Employers hold the key to shaping the healthcare market.
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
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.
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.
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?
A perspective from Italy
A perspective from the United Kingdom
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.
A perspective from the United Arab Emirates
A perspective from Canada
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.
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.
A perspective from the Philippines
A perspective from India
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.
A perspective from Brazil
Insurers were asked: Which of the following employee communication mechanisms does your organization provide to plan members?
A perspective from China
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:
Aligning reimbursement with value (ensure plan designs incentivize the right behavior)
Delivering the right care at the right time, in the right setting, error-free (for example, review coverage gaps that delay treatment, consider centers of excellence)
Leveraging better data and technology to engage employees in their health and health consumption decisions
Injecting change into the system — with internal stakeholders and external partners — to be future-ready