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1、Getting the right balance between managing costs and meeting employee needsHealth Trends 2024 The rising cost of medical care is a significant concern globally,and over half of countries are forecast to see double-digit rate increases on average over 2022,2023 and 2024 for employer-sponsored health
2、insurance.Non-communicable diseases(for example,cardiovascular and cancer conditions)are major drivers of claim costs and claim frequency.Costs are also rising in part because of less attractive public healthcare delivery,most notably in Europe,so employers are increasingly requiring cost-containmen
3、t mechanisms within their insurance plans.At the same time,health systems are transforming as health innovations change how care is delivered.In August 2023,Mercer Marsh Benefits(MMB)surveyed 223 insurers across 58 countries outside the United States to explore the key trends shaping employer-provid
4、ed health benefits and produce our Health Trends 2024 report.The fine balancing act for employers and healthcare insurers in 2024 is cost containment but not at the expense of quality and inclusivity.The trends revealed in this report are invaluable for employers designing fit-for-purpose healthcare
5、 and benefits plans.Insurers practices,policy language,flexibility,willingness to innovate,and access to large pools of claims data give them a key role in shaping the future of employee benefits,but employers must also shape benefits to meet the needs of their own workforces as well as anticipate,c
6、ontain and mitigate business risk.IntroductionHealth trends 2024:Getting the right balance between managing costs and meeting employee needs2AsiaEuropeLatin American and CaribbeanMiddle East and AfricaNorth AmericaPacific45%20%17%14%2%1%3Executive summary tableTrendWhat it meansKey findingOver half
7、of markets are facing double digit cost increases;Cancer tops the list of claim costs.Preventative measures such as screening programs continue to need prioritization and focus while newer solutions to support people with a serious diagnosis should be considered.86%of insurers globally believe medic
8、al inflation had a significant or very significant impact on 2023 medical trend.Health systems are undergoing transformation as they face disruption from skills shortages with digital healthcare still at an early stage.Employer-sponsored healthcare provides opportunities to lead the way,both in offe
9、ring access to high-quality centers of excellence and in embracing digital health solutions.70%expect using AI for first-line diagnosis and/or navigation to have a transformative impact on employer-sponsored health care over the next five years.Insurers are responding to the need for cost containmen
10、t and providing options for employers to make plan design changes.Employers and their advisors must negotiate with insurers to make sure that sensible cost containment measures,such fraud,waste and abuse controls as well as claims sharing features are updated and competitive.42%of insurers have not
11、adjusted deductible/excesses and co-payments in line with inflation and have no plans to do so.Mental health,womens health and inclusive benefits gaps continue to persist.Employers have an opportunity to make meaningful change for employees by offering inclusive benefits and targeting coverage gaps.
12、56%of insurers do not currently cover targeted mental health,socialization and learning issues for children,teenagers and families.Health trends 2024:Getting the right balance between managing costs and meeting employee needsOver half of markets facing double-digit cost increasesPart 1Health trends
13、2024:Getting the right balance between managing costs and meeting employee needs4Medical trend rates are beginning to exceed pre-pandemic levels.In 2021 and 2022,we saw rate increases of 10.1%,close to the pre-pandemic level of 9.7%we saw in 2018 and 2019.In 2023,we expect rates to increase to 12.4%
14、globally as a result of inflation,utilization,and changes in treatment mixes.Although the rate of increase is forecast to drop to 11.7%in 2024 due to expected slowing of inflation,that rate will still be higher than levels we saw prior to the pandemic.Our research this year found that over half of c
15、ountries are forecast to see double-digit rate increases over the average of 2022,2023 and 2024.Poland has a three-year medical trend average of 23%,2 driven by high general inflation;increased minimum wages in the health sector;and a challenged public health system,which is driving higher use of pr
16、ivate services.In Argentina,medical expenses are growing at a faster pace than general inflation due to hyperinflation and scarcity of goods.This means the costs of prepaid medicines doubled in 2022(100%)and is expected to increase by at least 91%in 2023.In the Philippines,medical personnel shortage
17、s caused by outward migration;the ongoing impact of COVID-19;higher claims utilization;and a preference for face-to-face care over telemedicine has resulted in a medical trend average of 20%.1 Rates for 20182022 are retrospective.Rates for 2023 and 2024 are prospective.Unweighted global averages are
18、 used for medical trend.See Appendix A for additional detail,including inflation data sources.2 Average of 2022,2023 and 2024 medical trend rates.Health trends 2024:Getting the right balance between managing costs and meeting employee needs5Year-over-year cost increase for claims on a per-person bas
19、is made under a medical schemeMedical inflation (increase in cost for services/supplies;can be driven by currency fluctuations with respect to imported supplies)Changes in treatment mix(potentially more expensive options now being administered)Utilization changes (more/less of certain age groups lev
20、erageing health services)Regulatory changes+=Defining medical trendFigure 1:Medical trend rates continue to exceed general inflation rates120180%2%4%6%8%10%14%12%20022202320249.7%3.2%9.7%3.4%5.7%2.4%10.1%4.3%10.1%8.3%12.4%6.6%11.7%4.2%Medical trend rateGeneral inflationUS health updateTo
21、capture developments in the US health landscape,which are outside the scope of this survey,Mercer conducts the annual National Survey of Employer-Sponsored Health Plans.According to the 2023 survey,employers expect total health benefits cost per employee to rise 5.4%on average in 2024,even after tak
22、ing into account changes made by US-based employers to healthcare plans designed to slow cost growth.The estimate suggests that last years high inflation and labor shortages in the healthcare industry have pushed healthcare costs higher,contributing to higher health benefits costs.The projected incr
23、ease comes after more than a decade of annual cost increases typically averaging from 3%4%.In addition to the effects of recent inflationary pressures,health benefits costs are rising due to the consolidation of health systems and the introduction of ultra-expensive gene and cellular therapies.Many
24、employer plan sponsors have also chosen to absorb cost increases in recent years rather than ask employees to pay more out of pocket for healthcare.These actions are offset by employers implementing cost-management strategies directed at the biggest cost drivers complex care and chronic medical cond
25、itions.Additionally,42%have improved access to mental health care within the past three years by adding supplemental behavioral healthcare provider networks for virtual or in-person care.Behavioral healthcare remains a strong focus for employers.These types of interventions which lead to better outc
26、omes for the patient also tend to save money for the plan as a result.Employers expect total health benefits cost per employee to rise 5.4%on average in 2024Health trends 2024:Getting the right balance between managing costs and meeting employee needs6Health trends 2024:Getting the right balance bet
27、ween managing costs and meeting employee needs7Expatriate Medical We are pleased to share that for the first time this year our medical trend rates table(see appendix A)includes expatriate medical(international private medical insurance).We would like to thank all the new insurers who participated i
28、n this years survey.Please note that the global expatriate rates are lower than the global average of the domestic rates,because the trend rates provided by each expatriate insurer reflect weighting of typical membership country distribution.This suggests that expatriate membership is more weighted
29、towards slightly lower trend rate countries.The impact of medical trend Medical inflation is the top concern in every region except the Middle East and Africa,and is particularly acute in Europe,where 95%of insurers have concerns.Changes in utilization and in treatment mix have both had a significan
