2018世界医学趋势报告（英文版）-8mb

2018 Medical Trends Around the World Summary

Core Content

The 2018 Medical Trends Around the World report by Mercer Marsh Benefits (MMB) provides insights into global healthcare cost trends, key challenges, and strategies being employed by insurers and employers to manage medical expenses. The report highlights the persistent issue of rising healthcare costs, which continue to outpace inflation, and emphasizes the need for innovative and sustainable approaches to address this challenge.

Main Trends and Key Findings

1. Medical Trend Rate

• Global Medical Trend Rate (2017): 9.5%

• Global Medical Trend Rate (2018 Projection): 9.1%

• Inflation Rate (2017): 3.4%

• Inflation Rate (2018 Forecast): 3.5%

• The global medical trend rate remains around three times the inflation rate.

• There is a slight decline in the global trend rate from 2017 to 2018.

• Regional variations exist, influenced by currency fluctuations and country-specific factors.

• The US is excluded due to its unique healthcare market, but its trend rate is noted to be relatively moderate at 2.6% in 2017, with projections for 2018 at 4.2%.

2. Top Claims by Cost

• Globally:

  • Top 3: Endocrine and metabolic diseases, noncommunicable diseases, and respiratory diseases.
  • Inpatient: Cancer and circulatory diseases.
  • Outpatient: Respiratory conditions and tobacco use-related illnesses.

• Asia:

  • Inpatient: Obstetrics and pregnancy.
  • Outpatient: Air pollution and tobacco use.

3. Top Claims by Frequency

• Globally:

  • Respiratory conditions and circulatory diseases are the most frequent.
  • Cancer and gastrointestinal diseases are tied for third.

• Regional Variations:

  • Latin America: Osteomuscular disease and obstetrics and pregnancy.
  • Asia and Middle East & Africa: Infectious diseases.

Strategies for Cost Management and Health Improvement

Insurers' Strategies

• Digitalization and Data Analytics: Increasing investment in digital tools to improve efficiency and data-driven decision-making.
• Provider Management:
  • Managing health providers, such as hospitals, through pre-authorization, cost reviews, and preferred provider networks.
  • Negotiating bundled pricing for procedures and limiting fees through reasonable and customary charging limits.
• Fraud and Abuse Control: Tightening processes to prevent fraudulent claims and abuse of benefits.
• Technology and Pharmaceuticals: Managing the costs of new and expensive medical technologies and high-cost pharmaceuticals.

Employers' Strategies

• Wellness Programs: Expanding and creating wellness and well-being solutions for employees and families.
• Engagement: Engaging members through new coverage options tailored to diverse workforces.
• Cost Containment: Refocusing on cost and behavior management, including encouraging outpatient care over inpatient.

Cost Drivers and Influencing Factors

Supplier-Driven Cost Increases

• Top Reasons for Cost Increases (Global):
  • New and expensive technology.
  • High-cost pharmaceuticals and biologics.
  • Overprescribing of low-value health tests and procedures.
  • Extensive hospital inpatient lengths of stay.
  • Limited access to high-quality care reducing market competition.
  • Regulatory environments that restrict payment competition and pre-authorization.

Influencing Factors for Future Cost Trends

• Increased Noncommunicable Diseases: Expected to significantly impact costs, especially in regions like Asia and the Middle East & Africa.
• Aging Population: Likely to increase healthcare demand and costs.
• Rising Employee Expectations: Employers are expected to meet higher expectations for benefits and services.
• Changes in Health Provider Fee Guides: Likely to affect costs in various regions.
• Health Reform and Legislation: Government policies may influence cost and quality of care.
• Environmental Factors: Air pollution is a key concern in Asia.

Future Outlook

• 2019 Medical Trend Rate Expectations:

  • Higher than 2018: 50% globally, 65% in Asia, 51% in Latin America, 47% in Middle East & Africa.
  • Same as 2018: 41% globally, 30% in Asia, 26% in Latin America, 32% in Middle East & Africa.
  • Lower than 2018: 9% globally, 5% in Asia, 23% in Latin America, 21% in Middle East & Africa.

• Insurers generally expect continued cost increases, with some cautious optimism that the rate might remain stable.

Conclusion

The report underscores the ongoing challenge of rising healthcare costs and the importance of managing these costs through provider strategies, digital solutions, and employer engagement. It also highlights the growing influence of noncommunicable diseases, aging populations, and environmental factors on future healthcare trends. MMB encourages collaboration among employers, insurers, and stakeholders to drive sustainable improvements in healthcare access and quality.