2019年全球医疗趋势报告（英文版）

2019 Global Medical Trend Rates Report Summary

Core Content

This report presents the 2019 global and regional medical trend rate data, highlighting the factors influencing medical cost increases and the strategies employed by employers to manage these costs. It also outlines the prevalence of medical plan features, financing approaches, and employee cost-sharing practices across various regions.

Key Highlights

• Global Medical Trend Rates: The 2019 global average nominal medical trend rate was 7.8%, down from 8.4% in 2018. The real medical trend rate was 5.3%, also lower than the 5.8% in 2018.
• General Inflation: The global average general inflation rate for 2019 was 2.9%, compared to 3.1% in 2018.
• Regional Trends: All regions are expected to see lower medical trend rates in 2019 than in 2018, with the most significant declines in North America and Europe.
• Venezuela Excluded: Due to hyperinflation, Venezuela was excluded from the regional and global averages.
• Cost Drivers: Medical cost increases are influenced by population aging, chronic diseases, and cost shifting from social programs to private insurance.
• Employer Strategies: Employers are focusing on wellness initiatives, cost containment, and plan design changes to mitigate rising medical costs.

Global Overview

• The prevalence of employer-sponsored medical plans is increasing globally.
• The scope of medical plan provisions is expanding, including more comprehensive coverage and higher benefits.
• The global average medical trend rate is the lowest since 2013, reflecting lower projected inflation and employer cost containment measures.
• Despite the drop, medical trend rates continue to outpace general inflation.

Regional Commentaries

North America

• USA: Slight cost reductions expected due to improved cost management in medical services and pharmacy, including cost transparency, provider referrals, and formulary management.
• Canada: High medical trend rates due to prescription drug costs and regulatory changes.

Asia-Pacific (APAC)

• China: Reforms such as removing drug mark-ups and promoting generic drugs are expected to temper medical trend rates.
• Hong Kong: Rising medical trend rates due to aging population, stress, and respiratory infections.
• India: Medical trend rates remain stable due to lower general inflation and insurer regulations.
• Singapore: High gross and net medical trend rates due to chronic conditions and health intervention initiatives.
• South Korea: Medical trend rates decreased due to regulatory changes and increased coinsurance.
• United Arab Emirates (UAE): Higher healthcare spending due to chronic diseases and lifestyle changes.
• Egypt: Medical inflation is expected to decline due to government reforms.
• Saudi Arabia: High net medical trend rates due to VAT taxes and regulatory enhancements.
• South Africa: Medical trend rates increased due to higher utilization, hospital costs, and VAT increases.

Latin America (LAC)

• Mexico: Higher gross and net medical trend rates due to currency erosion and cost shifting.
• Puerto Rico: Severe drops in medical trend rates due to economic challenges and Hurricane María impact. Employers and insurers are implementing discount networks and pharmacy benefit reviews.

Middle East and Africa (MEA)

• Brazil: Medical trend rates reflect expansion of minimum provisions and reduced geographic coverage.
• United Kingdom: High medical trend rates due to NHS deterioration and high oncology claims.

Medical Plan Features

• Inpatient Hospitalization: 90% of countries have this feature.
• Outpatient Services: 87% of countries offer outpatient coverage.
• Vision: 65% of countries include vision benefits.
• Dental: 67% of countries provide dental coverage.
• Prescription Drugs: 78% of countries cover prescription drugs.
• Preventive Medicine: 68% of countries include preventive care.

Medical Plan Financing Approaches

• Self-Insurance is common in North America and APAC.
• Insurance is prevalent in Europe, LAC, and MEA.
• Mixed approaches are also used in various regions.

Employee Cost Sharing

• Share of Medical Premium: 78% globally, with Europe at 94% and MEA at 56%.
• Contributions to Spouse Premium: 78% globally, with Europe at 93%.
• Contributions to Children Premium: 77% globally, with Europe at 93%.
• Share of Medical Claims: 93% globally, with MEA at 100%.
• Deductibles, Copays, Coinsurance: Vary by region, with coinsurance being the most common in Europe (42%) and LAC (86%).

Most Important Elements of Medical Plan Cost

• Hospitalization is the most important cost element in most regions.
• Prescription Drugs are a major cost driver in North America and APAC.
• Physician Services and Clinics/Labs are significant in Europe and MEA.
• Maternity is a key cost factor in MEA and APAC.

Key Conditions Driving Adverse Medical Claims

• Musculoskeletal/Back and Cardiovascular are leading conditions in North America.
• Cancer/Tumor Growth is a major driver in APAC and LAC.
• High Blood Pressure/Hypertension is prevalent in MEA and APAC.
• Diabetes and Gastrointestinal are key in Europe and LAC.

Risk Factors Driving Medical Plan Costs

• Physical Inactivity and Bad Nutrition are significant risk factors in North America and APAC.
• Obesity and Poor Stress Management are notable in Europe and LAC.
• High Blood Pressure and High Cholesterol are key in MEA and APAC.
• Unsafe water, sanitation, hygiene is a concern in MEA.

Mitigation Initiatives

• Wellness Initiatives are the most common mitigation method globally and in most regions.
• Cost Containment and Plan Design Changes are widely used in North America, APAC, and Europe.
• Access & Delivery Restrictions and Providers Network are key in LAC and MEA.

Average Medical Trend Rate Table

Conclusion

The report emphasizes the need for employers to optimize plan design, financial strategies, and delivery mechanisms to manage rising medical costs. It also highlights the importance of targeted wellness and health promotion initiatives that align with regional risk factors and health conditions. Continuous monitoring and proactive measures are essential to address the long-term challenges of medical cost escalation.