30、t impact across all regions,perhaps reflecting perceived deteriorating public health services(see Section 2)and the high costs of new drugs and therapeutics.Increased scope of coverage may also be driving up utilization rates.Figure 2:Medical inflation is the top concern across regions.How would you
31、 describe the impact of the following on 2023 medical trend rate within your market?86%62%35%76%36%84%61%27%71%32%95%73%45%85%40%85%77%46%69%38%83%43%37%87%43%GlobalAsiaEuropeMiddle East and AfricaLatin America and CaribbeanMedical inflationUtilization changesChanges in treatment mixDemographic chan
32、gesRegulatory/system changesHealth trends 2024:Getting the right balance between managing costs and meeting employee needs8Cancer is a key risk Cancer remains a key health risk worldwide.In this years research it was the top cause of claims in 2022 by dollar amount globally.Cancer is also having a s
33、ignificant impact on frequency of claims compared to last year,along with diseases of the circulatory system.Endocrine and metabolic diseases,most notably diabetes-a major cause of kidney failure,heart attacks and stroke-continue to affect claims experience most notably in Latin America and the Cari
34、bbean.The World Health Organization reports that prevalence of diabetes has been rising more rapidly in low-and middle-income countries compared to high-income countries.3Figure 3:Cancer and diseases of the circulatory system are the top causes of high medical claims costs.Based on dollar amount cla
35、imed,what where the top causes of claims cost in 2022 based on your book of group or overall business?GlobalAsiaEuropeLatin America and CaribbeanMiddle East and AfricaCancerCancerMusculoskeletal conditionsCancerDiseases of the circulatory systemDiseases of the circulatory systemDiseases of the circu
36、latory systemCancerDiseases of the circulatory systemCancerMusculoskeletal conditionsGastrointestinal diseasesDiseases of the circulatory systemMusculoskeletal conditionsRespiratory conditionsGastrointestinal diseasesRespiratory conditionsGastrointestinal diseasesEndocrine and metabolic diseasesObst
37、etrics and pregnancyRespiratory conditionsCOVID-19Mental conditionsAccidents and injuries caused by external factorsMusculoskeletal conditions1 12345Health trends 2024:Getting the right balance between managing costs and meeting employee needs9More support for cancer claimantsInsurers are recognizin
38、g the need for wider cancer support to help claimants and reduce claim costs.of insurers globally make cancer rehabilitation and return-to-work support available for employer sponsors of private group medical insurance,and a further 30%are considering it.These benefits can be a significant support f
39、or employees to pick up their careers again after diagnosis and treatment.of insurers globally make communications on cancer prevention/preventive care available for employer sponsors of private group medical insurance,and a further 27%are considering it.Additional services to support cancer in grou
40、p medical insurance plans often include second-opinion services,which are particularly well embedded in Europe.However,it is less common to offer hands-on support like advocacy and navigation support to help employees optimize use of their insurance and get the highest-quality care to avoid errors i
41、n diagnosis and treatment.43%61%Figure 4:Cancer-related services typically included in group medical insurance.Related to cancer,which of the following does your company typically make available for employer sponsors of private group medical insurance to include in their plan?(Typically included)Glo
42、balAsiaEuropeLatin America and CaribbeanMiddle East and AfricaSecond-opinion services(a service that coordinates expert independent diagnosis and treatment plan)70%60%83%74%73%Navigation,advocacy and case management57%49%50%64%60%Steerage toward specialist centers of excellence58%47%40%90%70%3 World
43、 Health Organization.“Diabetes,”2023,available at www.who.int/news-room/fact-sheets/detail/diabetes.Innovations in cancer careWe are seeing exciting innovations in cancer care.Second-opinion services are now regularly incorporated into plans,and we see great future potential for new innovations,incl
44、uding:Personalized risk assessments for cancer using polygenic-risk scoring Increasing use of pharmacogenomics testing to personalize the required dose of chemotherapy and reduce the risk of adverse drug reactions Increasing the use of oral chemotherapy drugs to provide more treatment at home rather
45、 than in a clinical setting Leveraging specialized multidisciplinary care to improve outcomes.These innovations may be applied to care for other medical conditions in addition to cancer.Plan sponsors should carefully monitor the latest developments with an eye toward understanding where plan design
46、decisions and other controls may need to be considered in the future.Other wrap-around services,such as mental health coverage and caregiver advocacy programs,are now beginning to feature in cancer support.Genetic testing is also gathering pace,with 30%of insurers considering this.Health trends 2024
47、:Getting the right balance between managing costs and meeting employee needs10Health trends 2024:Getting the right balance between managing costs and meeting employee needs11Figure 5:Cancer-related services typically included or not included in group medical insuranceInpatient treatmentOutpatient tr
48、eatment(including pharmaceuticals)Second-opinion servicesCommunication on cancer prevention/preventive careCaregiver and family advocacy programsGenetic testingTop services typically covered or provided86%32%30%27%85%70%Top services insurers do not include but are consideringHealth trends 2024:Getti
49、ng the right balance between managing costs and meeting employee needs12Noncommunicable diseases are top causes of claims frequencyThe top three causes of claims by frequency are all related to noncommunicable diseases(NCDs),including cancer.Diseases of the circulatory system,such as hypertension an
50、d cardiovascular disease,are now the top cause of claims frequency globally,and respiratory disease is the third highest after cancer.Employers can help mitigate the risk of NCDs through prevention,diagnosis,treatment and workplace support.Many of the services now being developed to support cancer p
51、atients,such as virtual advocacy services,could also benefit employees with other NCDs.Figure 6:Insurers list cancer and diseases of the circulatory system as the top causes of high medical claims frequency.Based on frequency,what were the top causes of claims cost in 2022 based on your book of grou
52、p or overall business?GlobalAsiaEuropeLatin America and CaribbeanMiddle East and AfricaDiseases of the circulatory systemDiseases of the circulatory systemMusculoskeletal conditionsDiseases of the circulatory systemDiseases of the circulatory systemCancerRespiratory conditionsDiseases of the circula
53、tory systemCancerRespiratory conditionsRespiratory conditionsCancerMental conditionsAccidents and injuries caused by external factorsMusculoskeletal conditionsMusculoskeletal conditionsGastrointestinal diseasesCancerEndocrine and metabolic diseasesEndocrine and metabolic diseasesGastrointestinal dis
54、easesAccidents and injuries caused by external factorsGastrointestinal diseasesGastrointestinal diseasesCancer1 12345Figure 7:Noncommunicable diseases are on the rise,but employers can helpOften,individuals may not be aware they have a condition,in part due to unaffordable testing and limited access
55、 to careEvaluate barriers to accessing care;consider care navigation and advocacy services to refer members to high-quality care as well as mental health and community supportPhysical inactivity,tobacco use,alcohol consumption,unhealthy diets and air pollution increase risk,but employers can help mi
56、tigate the impact of these factorsThe employee experience related to treatment is often sub-optimal due to complex systems,lack of coordination and outdated models of careEnsure benefits encourage and provide preventive care,including health screeningsConsider various benefits coverage gaps includin
57、g plan maximums,case management,prescription drugs,income continuationEmployees who are unwell need varying levels of job supports as they perform or return to their dutiesCreate accommodation policies and make sure managers are trained on supervision of known or invisible conditions,including suppo
58、rting a return to the workplace after a leave of absence and promoting anti-stigma team dynamics and communicationEmployer supports for individuals with health conditionsHealth trends 2024:Getting the right balance between managing costs and meeting employee needs13Workplace supportsDiagnosisPrevent
59、ionTreatmentHealth trends 2024:Getting the right balance between managing costs and meeting employee needs14The impact of emotional and mental health risksEmotional and mental health is a top-five risk globally for employer-sponsored plans,despite gaps in coverage.Occupational risk also features hig
