Medical data trends, observations, and outlook for the future

In partnership with Generli Employee Benefits Network, platinum sponsors at this year's Global Benefits Forum. Daniela's session is available to watch on-demand - click here to access the recording and hear her speak further on this topic at the forum back in June 2023 (opens a new window).

Over the past few years we have worked closely with Employee Benefit (EB) and Risk Managers to help them more quickly address changing needs and emerging trends and better plan and prepare for the future with an ever-changing healthcare landscape.

Now that the acute phase of the COVID pandemic has ended, we are able to study longer-term data trends that are impacting current and (potentially) future claims experience. Identifying and understanding these trends can help EB managers consider benefit program modifications to improve access to appropriate care, implement data-driven health and wellbeing programmes, and manage costs over the near and longer term.

Key trends and observations

Some of the key trends we’ve observed across our portfolio data over the past few years include:

Use of digital health services/remote care: One of the most significant trends during the pandemic was the rapid adoption of telemedicine services. Many routine doctor visits moved to virtual platforms due to the ease of better access and availability of care, with members receiving services from the comfort and safety of their home environment. Utilisation of digital mental health services also increased during this time, as well as use of apps designed to support remote patient monitoring.

Increased utilisation of Mental health services: The pandemic drove an increase in stress, anxiety, depression, and other mental illnesses. This led to increased demand for mental health benefits and services, including Employee Assistance Programs (EAPs) and mental health apps.

Increased claims for Musculoskeletal services: With many people working from home with ergonomically inadequate workstations, reduced access to fitness/gym services, and reduced participation in the external environment in general (specifically during lockdown periods), we saw an increased need for musculoskeletal services. In addition, we observed a shift from lower cost MSK physiotherapy claims to higher cost inpatient and outpatient surgery claims as well as emergency treatments.

Deferred/Delayed Care: Many people delayed or deferred non-urgent (i.e. scheduled) medical procedures including important diagnostic testing during the pandemic period (especially cancer screenings). This potentially led to worsening of undiagnosed or unaddressed conditions, with more significant claims costs when treatment was received at a later stage.

The impact of these trends on captives and EB programs could be significant and may result in increasing Medical, Disability and Life Insurance claims over time.

Additional risk factors on the horizon

Additional risk factors include the ongoing impact of high inflationary environments on medical plan costs. Across the globe, countries have been experiencing significant price increases in every sector, including healthcare. While inflationary pressure has come down in some areas, anecdotal evidence from our local Network Partners suggests that hospitals and other healthcare providers are still raising fees which will inevitably increase medical claims costs. For EB and Captive managers, plan designs that include cost containment measures (such as capped benefit limits and contracted/discounted provider arrangements) can help to manage rising costs.

Another significant near/long term concern is the impact of Long Covid.Patients with Long COVID may experience a range of health issues including fatigue, difficulty in thinking or concentrating, headaches, dizziness, heart palpitations, etc. New studies are also indicating an increased risk for developing certain chronic conditions in individuals who contracted COVID or Long COVID. While all of the potential long-range impacts of COVID are not yet known, they are likely to touch on several different disease categories, and even contribute to the development or worsening of chronic conditions. This may also impact several lines of risk in EB programmes.

As we transition into a post-pandemic world, it will be important for insurers and employers to understand the drivers of claims costs through data analysis. With this information organisations can take several action steps to address key cost drivers and manage the overall health of their employee populations.

Cost and care management strategies may include:

  • the introduction of wellness programs

  • employee education on their responsibility for maintaining and managing their overall health, including the importance of behavioural change

  • the education of C-suite and line managers on their duty of care to create and foster a healthy working environment

  • the introduction and/or enhancement of digital health services including remote counselling, telemedicine, second medical opinion, remote physio etc.

  • the enhancements of benefit design to better support access to mental health services;

  • the initiation of a cross-department approach for strategic planning of benefits design and the introduction of new health programs and services.

These actions can help control claims costs and support a healthier, more productive workforce.

Interested in hearing more on this topic? Watch Daniela Masters speaking at this year's Lockton Global Benefits Forum in June. Click here to access your copy of this recording (opens a new window).

For further information on how Lockton People Solutions can support your business, please contact:

Stephen James Vice President

M: + 44 7557 813 430

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