WTW-2021年全球医学趋势调查报告（英文）-2020.11-22页_16mb

2021 Global Medical Trends Survey Report Summary

Core Content

The 2021 Global Medical Trends Survey Report by Willis Towers Watson provides an overview of the impact of the pandemic on healthcare utilization and costs across different regions. It highlights the short-term decrease in medical trend in 2020 due to the delay of non-urgent procedures and elective care, but predicts a rebound in 2021 as these treatments catch up, potentially leading to increased costs and more severe health conditions.

Main Points

• Global Medical Trend:

  • A sharp decline in 2020 due to pandemic-related restrictions.
  • Expected to rebound to 8.1% in 2021, slightly higher than the 2020 rate of 5.88%.
  • Long-term projections suggest a continued increase in costs over the next three years, with 67% of respondents expecting a rise in medical trend.

• Regional Variations:

  • Asia Pacific: Projected to drop to 6.2% in 2020, then rebound to 8.5% in 2021.
  • Europe: Trend dropped to 4.24% in 2020, expected to increase to 5.76% in 2021.
  • Latin America: Highest trend with 10.83% in 2020 and a jump to 13.63% in 2021.
  • Middle East and Africa: Trend remained stable in 2020 at 8.66%, with an increase to 10.01% in 2021.
  • North America: Trend dropped to 2.76% in 2020, rebounding to 7.13% in 2021.

• Cost Drivers:

  • Overuse of care is the primary contributor to rising medical costs.
  • Provider behavior (overprescribing) and insured behavior (seeking inappropriate care) are both significant concerns.
  • Telehealth adoption increased, with 50% of insurers globally offering it across all plans.
  • Mental health conditions are expected to become a major cost driver in the coming 18 months, with 40% of respondents predicting their inclusion in the top three most common and expensive conditions.

• Claim Data:

  • ICD-10 is widely used by 48% of insurers globally for claim coding.
  • Local coding systems are used by only 14% of insurers.

• Pandemic Impact:

  • Non-urgent surgeries and elective care were significantly delayed, especially between March and August 2020.
  • Telehealth became more prevalent, although its long-term integration and cost implications remain uncertain.
  • PPE costs, cleaning procedures, and increased surgical costs due to reduced procedures are expected to influence future costs.

• Coverage Gaps:

  • Alcoholism, drug use, and HIV/AIDS are commonly excluded from group policies.
  • Group policies for less than 50 employees are more likely to exclude preexisting conditions.

Key Information

• Projected Cost Increases:

  • Asia Pacific: 8.5%
  • Europe: 5.76%
  • Latin America: 13.63%
  • Middle East and Africa: 10.01%
  • North America: 7.13%
  • U.S.: Expected to remain stable at 7.3% in 2021.

• Telehealth:

  • 50% of insurers globally offer telehealth across all plans.
  • It is expected to become a long-term solution for healthcare access and cost management.
  • Mental health and virtual solutions are key priorities for employers.

• Claim Frequency and Cost:

  • Gastrointestinal conditions (40%) and cancer (48%) are among the top three conditions causing the highest incidence of claims.
  • Mental health conditions are predicted to be among the top three most expensive conditions in 18 months.

• Country-Specific Insights:

  • China: Continued increase in medical costs for treatments outside social security coverage.
  • Hong Kong: Low utilization and recession forecast drive trend decline.
  • India: Mixed impact with lower claim frequency and rising procedure costs.
  • Indonesia: Utilization of BPJS Kesehatan helps stabilize trend.
  • Malaysia: Trend decreased in 2020 due to lockdown, but is expected to rise in 2021.
  • Philippines: HMO model dominates, with increased fees for services.
  • Singapore: Conservative trend rates due to delayed procedures and employer focus on wellbeing.
  • France: Negative trend in 2020 due to lockdown, expected to rebound in 2021.
  • Norway: Trend continues to increase due to more expensive treatments and psychological services.
  • Portugal: Negative trend in 2020, expected to return to 2019 levels in 2021.
  • Turkey: Weak currency and inflation impact medical costs.
  • U.K.: Trend continues to increase despite pandemic impact, due to aging population and demand for private care.
  • Venezuela: Excluded from regional totals due to hyperinflation.

Conclusion

The report underscores the short-term impact of the pandemic on medical trends and costs, with a rebound expected in 2021 due to catch-up on delayed procedures. Telehealth is becoming a permanent part of the healthcare landscape, while mental health is anticipated to be a growing cost driver. Regional disparities are evident, with Latin America experiencing the highest increases, and Asia Pacific showing a moderate rise. The long-term outlook suggests a continued acceleration in medical costs, requiring strategic cost management and policy adjustments to address these challenges.