60、hly across all regions.Figure 6:Emotional or mental health risks are one of the top 5 risk factors for medical claims costsHow much of an impact do the following risk factors have on employer-sponsored group medical costs?GlobalAsiaEuropeLatin America and CaribbeanMiddle East and AfricaMetabolic and
61、 cardiovascular riskMetabolic and cardiovascular riskMetabolic and cardiovascular riskMetabolic and cardiovascular riskMetabolic and cardiovascular riskEndemic infectious diseasesEndemic infectious diseasesEmotional or mental risksEndemic infectious diseasesEndemic infectious diseasesOccupational ri
62、skOccupational riskOccupational riskEmotional or mental risksEnvironmental riskEmotional or mental risksTobacco smokeTobacco smokeOccupational riskChildhood and maternal under nutritionTobacco smokeEnvironmental riskEndemic infectious diseasesTobacco smokeOccupational risk1 12345Extreme heat is a ri
63、sk area to watchWith temperature records being shattered worldwide,4 populations are feeling the physical and economic impacts of extreme heat.Death is the biggest concern,but heatstroke,increases in mental health conditions,and exacerbation of respiratory and cardiovascular conditions make extreme
64、heat the deadliest climate risk.6Extreme heat also has economic impacts,with hundreds of billions of work hours lost every year,equating to roughly 1.7%of global GDP.7These challenges are not exclusive to employers with outdoor workforces,as many workers currently lack cooling systems8 at indoor wor
65、k locations or at home.Health trends 2024:Getting the right balance between managing costs and meeting employee needs154 France24.“Hottest global temps ever shatter records for two consecutive days,preliminary data show,”2023,available at World Health Organization.“Heat and health,”2018,available at
66、 www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health.6 Adams-Fuller T.“Extreme heat is deadlier than hurricanes,floods and tornadoes combined,”Scientific American,July 2023,available at Parsons LA,et al.”Global labor loss due to humid heat exposure underestimated for outdoor work
67、ers,”Environ.Res.Lett.17 014050,2022,available at https:/iopscience.iop.org/article/10.1088/1748-9326/ac3dae.8 Worland J.“Why air conditioning is a life-saver and a danger,”Time,July 2018,available at https:/ is receding,but linked conditions remainIn our 2023 Health Trends survey,COVID-19 was still
68、 the third-highest cause of claims by dollar amount globally(based on 2021 claims data),but its impact is lessening.In this years report,COVID-19 is no longer a major cause of claims globally,although it remains a top-five cause of claims cost by dollar amount claimed in Asia.However,COVID-19 could
69、still be having a wider impact,in areas such as mental health.Musculoskeletal conditions are now the top cause of claims cost in Europe,perhaps influenced by more emphasis on remote or home working.Respiratory conditions,some of which may be COVID-19-related,continue to be a top-five cause of claims
70、 globally.Health trends 2024:Getting the right balance between managing costs and meeting employee needs16Employer actionsHealth trends 2024:Getting the right balance between managing costs and meeting employee needs17Evaluate cancer strategies(both policy and benefits-related)around prevention,diag
71、nosis,treatment and workplace supports,including rehabilitation.Monitor the market for innovative services to support care for cancer and other NCDs,and question insurers on integrating new ideas into employer-sponsored plans.Understand the workplace and personal risks posed by emotional and mental
72、health issues and identify solutions for mitigating these.123Health systems are transforming Part 2Health trends 2024:Getting the right balance between managing costs and meeting employee needs18Health trends 2024:Getting the right balance between managing costs and meeting employee needs19Public he
73、alth services are feeling the strainOver the past three years,public health systems have been put under unprecedented stress by the COVID-19 pandemic and other factors,including industrial action and skills shortages.This pressure is now starting to take a toll,with marked differences in insurer per
74、ception between the quality of public and private health provision in regions including Europe.Overall,views on public health systems are more favorable in Asia and the Middle East and Africa than in other regions.Views on the scope and quality of private medical care are universally positive but af
75、fordability and access show a more varied picture.40%of insurers found this aspect of private or public healthcare had worsened40%of insurers found this aspect of private or public healthcare had improvedFigure 9:For better and for worse:perceptions of public and private healthcare.In your opinion,h
76、ow do attributes of todays public and private systems compare to before the pandemic?Public HealthcareScopeQualityAffordabilityAccessBetterWorseBetterWorseBetterWorseBetterWorseGlobal34%18%29%28%22%29%19%48%Asia49%6%48%12%31%22%31%33%Europe15%38%10%48%13%35%8%73%Latin America and Caribbean21%31%13%3
77、8%8%42%3%59%Middle East and Africa43%13%27%23%33%27%23%30%Private HealthcareScopeQualityAffordabilityAccessBetterWorseBetterWorseBetterWorseBetterWorseGlobal52%3%50%3%26%42%37%14%Asia52%3%59%1%32%38%46%5%Europe50%0%40%3%13%50%28%28%Latin America and Caribbean54%3%59%3%42%16%44%13%Middle East and Afr
78、ica60%7%47%10%23%63%33%7%Health trends 2024:Getting the right balance between managing costs and meeting employee needs20The impact of digital health Innovation in digital health has the potential to make far-reaching changes to the way that both private and public healthcare providers and employers
79、 alike deliver services.However,as we saw in 2023,change is likely to be incremental rather than revolutionary.Virtual tools and telemedicine could support wider access and improve the affordability of private healthcare services,but insurers are still undecided about their impact.Artificial intelli
80、gence(AI)is becoming an increasing force in healthcare,from improved first-line diagnoses to personalized medicines.Insurers believe AI can have a transformative impact on employer-sponsored healthcare costs over time.Virtual tools and telemedicine could support wider access and improve the affordab
81、ility of private healthcare services,but insurers are still undecided about their impact.Virtual toolsand plan costs55%22%no effect onplan costs23%increasedcostssayingcosts havedecreasedFigure 10:The impact of virtual tools and telemedicine on plan costsHealth trends 2024:Getting the right balance b
82、etween managing costs and meeting employee needs21Figure 11:Factors with the greatest transformative impact on employer-sponsored healthcare costs.Which of the following do you think will have the most transformative impact on employer-sponsored healthcare costs over the coming five years?Please sel
83、ect three.We were somewhat surprised not to see pharmaceutical developments rank higher on the list,given relatively new drugs for conditions like diabetes and the number of drugs in development,especially within oncology,and the potential high cost of these advanced cancer therapies.Regarding AI,in
84、surers have seen the power of deploying this technology in non-clinical aspects of delivery(for example,basic customer service).However,we see potential for further optimization around clinical navigation/triage using AI in terms of ensuring individuals are directed quickly and appropriately to the
85、right person,which would free up valuable clinician time.With respect to remote monitoring,much more needs to be done to assess the effectiveness of concepts like“hospital at home”and whether this actually delivers robust clinical outcomes for the individual as well as healthcare savings for the fun
86、der.Currently,virtual wards are being rolled out across the UKs National Health Service focusing on the use of remote monitoring of biometrics to achieve earlier discharge of patients delivering positive outcomes,driving efficiencies and improved patient satisfaction.99 NHS England.“Caring for peopl
87、e with acute respiratory infections at home,through a virtual ward in Wolverhampton,”2022,available at www.england.nhs.uk/virtual-wards/case-studies/caring-for-people-with-acute-respiratory-infections-at-home-through-a-virtual-ward-in-wolverhampton.70%64%61%30%28%AI for first-time diagnosis and/or n
88、avigationAdvances in remote patient monitoringPharmaceutical developmentsReduced reliance on public healthcare plansGenomics and personalized medicineEmployer actionsSeek to understand insurers proposals for integrating digital health tools and AI solutions into their plans in the next five years an
89、d how these are being used as potential levels for cost containment.Consider the impact of reliance on public health services in your region,especially in Europe.What could this mean for workplace absence/productivity?Monitor the affordability of private healthcare for your people and consider wheth
