1、2019 Medical Trends Around the World BENEFITS TM 22019 Medical Trends Around the World 32019 Medical Trends Around the World Contents 1 Message From Mercer Marsh Benefits . 4 2 Key Trends Shaping Employer-Sponsored Medical Plans . 6 3 Medical Trend Rate Exceeds Economic Inflation . 8 4 Causes of Cla
2、ims Risks and Conditions .12 5 Supplier-Driven Pressure on Cost of Care .16 6 Levers Being Employed for Cost Containment .18 7 Strategic Investments Into the Future . 24 8 In Closing. .30 9 About This Survey . 34 42019 Medical Trends Around the World 1 Message From Mercer Marsh Benefits 52019 Medica
3、l Trends Around the World On behalf of Mercer Marsh Benefits, I am delighted to release our fifth annual Medical Trends Around the World survey, which provides forward-looking insights into the rising cost of health insurance for our clients around the world. It is encouraging that insurance and adj
4、acent industries are moving forward with advancements to help organizations optimize their employee benefit plan costs so that programs are financially sustainable into the future. As the new leader of Mercer Marsh Benefits, I am keen to ensure that we maintain our industry leadership position by wo
5、rking with clients, insurers and other partners to drive innovative data-driven approaches that improve health and well-being and ensure that the right care is delivered at the right time in the right place. We are encouraged to see that insurers are responding to the challenges of the rising medica
6、l costs by continuing to make strategic investments in digitization and data analytics. However, we all need to do more to ensure health coverage and care are affordable for employers and employees: medical trends continue to outpace general inflation by close to three times. The average global medi
7、cal trend rate observed for 2018 was 9.7%, and a similar increase is expected for 2019. In the absence of using active plan management strategies, employers will need to allocate more and more of their remuneration budget toward benefits. This is at a time when the workforce is demanding a broader s
8、et of rewards and more engaging program delivery. Id like to thank the 204 insurers across 59 countries* who participated in this years “short form” survey (each year we alternate between a summary and detailed research), which ran from January to March 2019. Our clients tell us that data from the s
9、urvey are a key input into plan design decisions, so we are grateful to insurers for sharing their perspective on interventions that are most likely to be feasible and effective into the future. We hope that you find the data and insights helpful. We look forward to working with you to design, deliv
10、er and finance programs that can help you optimize cost, manage risk, simplify program delivery and digitally engage your workforce. Herv Balzano Mercer Marsh Benefits International Leader *Excludes the United States 62019 Medical Trends Around the World 2 Key Trends Shaping Employer-Sponsored Medic
11、al Plans 72019 Medical Trends Around the World Key findingsConsiderations for employers No reprieve in medical inflation Medical costs continue to outpace general inflation by close to three times. The average global medical trend rate observed for 2018 was 9.7%, with a similar increase expected for
12、 2019 and even higher rates for 2020. Plan ahead for design, delivery and financing cost- containment measures, prioritizing solutions that enhance access to quality healthcare. In the absence of aggressive short- and long-term interventions, employers will need to consider budgeting for higher cost
13、s. Shifting focus toward making members smarter healthcare consumers The number of insurers investing in initiatives to enable quality-focused care (right care at the right time in the right setting) has more than doubled 29% have indicated it as a top strategic investment area. We view this as a na
14、tural evolution of recent investments in data analytics, which continue to be the top strategic focus for insurers (for example, to identify abnormalities in costs and medical practices; in Europe, 15% more insurers are delisting health providers due to clinical or business practices). Engage with y
15、our benefit advisor, other employers, insurers and internal resources to seize opportunities to give plan members the knowledge, tools and incentive to change buying habits, promoting provider and consumer accountability. Exploration is increasingly shifting to execution Exploration of virtual care
16、both to contain medical costs and to encourage consumer-based behavior is increasingly turning to execution 78% of insurers around the world are now considering or already supporting virtual health consultations (highest in the Middle East and Africa at 88%). Embrace digital disruption to make healt
17、hcare accessible and affordable across a spectrum of service providers, including physicians, mental health providers and physical therapists. Supplement this with engaging and personalized communication to improve adoption of the services. Lifestyle factors continuing to drive increases in medical
18、costs Circulatory, gastrointestinal and respiratory conditions, largely related to lifestyle choices, continue to drive the top claims by cost and frequency. Make health a business imperative. Develop a holistic health and well-being strategy that supports employees across their physical, emotional,
19、 financial and social well-being. This years survey continues to explore how health conditions, supplier factors and consumer habits are driving cost. It also provides insights to how insurers are responding to these. We found no surprises in many respects: Cancer and diseases of the circulatory sys
20、tem remain the top two highest causes of claims, based on cost. The top three health risk factors remain metabolic and cardiovascular risk, dietary risk and emotional/mental risk. We would like to highlight four key findings from this years survey. 82019 Medical Trends Around the World 3 Medical Tre
21、nd Rate Exceeds Economic Inflation 92019 Medical Trends Around the World The data from this years survey reflect a slight increase in the actual medical trend rate experienced by insurers in 2018, just 0.2 percentage points above the average reported in our report last year. However, the average glo
22、bal medical trend rate of 9.7% continues to outpace economic inflation by about three times. Projections by survey respondents for 2019 reflect the potential for a 9.6% global average, with most countries reporting they expect the trend to remain similar to last year. Please note that the US is excl
23、uded from this report because it is a unique healthcare market. For information on US trends, see our separate Mercer National Survey of Employer-Sponsored Health Plans 2018 report. Based on your block of group or overall medical insurance business, what actual medical trend rate did you experience
24、in 2018 and are you projecting for 2019? All aspects of healthcare including hospitalization, outpatient, medications, maternity and vision can be included in your assessment, but where possible, please exclude dental. The trend rate should account for per- person increases in cost due to medical in
25、flation, changes in utilization patterns and other factors, like changes in government regulation. Country/Region 2018 medical trend rate experienced1 2018 estimated inflation rate2 2019 projected medical trend rate1 2019 forecast inflation rate2 Global3 9.7%3.2%9.6%3.3% North America Canada8.5%2.6%
26、8.5%2.2% Asia10.4%2.5%10.3%2.6% China9.7%2.2%10.2%2.4% Hong Kong9.3%2.3%9.1%2.1% India8.5%4.7%9.3%4.9% Indonesia11.0%3.4%10.5%3.8% Malaysia13.4%1.0%13.6%2.3% Philippines13.0%4.9%13.7%4.0% Singapore10.0%1.0%10.1%1.4% South Korea6.0%1.5%5.0%1.8% Taiwan11.5%1.5%9.1%1.3% Thailand7.9%0.9%8.5%0.9% Vietnam
27、14.5%3.8%14.2%4.0% Pacific6.0%1.8%5.1%2.0% Australia4.0%2.2%3.3%2.3% New Zealand8.0%1.4%7.0%1.7% 102019 Medical Trends Around the World Impact of Brexit5,6 Multiple stakeholders are expecting Brexit to adversely impact medical costs. The British Medical Association expects that the UKs withdrawal fr
28、om the European Union will significantly affect the quality of care received by patients due to notable threats, such as workforce shortages of EU nationals, the end of reciprocal health agreements and reduced funding for healthcare research. The cost of medical supplies is also expected to increase
29、. Given this trend, coupled with the increasing pressures on the National Health Service system, we expect to see increasing utilization of private treatment in turn contributing to the plan costs. 1. The medical trend rates reflect insurer survey results and may not be MMBs view. 2. Sources for inf
30、lation rates include: For all countries unless noted: International Monetary Fund, World Economic Outlook Database, January 2019 For Latin America: Mercers Latin America Economic Trends, January 2019 Note for China and Mexico cities, the data refer to China and Mexico overall country data, respectiv
31、ely. Inflation rate information is strictly for general reference purpose; Mercer gives no guarantees as to its accuracy and will not accept liability for decisions based on it. 3. Average of 51 participating countries with an acceptable number of responses. 4. Venezuela is not included in the table
32、 due to the current socioeconomic conditions. Also Argentina has been excluded from regional and global averages. 5. Nuffield Trust Research. 6. British Medical Association. Brexit Briefing The Impact of Leaving the EU on Patients, 2018. Country/Region 2018 medical trend rate experienced1 2018 estim
33、ated inflation rate2 2019 projected medical trend rate1 2019 forecast inflation rate2 Europe8.1%3.1%8.3%3.0% Belgium4.3%2.2%4.1%1.8% Bulgaria14.7%2.6%15.5%2.3% Denmark2.2%1.4%3.6%1.7% France3.3%1.9%1.3%1.8% Greece3.7%0.7%3.7%1.2% Hungary19.2%2.8%17.3%3.3% Ireland4.2%0.7%4.5%1.2% Italy3.7%1.3%3.2%1.4
34、% Latvia8.6%2.7%7.8%2.4% Lithuania8.3%2.5%11.1%2.2% Norway5.1%1.9%6.3%2.0% Poland7.1%2.0%7.7%2.8% Portugal1.6%1.7%2.1%1.6% Romania15.0%4.7%10.0%2.7% Russia8.4%2.8%8.7%5.1% Serbia10.5%2.1%7.1%2.3% Spain5.1%1.8%5.1%1.8% Sweden6.0%1.9%5.6%1.7% Switzerland4.0%1.1%4.0%1.4% Turkey15.5%15.0%27.0%16.7% Ukra
35、ine23.5%10.9%20.0%7.3% United Kingdom5.2%2.5%6.0%2.2% Country/Region 2018 medical trend rate experienced1 2018 estimated inflation rate2 2019 projected medical trend rate1 2019 forecast inflation rate2 Middle East and Africa (MEA) 14.0%5.6%13.6%5.0% Bahrain8.8%3.0%7.6%4.8% Egypt25.0%20.9%22.0%14.0%
36、Kenya13.8%5.0%12.2%5.6% Oman22.6%1.5%24.3%3.2% Qatar11.0%3.7%11.0%3.5% Saudi Arabia8.7%2.6%8.2%2.0% South Africa11.1%4.8%11.3%5.3% United Arab Emirates11.2%3.5%12.2%1.9% Latin America (LATAM)4 9.6%2.7%9.2%3.3% Argentina41.1%47.6%39.6%29.0% Brazil16.9%3.9%15.5%4.0% Chile6.1%2.5%6.2%2.7% Colombia7.0%3
37、.2%5.3%3.7% Dominican Republic7.7%1.2%5.5%4.2% Mexico12.9%4.8%14.2%3.9% Panama10.5%1.0%11.0%2.4% Peru6.5%2.2%7.0%2.5% 112019 Medical Trends Around the World *Global includes all responses to the survey, including Canada, Australia and New Zealand. Looking to the future Do you expect the 2020 medical
38、 trend rate figure will be higher, lower or the same? Global*AsiaEuropeLATAMMEA Higher than the prior year projection52%58%53%39%61% Lower than the prior year projection7%4%3%18%11% Same as the prior year projection41%38%45%42%28% Insurers are generally predicting further increases on the horizon in
39、 2020. Medical plan cost trends for the US are drawn from the Mercer National Survey of Employer-Sponsored Health Plans, which uses a national probability sample. The most recent survey, conducted in mid-2018, received responses from 2,409 employers. For more information on US health trends, interve
40、ntions and strategies to control cost, click here to purchase Mercers National Survey of Employer-Sponsored Health Plans report for 2018. Health benefit cost growth remained moderate in 2018, at 3.6%. But with an increase of 4.4% projected for 2019, the trend is slowly moving upward and its once aga
41、in above Consumer Price Index and workers earnings growth. Drugs remain a key cost driver in health plans in particular, specialty drugs. Even though the specialty drug trend has cooled slightly since last year, its still in the double digits. While midsize and large employers (those with 500 or mor
42、e employees) were able to hold cost growth to 3.2%, smaller employers (10499 employees) were hit with a substantially higher increase. Smaller employers tend to be fully insured and have fewer resources to devote to cost management. But cost experience varies considerably from one employer to the ne
43、xt across all size groups. Among all midsize and large employers, 27% had no increase at all, while 18% experienced increases of more than 10%. The smallest employers were the most likely to have had these very high increases. Very large employers those with 20,000 or more employees were better able
44、 to keep their cost increases moderate, but even in this group nearly 1 in 10 had increases of more than 10%. While employers are under pressure to achieve sustainable cost growth, they are also focused on providing a benefit package and working experience that will support an engaged and thriving w
45、orkforce. For the past several years, the survey has asked employers about their most important strategies for managing their health plans in the near term. Monitoring and managing high-cost claims was in the top spot in 2017 and 2018. Interestingly, “a focused strategy for creating a culture of hea
46、lth” has moved up from third to a strong second. US health update 122019 Medical Trends Around the World 4 Causes of Claims Risks and Conditions 132019 Medical Trends Around the World Non-communicable diseases continue to be the leading cause of claims across all regions. Globally, cancer and diseas
47、es of the circulatory system remain the top two highest claims reported (respectively) by most insurers, with gastrointestinal diseases and respiratory conditions tied to round out the top four claim categories in terms of cost. It should be noted that, consistent with prior years, fewer insurers in the Middle Ea
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