【美世咨询Mercer】2025年全球员工保险福利趋势报告_43页_2mb

Health Trends 2025 Summary

Core Content

The Health Trends 2025 report highlights the evolving landscape of employer-provided health benefits, emphasizing the need for adaptive strategies to manage rising medical costs and meet the diverse health needs of the workforce. The report is based on a survey of 225 insurers across 55 markets, conducted in June and July 2024.

Main Trends and Key Findings

1. Intensifying Medical Risks

• Cancer remains the top global cause of insurance claims by dollar amount and is the fourth highest by claim frequency.
• Cardiovascular and metabolic health is the leading risk factor for medical costs globally.
• Mental health and psychosocial risks are also significant contributors to rising costs.
• Preventative cancer screening is underutilized, with only 40% of global plans offering it by default, despite high employee demand.
• Catastrophic claims are increasing, with 43% of insurers reporting more employees reaching their lifetime coverage limits.

2. Rising Medical Trend Rates

• Global medical trend rates are projected to stabilize in 2024 and 2025, but remain persistently high, exceeding 10% in most regions.
• Medical inflation, treatment mix changes, and utilization shifts are the primary drivers of trend rates.
• US health benefit costs are expected to rise by 5.8% in 2025, after accounting for cost-reduction measures.

3. Emerging Innovations and Cost Containment

• Innovative treatments for obesity and cancer are becoming more prevalent but also more costly.
• Artificial Intelligence (AI) is expected to play a growing role in cost containment, with 46% of insurers believing AI will reduce costs within five years.
• Virtual care is increasingly seen as a valuable tool, with 85% of insurers offering telemedicine options. However, only 22% of global plans incentivize its use.

4. Regional Challenges

• Europe is the only region where healthcare system deterioration is a top concern for affordability.
• Latin America and the Caribbean (LAC) and Middle East and Africa (MEA) face significant fraud issues, which are ranked as top three concerns.
• Asia is an exception in cost containment practices, with less use of bundled pricing and preauthorization as standard features.

Key Recommendations for Employers

• Evaluate and optimize health benefit programs to balance cost and employee experience.
• Invest in preventative care, including cancer screening, early detection, and digital self-management tools.
• Explore innovative cost containment strategies, such as AI integration, virtual-first care, and bundled pricing.
• Review lifetime limits and ensure they are aligned with the needs of the workforce.
• Develop targeted programs for cardiovascular and metabolic health, including access to essential medications, education, and prevention initiatives.
• Enhance virtual care integration by understanding eligibility, delivery methods, and incentives.
• Implement risk management frameworks that include governance, oversight, and data-driven decision-making.

Spotlight on GLP-1 Drugs for Weight Loss

• Over 40% of adults are overweight, increasing the risk of cardiovascular disease, diabetes, and mental health issues.
• GLP-1 drugs (e.g., Zepbound, Wegovy) show promise for weight loss and metabolic improvement, but are not widely covered.
• 43% of insurers globally report that GLP-1 drugs are a concern for plan affordability, with higher concerns in LAC and MEA.

Conclusion

The report underscores the importance of adapting health benefit strategies to address changing medical trends, rising costs, and unmet workforce needs. Employers must engage in proactive plan management, leverage technology and data, and ensure that coverage aligns with both employee health outcomes and financial sustainability.