90、er any concerns can be managed through benefits design.Health trends 2024:Getting the right balance between managing costs and meeting employee needs22123Insurers are responding to demand for cost containment Part 3Health trends 2024:Getting the right balance between managing costs and meeting emplo
91、yee needs23Health trends 2024:Getting the right balance between managing costs and meeting employee needs24As outlined in Section 1,the impact of medical trend costs and wider inflation are causing concern for insurers and employer plan sponsors alike.Employers need to make sure their programs remai
92、n affordable both at an organizational level and for employees.That means employers need to:Monitor claims experience over time to get ahead of trends.Understand plan features that are important to the workforce.Create an intentional,strategic plan to manage costs over the long term.Opportunities fo
93、r cost containment by employers:a checklist Design for value:Within your portfolio of benefits,what programs are highly valued by employees?Are there opportunities to integrate new solutions with a positive return on investment(ROI)?Could underused programs in your offering be replaced?How are you u
94、sing plan design to encourage high-quality care?(This could include higher reimbursement levels for getting treatment from a center of excellence,reducing risk of misdiagnosis or treatment complications.)Managing health risk:Are you consistently analyzing areas of claim spend and identifying cost dr
95、ivers for your plan?Are there specific preventive and management strategies to address illnesses,such as cancer,hypertension or diabetes?Drive efficiencies:Are there alternative financing and placement options available as the healthcare marketplace continues to evolve?Have you considered captives o
96、r self-insurance?To what extent is your insurer tackling fraud,waste and abuse?When did you last evaluate your providers?Is your insurer offering fair,transparent and competitive terms?123Health trends 2024:Getting the right balance between managing costs and meeting employee needs25Insurers expect
97、plan improvements to take precedence over cost-containment measuresInsurers expect plan improvements to take precedence over cost containment measures,with 57%of insurers globally saying that they believe employer plan sponsors will prioritize making plan improvements,compared to 43%who believe spon
98、sors will reduce coverage to manage cost.This rises to 63%who believe plan improvements will take precedence over reduced coverage in Europe,and 74%in Latin America and the Caribbean.Figure 12:Globally and in most regions,plan improvements to address attraction,retention and engagement are viewed as
99、 the priority.Based on your experience with recent medical plan renewals,which of the following objectives do you think most employer plan sponsors will prioritize over the next year?(Regional and global results)Europe63%38%Latin America and Caribbean74%26%Asia53%47%Global57%43%Middle East and Afric
100、a43%57%Reducing plan coverage to manage costMaking plan improvements to help address attraction,retention and engagementHealth trends 2024:Getting the right balance between managing costs and meeting employee needsFigure 13:In 2024,employer plan sponsors will prioritize making plan improvements to a
101、ddress attraction,retention and engagement.Based on your experience with recent medical plan renewals,which of the following objectives do you think most employer plan sponsors will prioritize over the next year?(Global results:2023 vs 2024)Although cost-of-living crises and soaring inflation have a
102、ffected both employers and employees,good-quality health plans are still crucial to business objectives for growth,such as attracting,retaining and engaging employees and contributing to broader societal and sustainability objectives.Global 202457%43%68%32%26Reducing plan coverage to manage costMaki
103、ng plan improvements to help address attraction,retention and engagementGlobal 2023Health trends 2024:Getting the right balance between managing costs and meeting employee needs27Keep checking cost-sharing featuresEmployer sponsors and insurers both need to focus on rigorous cost optimization in a h
104、igh-inflation environment,including review of cost-sharing features such as:Deductibles Co-pays Covered expense sub-limits Out-of-pocket maximumsIdeally,these features will be designed in a way that encourages individuals to behave in the desired manner;for example,seeking treatment on an outpatient
105、 instead of inpatient basis when appropriate or seeking treatment from preferred network providers.Initiate conversations about these changes on a regular basis,as insurers may not proactively review these.Many of these concepts are not routine in Europe,where insurers and employers have been less a
106、ggressive about intrusive cost-containment approaches.Although cost shifting to employees is an unattractive option,some cost sharing will be inevitable.This should be combined with more effective communication and preventive care.Figure 14:Cost-containment features offered for employer sponsors of
107、private group medical insurance.Related to cost-containment options,which of the following does your company typically make available for employer sponsors of private group medical insurance to include in their plan?Cost containment featureTypically included (Globally)Education to make plan members
108、smarter consumers of health care59%Steering members away from unproven/unnecessary treatment/technologies/pharmaceuticals59%Steering members to quality care(e.g.,narrow networks,centers of excellence),through a navigation or advocacy service(beyond the health plans standard customer service)39%Tiere
109、d coinsurance/co-pays(claims sharing)for preferred vs.non-preferred treatment/provider45%Tiered coinsurance/co-pays(claims sharing)to incentivize virtual-first care32%Insurers are also focused on AI to support future cost containment;for example,by detecting fraud,waste and abuse.Forty-four percent
110、of insurers globally are considering introducing this feature,rising to 60%in the Middle East and Africa.Figure 15:Plan design adjustments made in line with inflation.Has your company adjusted the following in line with inflation for group medical insurance?Health trends 2024:Getting the right balan
111、ce between managing costs and meeting employee needs28Deductibles/excesses and/or co-paymentsCovered expense sub-limits,overall annual/lifetime36%38%14%11%42%43%8%9%YesNo,but plan to in the next 6 monthsNo,and do not have plans to do soUnsureEmployer actionsProactively discuss cost containment with
112、your advisors or insurers to make sure features such as deductibles and treatment limits are realistic and take account of inflation.Audit your healthcare benefits to make sure they are designed for value and drive efficiencies.Create a long-term plan for managing healthcare costs and monitor data,s
113、uch as claims costs to build a realistic picture of current use.Health trends 2024:Getting the right balance between managing costs and meeting employee needs29123More action is needed on gaps such as mental health,womens health and inclusive benefits design Part 4Health trends 2024:Getting the righ
114、t balance between managing costs and meeting employee needs30Health trends 2024:Getting the right balance between managing costs and meeting employee needsGeneral health and benefits modernizationSome digital health benefits are now becoming part of everyday plan modernization,with virtual care or t
115、elemedicine services becoming a standard part of most insurers offering.69%of insurers globally offer telemedicine,with 78%doing so in Europe and 82%in Latin America.Insurers are also becoming more conscious of emerging needs,such as combatting health misinformation,and this needs to be managed in c
116、ollaboration with employers as well.31Health trends 2024:Getting the right balance between managing costs and meeting employee needs32Figure 16:Companies typically provide a telemedicine service,but not efforts to combat health misinformation.Related to general health and benefits modernization,whic
117、h of the following does your company typically make available for employer sponsors of private group medical insurance to include in their plan?Virtual care or telemedicine serviceAn app to support finding the right doctor or medical care when and where needed Efforts to combat health misinformation
118、Efforts to combat health misinformationApps and/or wearable technology to self-manage well-beingApps and/or wearable technology to self-manage conditionsTop services typically included69%43%42%29%40%Top services insurers do not include but are considering65%Health trends 2024:Getting the right balan
