2018全球医疗趋势（英文版）-1mb

2018 Global Medical Trend Rates Summary

Core Content

Aon conducted a 2018 global survey on medical trend rates, covering 98 countries, to provide insights into medical cost trends and help multinational companies manage their medical plan budgets. The survey highlights key factors influencing medical costs, employer practices, and the role of wellness initiatives in mitigating these costs.

Key Highlights

• Prevalence of Medical Plans: Employer-sponsored medical plans are becoming more widespread in all surveyed countries, with expanded coverage including higher maximum lifetime benefits, broader maternity allowances, and fewer exclusions.
• Medical Trend Rates: The global average nominal medical trend rate increased slightly in 2018 to 8.4%, while the real average decreased to 5.3%.
• Inflation Comparison: The gap between medical trend rates and general inflation rates narrowed to 5.3 percentage points in 2018 from 5.4 in 2017.
• Cost Containment Challenges: Aon expects further medical cost escalation due to aging populations, declining health, poor lifestyle habits in emerging markets, and increased utilization of employer-sponsored plans.
• Venezuela Exclusion: Due to hyperinflation, Venezuela was excluded from regional and global averages for 2018.

Medical Plan Features

• Common Features: The most prevalent medical plan features globally include hospitalization (90%), outpatient care (86%), and prescription drugs (72%).
• Regional Variations: Vision and dental coverage are also significant in some regions, with vision being the most common in APAC and dental in Europe.

Medical Plan Employee Cost Sharing

• General Practices: Employee cost sharing is a key strategy for cost mitigation. It is prevalent in both premium costs and claim outlays.
• Global Averages:
  • 78% of countries have employees sharing the cost of medical premiums.
  • 85% of countries have employees sharing in medical claim outlays.
• Regional Breakdown:
  • APAC: 68% for premium sharing, 95% for claim sharing.
  • Europe: 94% for premium sharing, 65% for claim sharing.
  • Latin America: 90% for premium sharing, 86% for claim sharing.
  • Middle East/Africa: 52% for premium sharing, 100% for claim sharing.

Medical Plan Financing Media

• Common Approaches:
  • Prepaid Services: Medical coverage funded via set fees per participant, community-rated, and assessed by the provider network.
  • Direct Provision Through Company-owned Facilities: Clinics or medical dispensaries owned or rented by the company, offering basic services and drugs.

Alternative/Innovative Delivery Mechanisms

• Aon offices reported various alternative delivery mechanisms supporting medical benefit plans, though specific details are not included in the text.

Call to Action

• Employers are urged to accelerate their wellness and health promotion efforts to address rising medical costs and chronic conditions.
• The report emphasizes the need for targeted initiatives based on regional and country-specific health risk factors and behaviors.

Survey Results

Average Medical Trend Rate Tables

Most Important Elements of Medical Plan Cost

• Top Global Cost Elements:

  • Hospitalization: 86%
  • Clinics/Labs: 74%
  • Physician Services: 73%
  • Prescription Drugs: 67%
  • Maternity: 34%

• Regional Cost Elements:

  • APAC: Hospitalization (89%), Clinics/Labs (68%), Prescription Drugs (63%)
  • Europe: Hospitalization (86%), Physician Services (62%), Prescription Drugs (38%)
  • LATAM: Clinics/Labs (86%), Physician Services (81%), Prescription Drugs (86%)
  • MEA: Clinics/Labs (88%), Physician Services (80%), Prescription Drugs (84%)

Key Reported Conditions Driving Adverse Medical Claim Experience

• Top Global Conditions:

  • Cancer/Tumor Growth: 68%
  • Cardiovascular: 66%
  • High Blood Pressure: 54%
  • Diabetes: 48%
  • Respiratory: 44%

• Regional Conditions:

  • APAC: Cancer/Tumor Growth (74%), Gastrointestinal (63%), Diabetes (57%)
  • Europe: Cardiovascular (86%), High Blood Pressure (62%), Diabetes (57%)
  • LATAM: Cancer/Tumor Growth (63%), Diabetes (57%), Cardiovascular (57%)
  • MEA: High Blood Pressure (63%), Diabetes (57%), Respiratory (57%)

Risk Factors Driving Medical Cost Inflation

• Top Risk Factors:

  • High Blood Pressure: 78%
  • Physical Inactivity: 49%
  • Obesity: 48%

• Regional Risk Factors:

  • United States: Physical Inactivity (26%), Bad Nutrition (49%), Obesity (48%)
  • Canada: Aging (49%), Physical Inactivity (49%), Obesity (48%)
  • APAC: High Blood Pressure (78%), Obesity/Physical Inactivity (49%), High Cholesterol/Bad Nutrition (48%)
  • Europe: High Blood Pressure (49%), Obesity/Physical Inactivity/Smoking (49%), Poor Stress Management (49%)
  • LATAM: High Blood Pressure (49%), Bad Nutrition (49%), Obesity/High Cholesterol (49%)
  • MEA: High Blood Pressure (49%), Bad Nutrition (49%), Physical Inactivity (49%)

Cost Mitigation Methods

• Top Methods:

  • Wellness Initiatives: 71%
  • Cost Containment: 69%
  • Access and Delivery Restrictions: 49%

• Regional Methods:

  • United States: Cost Containment (71%), Plan Design Changes (69%), Access and Delivery Restrictions (49%)
  • Canada: Cost Containment (71%), Wellness Initiatives (69%), Plan Design Changes (49%)
  • APAC: Cost Containment (71%), Wellness Initiatives (69%), Access and Delivery Restrictions (49%)
  • Europe: Cost Containment (71%), Wellness Initiatives (69%), Provider Networks (49%)
  • LATAM: Wellness Initiatives (71%), Cost Containment (69%), Access and Delivery Restrictions (49%)
  • MEA: Wellness Initiatives (71%), Cost Containment (69%), Access and Delivery Restrictions (49%)

Most Common Wellness and Health Promotion Initiatives

• Top Initiatives:
  • Wellness Programs: 83%
  • Education Programs: 72%
  • Wellness Interventions: 69%

Conclusion

The 2018 Aon survey provides a comprehensive overview of global and regional medical trend rates, emphasizing the need for employers to adopt targeted cost-containment strategies and wellness initiatives. The report highlights the growing importance of employee cost sharing and the increasing prevalence of chronic conditions and non-communicable diseases (NCDs) as key drivers of medical cost inflation. Aon encourages continuous monitoring and adaptation of medical plan strategies to address these challenges effectively.