2022 Global Medical Trends Survey report

The 2022 survey tracks medical costs from a global network of 209 insurers in 61 countries. Explore key findings and trends at a glance.

https://www.willistowerswatson.com/en-BM/Insights/2021/11/2022-global-medical-trends-survey-report

Vietnam

Most of the insurance companies participating in the survey predict that medical costs in Vietnam will increase next year to about 9% compared with 7% in 2021 and 5% in 2020.

COVID-19 has been the main driver of this, but 2022 is still showing a level of trend below that of 2019; however, this situation will not last long, as we expect utilization to return to normal gradually, especially in 2022 and 2023.

U.K.

The U.K. has seen routine and elective medical treatments delayed for much of 2020 and the first half of 2021. At the end of Q2 2021, claims were suppressed by around 5% to 10% against expected corporate norms. Although during Q3 2021, claims returned to near pre-pandemic levels, much uncertainty remains regarding how much of these deferred claims will come through in late 2021 or into early 2022.

We expect to see the pandemic continue to have an adverse impact on medical trend in the following areas:

  • Claims incidence rates could be affected as the state National Health System (NHS) deals with record waiting lists for routine and elective treatments, prompting more employees to use private/corporate programs.
  • Delayed diagnoses and treatments could mean disease progression could affect average claim costs. This applies not only to more routine treatments, such as musculoskeletal, but also to serious and high-cost illnesses, such as cancer.

ƒ The effects of long COVID-19 are still unclear but could affect claim incidence rates both in the short and medium term.

ƒ Increasing claims around both musculoskeletal and mental health, due to changes in both work and social habits, are likely to be a key claims driver.

However, some impacts of COVID-19 are expected to positively affect medical trend:

ƒ Changing working behaviors and a move to permanent hybrid working could mean more treatments are delivered regionally and outside of more costly city centers.

ƒ The continued use of telehealth, remote consultations and therapies should positively affect claim costs given the efficiencies around delivery.

ƒ The development of digital pathways provides the opportunity for more consistency as well as the ability to optimize the patient journey and remove inappropriate treatments.

Canada

Medical trend in Canada is expected to slow slightly in 2022 compared with 2021. Nevertheless, employers continue to be concerned about COVID-19’s impact on mental health and disability needs. Day care subsidization across provinces has made an impact, supporting the return to work. Pharmacy costs remain a concern in Canada with progress on a national pharmacare plan still awaited.

U.S.

COVID-19 has cost employers more in 2021 than in 2020 with the upward trend expected in the second half of 2021. The delta surge and vaccine hesitancy has defined the national landscape. Other delayed medical services continue to resume gradually with the results that 2022 trend continues to edge upward from 2021 to an expected 7.6%. Pharmacy costs continue to be a large contributor to trend in the U.S. For employers, there is a focus on wellbeing programs (with an increase on digital vendors) as well as support for family/ caregivers and newer healthcare delivery strategies.

Executive summary

The 2022 Global Medical Trends Survey reveals considerable variation in healthcare cost increases around the world. With COVID-19 cases surging in different countries at different times in 2020 and 2021, the uneven trajectory of the pandemic created considerable volatility in healthcare utilization and costs. After dropping to 4.8% in 2020 and rebounding to 8.1% this year, the projected healthcare benefit cost trend is expected to continue at a similar level for 2022, at a global average of 8.1%; however, volatility is more marked at an individual country level due to the uncertainties with the ongoing effects of COVID-19, which is expected to extend into 2022.

Average increases across different regions next year are expected to range from 14.2% in Latin America to 10.6% in the Middle East and Africa to 7.6% in Asia Pacific to 6.7% in Europe. The average medical trend in the U.S. is projected at 7.6% in 2022 based on other Willis Towers Watson research.

Healthcare costs are expected to continue to accelerate beyond 2022, with over three-quarters of health insurers anticipating higher or significantly higher medical trend over the next three years. Eighty-six percent of insurers in Europe expect higher or significantly higher medical trend over this time period as do 82% of insurers in the Middle East and Africa, 74% of insurers in Latin America and 64% of Asia Pacific insurers.

The pandemic has helped accelerate the adoption of telehealth, with over half of insurers globally now offering telehealth across all plans with the associated potential for reductions in cost that virtual healthcare can bring. In this year’s survey, we devote a special section on the evolving role of telehealth in helping to manage medical trend and expediting access to effective care.

Key findings

Incidence of claims related to musculoskeletal disorders soar

Respondents ranked musculoskeletal disorders, potentially attributable to poor ergonomics in employees’ work-from-home environment, as the top condition by incidence of claims followed by cardiovascular diseases and respiratory conditions. In the 2021 survey, insurers ranked musculoskeletal disorders as number five.

Cancer, which in prior surveys held the top spot, dropped to number five by incidence likely due to deferred treatments during the pandemic; however, cancer continues to be a top condition affecting medical costs, followed by cardiovascular and musculoskeletal disorders.

Insurers expect mental and behavioral disorders to be the fastest-growing condition by incidence in the next 18 months, followed by cancer and musculoskeletal disorders. And insurers expect cancer to be the fastest-growing condition by cost in the next 18 months, followed by cardiovascular and musculoskeletal disorders.

Insured coverages continue to see restrictions

Gaps in coverage persist for conditions that are prevalent in the covered population and for which treatments exist. Over half of group policies, regardless of size, have exclusions for HIV/AIDS (54% to 56%) as well as alcoholism and drug use (52% to 53%). Employers should continue to try to remove these exclusions and leverage their consultants/brokers to help negotiate inclusion coverages that are part of global benefit philosophies and of critical value to many employees.

Telehealth emerges as a top cost management method

Insurers ranked contracted networks of providers (75%) and preapproval for scheduled inpatient services (67%) as the top two cost management methods. Telehealth (63%) moved up from number five in last year’s survey to number three, suggesting that more insurers are recognizing the potential for improved cost management through remote diagnosis and treatment of patients.

Overuse of care continues to affect medical costs

Overuse of care by medical practitioners (64%) recommending too many services continues to be the most significant factor contributing to rising medical costs related to employee/provider behavior. Fifty-nine percent of insurers also think that overuse of care by insureds is driving up costs.

Volatility will continue in the short term

COVID-19 has produced the biggest impact to global medical trend variation the industry has seen. Nevertheless, we expected the impact and volatility from COVID-19 to extend into 2022 and beyond. Countries and employers are experiencing the impact at different times and rates. For some countries the impact of a recovery in demand of regular medical services will occur in 2021, while for others this might not happen until 2022 or 2023. COVID-19, combined with the changing face of the work environment, has had a significant impact on medical trend, service delivery and the future drivers of medical claims.

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