119、ce between managing costs and meeting employee needs33The rise of apps and wearablesWe are also seeing providers developing plans to offer more apps and wearable technology to self-manage well-being or specific conditionsWe are also seeing insurers developing plans to offer more apps and wearable te
120、chnology to self-manage well-being or specific conditions.In our 2023 Health on Demand research we found that digital tools to self-manage well-being are an increasing priority among employees,with 45%saying this was helpful to them and their families.10We are also seeing providers developing plans
121、to offer more apps and wearable technology to self-manage well-being or specific conditions2022 18%2023 25%2024 31%Already offerNot included but consideringTotalGlobal31%43%74%Asia27%48%75%Europe30%35%65%Latin America and Caribbean36%44%80%Middle East and Africa23%43%66%Figure 17:Percentage of insur
122、ers who offer apps and/or wearable technology to self-manage well-being over time10 Mercer.Health on Demand,2023,available at makeup and lifestyle choices:a new frontier Tests that use genetic makeup to offer lifestyle suggestions and/or screen for certain conditions are beginning to gain traction w
123、ith insurers.Although current provision is low,at roughly 9%globally,around a quarter of insurers are currently considering including this service.Employees in some regions may already be familiar with genetic testing in a consumer setting,related to suitability of pharmaceuticals or nutritional adv
124、ice.This could drive wider use in a healthcare plan context,but with wariness around introduction of unethical underwriting practices.Figure 18:Insurers considering genetic makeup testing Already includeNot included,but consideringTotal included or consideringGlobal9%26%35%Asia9%32%41%Europe10%28%38
125、%Latin America and Caribbean5%15%20%Middle East and Africa3%20%23%34Health trends 2024:Getting the right balance between managing costs and meeting employee needsInclusive benefits Insurers are becoming more aware of inclusivity in the context of their own behaviors and general product offerings.For
126、 example,more than half of insurers globally(59%)say that they offer regular training for member services teams to increase cultural competency,and the same number regularly review plan communications for inclusivity.It is also encouraging to see that 31%of insurers globally are considering adding d
127、iagnosis,learning support or occupational therapy to support neurodiversity(although only 18%of European insurers are considering doing so).Around a quarter(26%)of insurers globally are considering making sure member communications are accessible and inclusive for all.But insurers are currently show
128、ing less commitment to making sure the wider ecosystem of medical network partners they work with are diverse,with almost a third(29%)saying that they do not address this and have no plans to do so,rising to 45%in Europe.Figure 19:Top five inclusivity features and actions that insurers include in th
129、eir plansTop five offerings59%59%58%51%33%Assuring plan member communications are accessible and inclusive for all,including for people with disabilitiesProviding regular training for your member service teams to increase cultural competency and inclusionCovering same-gender partners/spousesAllowing
130、 coverage for segments of the workforce who may not be permanent full-timeProviding travel benefits for services if care is not accessible within a reasonable distanceHealth trends 2024:Getting the right balance between managing costs and meeting employee needs35Health trends 2024:Getting the right
131、balance between managing costs and meeting employee needs36Ensuring medical networkproviders are diverse(e.g.,ethnic composition,sexual orientation,gender)25%Not sure31%Typicallyincluded15%Not includedbut considering29%Not includedand notconsideringFigure 20:Limited commitment to ensuring medical ne
132、twork providers are diverseHealth trends 2024:Getting the right balance between managing costs and meeting employee needs37More action needed on race and ethnicityHealth-related disparities based on race and ethnicity are well documented around the world,but it is rare for insurers to use data to he
133、lp address these inequities.Plans to make greater use of data are also muted.In Europe in particular,there is very little appetite for data collection(likely due to the regulatory environment),although more insurers in Asia and the Middle East and Africa are considering introducing this analysis.Fig
134、ure 21:Percentage of insurers that collect data on members race/ethnicity to address health disparities(table excludes respondents who said not sure)GlobalAsiaEuropeLatin America and CaribbeanMiddle East and AfricaCollecting data on members race,ethnicity to address health disparitiesTypically inclu
135、ded11%18%3%10%7%Not included but considering19%25%0%10%33%Not included and not considering57%46%85%64%43%Access to healthcare benefits requires monitoring As we saw in Section 2,access to private healthcare is generally perceived as improving.However,localized access issues remain that may mean insu
136、rers need to revisit medical travel benefits and policies to ensure inclusivity.Figure 22:Percentage of insurers that offer travel benefits for services if care is not accessible within a reasonable distance(table excludes respondents who said not sure)GlobalAsiaEuropeLatin America and CaribbeanMidd
137、le East and AfricaProviding travel benefits for services if care is not accessible within a reasonable distanceTypically included33%24%30%36%40%Not included but considering26%34%18%28%30%Not included and not considering23%24%33%18%13%What you see above the surface:Problems lurking below:Alcohol/subs
138、tance abuseStigma/shameFear of failureInability to keep up with tech changeLack of trust in leadersInability to cope with painLack of self-careSocial isolation Domestic violencePotential for suicidePotential for workplace violencePotential for misconductSafety mistakesPotential for catastrophic erro
139、rsIndirect medical/disability claimsPeople not feeling valuedInability to find/afford therapyPoor morale and employee engagementColleague irritability or inability to cope at workSickness absenceDisability claimsDirect medical claimsMental health benefits Despite growing awareness,mental health rema
140、ins a blind spot for many businesses,and coverage from medical insurers is still less consistent than some other areas of health.The top mental-health-related benefits offered by insurers are focused on traditional services,such as counseling,in-patient treatment and coverage for prescription medica
141、tions.Health trends 2024:Getting the right balance between managing costs and meeting employee needs38Figure 23:Top five mental health benefits offered globally Figure 24:The three least-covered mental health benefits(percentage of insurers that said they do not offer this and have no plans to do so
142、)Typically includedGlobalCoverage for psychological and/or psychiatric counseling sessions(outpatient)69%Inpatient treatment62%Coverage for prescription medications prescribed for mental health(outpatient)57%Education,resources and tools on mental health topics such as self-care,anti-stigma,mindfuln
143、ess and resilience49%Virtual mental health counseling via video chat with a therapist to manage anxiety,sadness or personal relationship issues48%Not included and not consideringGlobalAlternative mental health therapies(e.g.,culturally relevant health therapy,animal therapy)41%Substance use/abuse tr
144、eatments35%Virtual advice via chat,powered by artificial intelligence(no human involved),for anxiety,sadness or relationship issues29%Health trends 2024:Getting the right balance between managing costs and meeting employee needs39Mental health benefits:What employees value 44%35%17%36%57%35%41%33%48
145、%62%42%Health on Demand 2023What people would find helpfulProvider offerings42%41%41%In our 2023 Health on Demand research,11 we asked employees about the benefits they found the most helpful for themselves or their family.Comparing these results to insurers current and future offerings reveals some
146、 gaps.of insurers offer thisof insurers offer thisof insurers offer thisof insurers offer cover for prescription treatmentsdont currently offer,but have plans to do sodo not and have no plans to do sodo not but have plans to do soof insurers currently offer virtual counselingcover in-patient treatme
147、ntHealth trends 2024:Getting the right balance between managing costs and meeting employee needs4011 Mercer.Health on Demand,2023,available at 25:Top five most helpful benefits for employees and insurers plans(percentage of employees who said each service would be helpful to them or their families,a
148、nd the percentage of insurers that offer it)Targeted services for children,teenagers and parents to support youth mental health,socialization and learning issuesAlternative mental health therapiesTraining to recognize/address mental health challenges in myself/othersInsurance/program to reduce the c
149、ost of mental health treatmentVirtual counseling(video text/chat)with therapist for anxiety,sadness,relationship issuesFigure 26:Areas of significant mental health coverage gaps(from Health on Demand 2023)Mental health benefits22%44%38%24%Treatment/programs for substance use,including therapy,counse
150、lingTargeted services for children,teenagers and parents to support youth mental health,socialization,learning issuesProvided by my employerHelpful to me or my familyInsurers are adding more coverage related to one of employees top area of need targeted services to support youth mental health,social
151、ization and learning.Substance-abuse treatment is an underserved mental health offering,with 35%of insurers saying they do not offer it and have no plans to do so.Health trends 2024:Getting the right balance between managing costs and meeting employee needs41Health trends 2024:Getting the right bala
152、nce between managing costs and meeting employee needs42Figure 27:Most plans cover counseling sessions but limited to 10 sessions or less.Counseling cover may not be sufficient Few plans provide meaningful support for employees who need ongoing therapy.Although 69%of insurers globally say they cover
153、psychological and/or psychiatric counseling sessions,in practice,52%of those only cover 10 sessions or fewer.Typically includedGlobalAsiaEuropeLatin America and CaribbeanMiddle East and AfricaCoverage for psychological and/or psychiatric counseling sessions(outpatient)69%54%85%79%67%Percentage that
154、offer coverage for psychological and/or psychiatric counseling sessionsPercentage of those that offer counseling but only offer 10 sessions or less Global69%52%Asia54%67%Europe85%56%Latin America and Caribbean79%16%Middle East and Africa67%65%How much counseling is enough?A lot depends on the reason
155、s for counseling,and the severity of an individuals mental health concerns.However,various studies have shown that 10 sessions are unlikely to be sufficient.For depression,68 sessions offer more benefit than 15 sessions.Having more than eight does not confer any additional benefit.12For more severe
156、depression,the recommendation is 16 regular sessions,although additional sessions may be needed for certain individuals.13Research indicates that on average 1520 sessions are required for 50%of patients to recover.1412 Forde F,Frame M,Hanlon P,MacLean G,Nolan D,Shajahan P,Troy,E.“Optimum number of s
157、essions for depression and anxiety,”Nursing Times,2005,available at https:/pubmed.ncbi.nlm.nih.gov/16276843/#:text=Results%3A%20For%20depression%2C%20the%20study,benefit%20than%201%2D5%20sessions.13 NICE guidelines.“Depression in adults:treatment and management,”National Institute for Health and Car
158、e Excellence,2022,available at www.nice.org.uk/guidance/ng222/chapter/Recommendations#:text=Depression%20in%20adults,29%20June%202022.14 American Psychological Association.“How long will it take for treatment to work?”2017,available at www.apa.org/ptsd-guideline/patients-and-families/length-treatmen
159、t.Health trends 2024:Getting the right balance between managing costs and meeting employee needs43Womens health benefits Coverage for womens health benefits remains sporadic and varies across geographic regions.For example,64%of insurers in Asia do not offer contraception access and coverage,compare
160、d to only 33%in Latin America and the Caribbean.In some cases,womens health benefits are not provided through private plans as they are offered through the public system.However,with public health systems struggling following the pandemic,this may result in gaps.For example,almost a quarter(24%)of i
161、nsurers globally do not provide post-partum care,leaving women on those plans to either receive the care through the public system or receive none at all.Figure 28:Globally,insurers say that many reproductive/womens health benefits are not available.Related to reproductive health benefits,which of t
162、he following are not available under employer sponsored group medical insurance?GlobalAsiaEuropeLatin America and CaribbeanMiddle East and AfricaEgg/sperm freezing67%73%60%54%86%Lactation equipment and support(coaching,pump,hygienic storage)59%62%63%49%66%Pre-conception family planning55%61%55%38%62
163、%Contraception access/coverage53%64%56%33%59%Fertility (e.g.,coverage for IVF)46%52%38%41%59%Menopause care and support44%56%43%37%31%Abortion access/coverage43%52%50%31%38%Postpartum care24%29%38%13%14%Support for high-risk pregnancies and pregnancy loss21%29%35%5%0%Maternity coverage(pre-natal car
164、e and delivery)6%5%15%0%0%Health trends 2024:Getting the right balance between managing costs and meeting employee needs44Health trends 2024:Getting the right balance between managing costs and meeting employee needs45Social and financial disparitiesFamily health decision makingHealth system biasCar
165、egiving expectationsUniversalwomens healthissuesCancer(including breast,ovarian and cervical)Sexual and reproductive health(including sexually transmitted illness,menopause and contraception)Maternalhealth(including familybuilding andpregnancy)Violenceagainst women(including intimatepartner abuseand
166、 sexualviolence)Noncommunicablediseases(including heart disease,osteoporosis)Mental health(gender specific like post-partumdepression including gender and non gender specific)Although coverage varies regionally,womens health issues are universal,with significant social and financial disparities and
167、health system inequalities to address in all regions.Employers looking to address gender equity in the workplace may want to evaluate these topics.Health trends 2024:Getting the right balance between managing costs and meeting employee needs46Reproductive health benefits have traditionally been seen
168、 as an aspect of womens health,but reproductive health and family support affects others in the workforce as well.Role of employer and legislative framework varies from market to market.Inclusive reproductive health and family supportSexual and reproductive health Elective abortion Sexual health and
169、 wellness Family planning and contraception Menstruation Perimenopause and menopauseFamily building and pregnancy Getting pregnant Infertility/fertility Pregnancy/high risk Pregnancy loss Emotional support Genetic testing and counseling Adoption/surrogacy Paid and unpaid time offPostpartum and newbo
170、rn care New baby delivery Newborn care Parental leave Postpartum depression Lactation support Sleep supportReturn to work Parental leave Sleep support Life adjustments/emotional support Financial and social security gaps Lactation support Return to work coachingParenting and child health Pediatric c
171、are Tutoring Parent coaching Mental health/substance abuse Education planning Special needs Adult child special needsCaregiving Childcare needs/back-up care Eldercare needs Caregiving leave Other caregiving needsEmployer actionsReview opportunities to meet inclusive benefit gaps,including unmet wome
172、ns health needs.Discuss mental health counseling coverage with your provider and ensure there is contingency for employees who need more than 10 sessions of counseling support.Compare insurers mental health offerings with employees greatest areas of need for your own workforce.Health trends 2024:Get
173、ting the right balance between managing costs and meeting employee needs47123ConclusionPart 5Health trends 2024:Getting the right balance between managing costs and meeting employee needs48Employers will need to continue to balance economics and empathy for the foreseeable future,using a mix of plan
174、 design changes,delivery and financial interventions,and health risk-management techniques to keep plans sustainable for employees.Understanding and addressing drivers of cost will be vital.Cancer continues to be a major source of claims,both in terms of per-dollar value and frequency.Developing str
175、ategies that address cancer prevention,diagnosis,treatment and work supports can help with cost mitigation and have relevance for other noncommunicable diseases as well.Broadening of support for cancer is just one example of transforming healthcare with an emphasis on health innovations.The future o
176、ffers great potential with AI-driven tools such as remote patient monitoring and pharmaceutical developments predicted to have a significant impact impact on employer-sponsored health plans within the next five years.If you only do five things:Refresh your benefits strategy in light of health system
177、 transformation,evolving employee needs,pervasive gaps and cost pressures.Twenty-first century challenges require 21st century benefits design and delivery.Is your provider offering or planning to offer these?Enhance prevention,diagnosis,treatment and workplace supports pillars for NCDs like cancer.
178、Challenge your plan to manage cost while improving the employee experience.Consider digital solutions for growing risks like ergonomic hazards,extreme temperature and mental distress.The majority of employees find the digital future of healthcare appealing and should be willing to embrace new digita
179、l solutions.Monitor the impact of disruptive technology and health advancements on your benefits and healthcare in general.AI is just a part of the picture,and many innovative solutions are under development.Be a catalyst to advance cost-management options that improve healthcare quality and cost.Be
180、 open to considering cost levers that have been viewed as too intrusive in the past,like steering people to high-quality care.14253Health trends 2024:Getting the right balance between managing costs and meeting employee needs49Appendix AMedical trend rates by country15 Country/Region2022 actual medi
181、cal trend rate2022 actual inflation rate162023 forecast medical trend rate2023 forecast inflation rate162024 forecast medical trend rate2024 forecast inflation rate16Global:without US10.1%8.3%12.4%6.6%11.7%4.2%Global:with US1710.0%8.3%12.3%6.6%11.6%4.2%Global:expat(IPMI)187.6%N/A11.0%N/A10.6%N/ANort
182、h America5.1%7.4%7.2%4.2%6.5%2.4%Canada7.0%6.8%9.0%3.9%7.5%2.4%United States173.2%8.0%5.4%4.5%5.4%2.3%Asia10.7%4.3%12.5%3.8%11.4%2.9%China7.2%1.9%10.5%2.0%10.1%2.2%Hong Kong7.3%1.9%7.8%2.3%8.3%2.4%India7.9%6.7%9.6%4.9%11.0%4.4%Indonesia12.6%4.2%14.6%4.4%13.0%3.0%Malaysia12.0%3.4%13.0%2.9%14.0%3.1%15
183、 This document does not constitute or form part of any offer or solicitation or invitation to sell by either Marsh or Mercer to provide any regulated services or products in any country in which either Marsh or Mercer has not been authorized or licensed to provide such regulated services or products
184、.You accept this document on the understanding and agreement that it does not form the basis of any contract,and Mercer and Marsh shall have no liability in respect of any reliance on,or decisions based on,the content of this document.The availability,nature and provider of any services or products,
185、as described herein,and applicable terms and conditions may therefore vary in certain countries as a result of applicable legal and regulatory restrictions and requirements.Please consult your Marsh or Mercer consultants regarding any restrictions that may be applicable to the ability of Marsh or Me
186、rcer to provide regulated services or products to you in your country.16 Inflation rates are sourced from the International Monetary Fund,World Economic Outlook Database,June 2023.Inflation rate information is strictly for general reference purpose;Marsh and Mercer give no guarantees as to their acc
187、uracy and will not accept liability for decisions based on them.17 US rates come from the National Survey of Employer Sponsored Health Plans report.18 Expat rates were calculated by taking a straight average of 15 expat(IPMI)insurer responses.Health trends 2024:Getting the right balance between mana
188、ging costs and meeting employee needs50Philippines20.0%5.8%23.0%6.3%18.0%3.2%Singapore10.0%6.1%11.0%5.8%12.0%3.5%South Korea7.9%5.1%7.8%3.5%7.6%2.3%Taiwan12.0%2.9%16.0%1.9%9.1%1.7%Thailand9.8%6.1%11.1%2.8%10.1%2.0%Vietnam11.0%3.2%13.3%5.0%12.0%4.3%Pacific2.9%6.9%8.2%5.4%6.5%2.9%Australia2.7%6.6%2.9%
189、5.3%3.5%3.2%New Zealand3.0%7.2%13.5%5.5%9.5%2.6%Europe11.4%11.1%13.0%7.3%11.0%3.5%Austria5.5%8.6%9.0%8.2%9.0%3.0%Belgium0.5%10.3%13.3%4.7%7.5%2.1%Bulgaria20.0%13.0%18.0%7.5%15.0%2.2%Denmark7.0%8.5%7.0%4.8%5.0%2.8%Estonia19.4%19.4%18.9%9.7%15.0%4.1%France1.8%5.9%5.7%5.0%6.1%2.5%Greece8.0%9.3%8.5%4.0%
190、10.0%2.9%Hungary22.0%14.5%25.0%17.7%20.0%5.4%Ireland14.5%8.1%9.0%5.0%7.0%3.2%Italy9.0%8.7%11.0%4.5%9.0%2.6%Latvia15.0%17.2%12.0%9.7%10.0%3.5%Country/Region2022 actual medical trend rate2022 actual inflation rate162023 forecast medical trend rate2023 forecast inflation rate162024 forecast medical tre
191、nd rate2024 forecast inflation rate16Health trends 2024:Getting the right balance between managing costs and meeting employee needs51Lithuania15.0%18.9%23.0%10.5%18.0%5.8%Netherlands5.2%11.6%6.5%3.9%6.0%4.2%Norway9.5%5.8%10.0%4.9%9.5%2.8%Poland20.0%14.4%25.0%11.9%25.0%6.1%Portugal17.5%8.1%15.0%5.7%1
192、0.0%3.1%Romania20.0%13.8%18.0%10.5%15.0%5.8%Spain6.5%8.3%8.0%4.3%8.5%3.2%Sweden5.0%8.1%4.0%6.8%4.0%2.3%Turkey1993.0%N/A91.0%N/A73.0%N/AUK5.6%9.1%13.8%6.8%11.0%3.0%Middle East and Africa9.3%8.0%12.7%8.4%14.4%6.6%Bahrain8.0%3.6%9.5%2.2%11.0%2.2%Egypt20.0%8.5%25.0%21.6%28.0%18.0%Ghana1927.5%31.9%40.0%4
193、5.4%35.0%22.2%Kenya3.0%7.6%9.0%7.8%7.0%5.6%Kuwait8.0%3.9%9.0%3.3%10.5%2.6%Lesotho10.0%N/A12.0%N/A10.0%N/AMalawi10.0%20.8%12.0%24.7%15.0%18.3%Mauritius15.0%10.8%23.0%9.5%30.0%6.9%Morocco2.5%6.6%2.5%4.6%2.5%2.8%Mozambique12.0%9.8%18.0%7.4%21.0%6.5%19 Country was not included in regional or global aver
194、ages,which are not weighted by factors such as national health expenditure or economy size.Country/Region2022 actual medical trend rate2022 actual inflation rate162023 forecast medical trend rate2023 forecast inflation rate162024 forecast medical trend rate2024 forecast inflation rate16Health trends
195、 2024:Getting the right balance between managing costs and meeting employee needs52Nigeria4.0%18.8%17.0%20.1%21.0%15.8%Oman11.0%2.8%13.0%1.9%12.5%2.4%Qatar5.0%5.0%6.0%3.0%7.0%2.7%Saudi Arabia17.0%2.5%16.0%2.8%15.0%2.3%South Africa5.0%6.9%8.9%5.8%9.0%4.8%Uganda8.0%6.8%10.0%7.6%20.0%6.4%United Arab Em
196、irates10.0%4.8%12.5%3.4%11.0%2.0%Latin America and the Caribbean2010.0%7.9%11.3%5.9%10.3%3.7%Brazil13.8%9.3%18.0%5.0%15.3%4.8%Chile7.3%11.6%8.2%7.9%8.5%4.0%Colombia10.2%10.2%12.5%10.9%11.0%5.4%Dominican Republic8.8%8.8%11.0%5.7%7.8%4.3%Mexico16.8%7.9%15.1%6.3%14.2%3.9%Panama11.0%2.9%10.0%2.2%10.8%2.
197、2%Peru6.7%7.9%9.7%5.7%7.8%2.4%Puerto Rico5.5%4.3%6.0%3.3%7.0%2.2%Venezuela1920.5%N/A29.5%N/A35.0%N/A20 Argentina was not included in the table due to current socioeconomic conditions(hyperinflation;multiple exchange rates for the dollar).Country/Region2022 actual medical trend rate2022 actual inflat
198、ion rate162023 forecast medical trend rate2023 forecast inflation rate162024 forecast medical trend rate2024 forecast inflation rate16Health trends 2024:Getting the right balance between managing costs and meeting employee needs53Appendix BParticipating insurers21We would like to thank all the insur
199、er respondents for participating in this research.We are very grateful to them for sharing their important perspectives,insights and outlooks.CountryInsurerAngolaNossa SegurosSanlamArgentinaWilliam HopeHospital AlemanASESancor SaludAustraliaNIB/GUBelgiumDKV BelgiumAXA BelgiumBrazilGolden CrossCare P
200、lusCanadaEquitable LifeMedavie Blue CrossCountryInsurerChinaMSHTaipingNew China LifeGBGAIA ShanghaiCITIC-Prudential LifeManulife-SinochemChina Life GuangzhouMedlinkPing An Annuity ShanghaiBupaSunlife Everbright Life BeijingGenerali China ShanghaiFosunProsper HealthICBC-AXAColombiaAXA ColpatriaSeguro
201、s BolivarPan American Life de ColombiaAllianzCompania de Medicina Prepagada Colsanitas S.A.Coomeva MP21 Only participants that indicated on the survey that their company names could be published are listed here.Names are printed as they were reported in the survey response.Health trends 2024:Getting
202、 the right balance between managing costs and meeting employee needs54CyprusMetLifeEurolifeDenmarkPFA PensionDominican RepublicGrupo YunenMapfre Salud ARSHumano SegurosEgyptAXA EgyptMetLifeLibano-Suisse-TakafulFranceGroupama Gan VieGhanaAcacia HealthGreeceGroupamaHong KongSun Life Hong Kong LimitedM
203、anulifeFWD General Insurance Company LimitedAXA China Region Insurance Co.LtdLiberty International Insurance LimitedAPRIL Hong Kong LimitedHungaryGroupama Biztost Zrt.IndiaLiberty VideoconAditya Birla Health InsuranceManipalCigna Health InsuranceRoyal Sundaram General InsuranceIndonesiaAstraLifeLipp
204、oInsuranceAIA FinancialIrelandLaya HealthcareIrish Life HealthItalyGenerali Life Assurance PhilippinesZurichMetLifeGenerali ItaliaKuwaitOrient InsuranceLibyaSAHARALithuaniaCompensa Vienna Insurance GroupMalawiMASMMalaysiaAmMetlifeGreat EasternEtiqaMexicoMAPFREZurichAllianzGrupo Nacional ProvincialSe
205、guros AtlasGrupo Nacional ProvincialAXA MexicoMozambiqueFidelidadeNew ZealandUnimedSouthern CrossNigeriaTotal Health Trust LimitedAXA MansardCountryInsurerCountryInsurerHealth trends 2024:Getting the right balance between managing costs and meeting employee needs55NorwayIf/VertikalGjensidige Forsikr
206、ingOmanOman Qatar InsuranceNational Life&General Insurance CompanyNew India OmanOman Qatar InsurancePanamaAseguradora del Istmo Adisa S.A.Assa Compania de SegurosBlue Cross and Blue Shield of PanamaPeruMapfre PeruPacifico SegurosPhilippinesThe Insular Life Assurance Co.Ltd.Insular Health Care,Inc.PA
207、CIFIC CROSS INSURANCE,INC.Medicard Maxicare Healthcare CorporationFirst Life Financial Co.,Inc.PortugalFidelidadeQatarDoha Insurance GroupAl KootSEIBRomaniaSignal IdunaGroupamaAsirom VIGSingaporeSinglifeRaffles Health InsuranceTokiomarine LifeCignaSouth AfricaLiberty HealthSpainAXA Seguros Generales
208、Cigna Life Insurance Company of EuropeASISASegurcaixaadeslasSwazilandOracle Insure EswatiniThailandTokio Marine Life Insurance(Thailand)PCLFWD Life InsuranceLMG Insurance PCL.Muang Thai Life Assurance PCL.Prudential Life Assurance(Thailand)PCL.TurkeyAnadolu SigortaUnited KingdomBupa GlobalWPAAviva H
209、ealth UKHealixAXA-PPPVenezuelaMapfreHuamanitasVietnamGeneraliCountryInsurerCountryInsurer 2023 Marsh McLennan.All right reserved.For further information,please contact your local Mercer Marsh Benefits office.Marsh McLennan businesses provide a range of solutions to help you build a resilient workfor
210、ce and business,including:Benefits strategy,broking,design,financing and delivery Health and well-being,including mental health and longevity Global benefits Business continuity Enterprise risk management Business resiliency and crisis management Cybersecurity risk management Environmental,social an
211、d governance(ESG)Diversity,equity and inclusion Workforce communications Flexible working and work design Employee experience,listening and total rewards Living wage RetirementAbout Mercer Marsh Benefits Mercer Marsh Benefits provides clients with a single source for managing the costs,people risks,
212、and complexities of employee benefits.The network is a combination of Mercer and Marsh local offices around the world,plus country correspondents who have been selected based on specific criteria.Our benefits experts,located in 73 countries and servicing clients in more than 150 countries,are deeply
213、 knowledgeable about their local markets.Through our locally established businesses,we have a unique common platform,which allows us to serve clients with global consistency and locally unique solutions.Mercer and Marsh are two businesses of Marsh McLennan(NYSE:MMC),the worlds leading professional services firm in the areas of risk,strategy and people,with 85,000 colleagues and annual revenue of over$20 billion.Through its market-leading businesses including Guy Carpenter and Oliver Wyman,Marsh McLennan helps clients navigate an increasingly dynamic and complex environment.