehensive access to the following, without significant barriers such as poor environmental conditions, a large out of pocket cost or treatment waiting list?

Please select three of the following health factors to view:

Insurer perspective: the extent to which plan members have high quality and comprehensive access to the following:

Greater access to healthy food choices, a trained general clinician to oversee medical care and safe, nonfraudulent medicines delivered out of hospital reveals that essential care is available and accessible to more and more individuals globally. However, as indicated previously, globally and in most regions, counselling and treatment for mental health conditions is only to some extent available to plan members covered under medical insurance plans.

Optimizing Onsite Clinics to Manage Costs and Deliver an Integrated Health Experience 

A perspective from the Philippines

Employers are Recognizing the Role of Access to Comprehensive Care, but Changes are Incremental Given Coverage Availability and Cost

What top three benefit package components are you considering to enhance your total rewards package?

Please select three benefit coverage components to view:

Insurer perspective: : the extent to which insurers are seeing employers seek to expand coverage under their insured medical plan for the following components:

Designing Health & Benefit Programs to Attract and Retain Women in the Workplace

 A perspective from India

Future of Health

The shift from incenting volume of care to a focus on the quality of care is underway. Insurers are starting this journey by focusing on data and provider management. 

 

STRATEGIC AREAS OF INVESTMENT

The Data Analytics Race is on

Rank your insurance company's 3 top strategic areas of investment relating to group medical insurance.

Select another region to learn more
Data Analytics
Plan member technology (e.g., online claims submission)
Rationale benefit design (e.g., incentive based design)
Wellbeing
Other forms of claims management
Government & other stakeholder engagement
Others

New benchmarking insights into claims analytics

A perspective from Brazil

PLAN MEMBER ENGAGEMENT

 

Insurers were asked: Which of the following employee communication mechanisms does your organization provide to plan members?

Great opportunity exists to engage plan members more effectively leveraging new technologies.

Select another region to learn more
Website
Call center
Digital brochures
Paper booklets
Medical network directories
Videos
Online chat
Online appointment
Other (i.e., group education sessions, email support, mobile apps, broker support)

Engaging Employees Through Innovative Digital Offerings

A perspective from China

Closing

Into the future, managing cost, improving the experience and optimizing plan design and delivery will require not just engagement of all key stakeholders, like insurers and employers, but also the creation of new, digitally integrated health ecosystems. We urge employers to drive change in four vital areas: