2017全球医疗趋势调查报告（英文版）_16页_1mb

2017 Global Medical Trends Summary

Core Content

The 2017 Global Medical Trends Survey by Willis Towers Watson provides an overview of medical cost trends across 79 countries, based on responses from 231 leading medical insurers. The report highlights the impact of various factors on medical cost increases, including the adoption of ICD-10, mental health treatment, and the role of cost-sharing strategies.

Main Points

• Claim Coding Improvements: High-level claim coding is improving, especially for larger employers, enabling better strategic planning. Insurers in many countries can now provide data on the top 10 health conditions for clients with over 500 covered lives. However, progress is slow in Europe, where even aggregate statistics are rarely provided.

• Mental Health Coverage: There has been a significant increase in the number of insurers offering mental health and stress treatment in standard medical insurance programs, rising from 50% in 2014 to 61% in 2017. Still, many insurers exclude treatment for alcoholism and drug use (72%) and HIV/AIDS (43%).

• Medical Trend Rates: Over half of global health insurers expect medical trends to increase or remain stable over the next three years. The Middle East and Africa are more optimistic, with 53% expecting no increase and 5% expecting a decline.

Regional Analysis

Asia Pacific

• Trend Projection: The region continues to show rising trends, with a weighted average of 7.1% in 2015, 7.7% in 2016, and a projected 8.6% in 2017.
• China: Medical trend significantly exceeds general inflation, expected to stay above 10% in the near future due to modernization and increased private medical awareness.
• Hong Kong: High trend rates are attributed to overprescribed services and higher costs for inpatient care.
• India: Medical trend is among the highest in Asia, with premiums increasing by 5% over the last three years due to regulatory changes and historical underwriting issues.
• Singapore: Lower trend rates are linked to increased market competition and the introduction of Medishield Life.
• Other Countries: Indonesia, Malaysia, and Thailand also show rising trends, with some countries like Vietnam experiencing extreme increases due to economic conditions.

Europe

• Low Trend Rates: Europe has the lowest gross weighted trend increases, with a projected 2017 trend below 5%, still above general inflation.
• France: Medical trend is heavily influenced by the government, which controls hospital and drug prices. New regulations have introduced cost ceilings, limiting the impact on private insurers.
• United Kingdom: Ongoing challenges in accessing timely NHS care are driving demand and costs in the private market. A medical premium tax rate increase has also contributed to higher private insurance premiums.

Middle East and Africa

• Trend Stability: The region's trend remains around 9%, with a projected increase to 9.8% in 2017.
• Saudi Arabia: Medical trend remains above general inflation, which has dropped due to economic slowdown and oil prices.
• United Arab Emirates: Similar to Saudi Arabia, the trend is expected to slightly decrease due to lower general inflation, but remains in double digits.
• Kenya: Medical trend is increasing, especially in Nairobi, with some insurers offering discounts tied to plan design changes.
• Nigeria: Medical costs have surged due to a local recession and dollar shortages, leading to high increases in drug and equipment costs.

The Americas

• Latin America: Medical trend remains high, with a projected 11.5% for 2017. Argentina's trend is particularly high due to general price inflation.
• Canada: Medical trends are expected to rise in 2017, driven by behavioral health claims and high-cost drugs.
• United States: Medical cost increases have slowed, but remain between 7% and 9% per year. Insurers are increasingly using cost-sharing strategies and alternative payment models to manage expenses.

Drivers of Medical Costs

• Hospital/Inpatient Services: These are the main cost drivers, with over 50% of insurers in most regions expecting significant increases. Asia Pacific leads with 92% of insurers attributing cost increases to these services.
• Pharmacy Costs: Especially in the Americas, 71% of insurers expect moderate to significant increases in pharmacy costs, particularly for specialty drugs.
• Maternity and Dental Care: These are also seen as contributing to cost trends, except in Europe.
• Provider and Employee Behavior: Overprescription and inappropriate care-seeking are major concerns, with 74% of insurers citing these as key issues.
• New Medical Technology and Provider Profits: 63% of insurers attribute rising costs to new technologies, while 40% point to provider profit motives.

Top Three Diseases

• Cardiovascular Disease, Cancer, and Respiratory Illness are the top three noncommunicable diseases reported by insurers worldwide.
• These conditions are expected to remain in the top three over the next five years.
• Claims for cardiovascular disease have significantly increased in the Middle East and Africa over the last five years.

Cost Sharing and Management Strategies

• Member Coinsurance is the most common cost-sharing approach in all regions, with 75% of insurers in the Americas using it.
• Annual Deductibles are also widely used, especially in the Americas (82%).
• Annual Out-of-Pocket Expense Limits and Premium Cost Sharing are other key strategies.
• These strategies are effective in managing costs and promoting employee awareness of health service utilization.

Key Insights

• Affordability Concerns: Employees in the U.S. and Canada are increasingly concerned about affordability, leading to changes in plan design to lower premiums and out-of-pocket costs.
• Market Dynamics: In the U.S., the shift towards value-based care models and the use of data for care management are reshaping the delivery system.
• Regulatory Impact: Regulatory actions in various countries are influencing medical cost trends, particularly in Asia and the Americas.

Conclusion

The 2017 Global Medical Trends Survey highlights a global trend of rising medical costs, with significant regional variations. While some regions like Europe show relatively stable or lower trends, others such as Latin America and parts of Africa experience much higher increases. The adoption of cost-sharing strategies and regulatory changes are key in managing these trends, with a growing emphasis on value-based care models in the U.S. and Canada.