employer-provided healthcare

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Employers need to work on their mental health support & coverage, medical claims experience, education on the prevention of chronic diseases, and access to medical & health plans and facilities.

As the pandemic continues to disrupt day-to-day life globally, access to mental health care is critical for a healthy and productive workforce. Asia insurers, however, continue to lag behind their global counterparts in terms of mental health support, according to Mercer Marsh Benefits’ (MMB) Health Trends Report.

The health trends report revealed that one in two employees in Asia say they highly value insurance coverage for mental health, yet only a small number (1%) of insurers in Asia regard mental health provision as a key priority.

To put it into perspective, seven out of 10 European and Latin American insurers offer mental health counselling, compared to just one in three (34%) insurers in Asia. Likewise, one in three insurers in Asia (compared to 26% globally) do not provide plans that cover mental health services.

Beyond that, insurers in Asia also fall behind in mental health coverage for outpatient treatment (36%) and preventative measures (21%), compared with the global average of 43% and 28% respectively.

Joan Collar, Managing Director, Asia Regional Leader, MMB said: "Companies should make establishing or reviewing their mental wellbeing strategy a top priority in 2022. This is an opportunity for employers to reinvent their programmes, identify gaps, address employee preferences, and cover needs across the entire spectrum of mental health conditions".

Medical trend rates

The report also discovered that medical trend rates — defined as the year-over-year cost increase for claims under a medical scheme on a per-person basis — rebounded in 2021 from the 2020 lows caused by the pandemic.

This trend is expected to continue, with the global rate forecasted to be 9.5% in 2022. In Asia, medical trend rates rebounded from 3.5% in 2020 to 8.8% in 2021, and are expected to hit 10% — four times the equivalent general inflation rate of 2.3% — this year which remains below pre-pandemic levels. This, cited in the report, could be a reflection of uneven utilisation patterns, with many people not being able to access medical services due to COVID-19 related restrictions across the region.

Further, more than half (53%) of the insurers in Asia reported lower medical claims activity than pre-pandemic levels, in contrast to other regions which observed higher claims activity than before the pandemic. Amid persistent COVID-19 uncertainty in Asia, it is no surprise that close to a third (29%) of these insurers remain cautious about when medical claims will return to normal.

A full return to normal usage of health services no doubt depends on how the pandemic evolves; and while medical utilisation is not at pre-pandemic levels, Collar noted that the costs to support them have "unfortunately soared".

As such, employers and individuals are advised to run periodic health checks on their benefits and claims experience, as well as to ensure sustainability in their medical & health programmes.

What employers can do:

  1. Plan for medical trend rates to return to pre-pandemic levels, but remain agile in the face of volatile claims and new variants, and if the pandemic is protracted;
  2. Review medical plan claims experience regularly to get ahead of changing claims activity, and
  3. Update cost containment strategies to balance economics with empathy and to position benefits as an investment, not an expense.

Medical claims experience

Globally and in Asia, COVID-19 is now the third-highest cause of claims in Asia by both dollar amount (36%) and frequency (34%). However, analysts shared that it "may not reflect the true cost" as insurers struggled to capture data about a condition that was unknown before 2019.

Insurers identified COVID-19 and emotional or mental risk as top influencers of employer-provided medical plan costs, and four in five surveyed expect to cover inpatient COVID-19 care in 2022. However, almost half of the insurers in Asia (47%) have made changes, or are considering invoking pre-existing condition limitations relating to long-term effects of COVID-19. Dissecting the results further, one in three (33%) are considering new long COVID exclusions, while more than one in 10 (11%) have already made policy changes to add future pandemic-related exclusions.

What employers can do:

  1. Monitor coverage for new COVID-19 prevention and treatment regimens, such as new medications, to understand employee access;
  2. Develop a mental health strategy for the workforce that not only looks at supporting those off sick, but also enhances overall wellbeing, and
  3. Review, monitor, and influence changes to policy language.

Mitigate health risks

Non-communicable diseases (NCDs), based on the report, are the leading cause of mortality globally. In Southeast Asia alone, such diseases account for an estimated 62% of all deaths. The report further revealed that cancer (55%), diseases of the circulatory system (43%), and COVID-19 (36%) were top cost drivers of medical claims, while respiratory diseases (47%), gastrointestinal diseases (36%) and COVID-19 (34%) are healthcare conditions that experienced the most frequent claims.

To combat these chronic diseases, employers can explore how to embed self-care products into benefit plans.

If we look at the numbers, one in three insurers in Asia (34%) are already considering covering or providing home testing kits for common conditions, such as blood tests for diabetes, and one in five (18%) now offer or cover the cost of wearable technology, to help self-manage wellbeing, an increase from 9% last year.

"HR teams can make a difference by running communication campaigns to educate about the risk of delaying preventive care, listening to employees to better understand what their unmet needs are, and exploring opportunities to embed self-care and digital health into benefit plans," Collar shared.

What employers can do:

  1. Run communication campaigns to educate about the risk of delaying preventive care;
  2. Listen to employees to better understand which of their unmet needs are of greatest concern, and
  3. Explore opportunities to embed self-care and digital health into the benefit plans.

Health equity

On top of that, the report revealed that insurers are making changes to facilitate the design of more inclusive medical plans.

A third (34%) of insurers in Asia have made changes to ensure there is diversity among the medical providers within their networks, so individuals can choose to see a doctor who shares their ethnic background and gender. At the same time, over half (54%) of insurers are either adding or considering adding eligible expenses that make coverages more inclusive for women. On a global level, over a quarter (27%) have changed eligibility access to make coverage more inclusive of LGBTQ+ employees. This includes measures such as allowing partners of the same gender to be named on medical plans.

That said, it is important to note that employers have the latitude to design their benefits to meet their needs. 

What employers can do:

  1. As part of the ongoing vendor management activities, have ESG conversations with insurers and understand what they are doing in the field;
  2. Determine to what extent you'd like the benefits to align to diversity, equity, and inclusion goals, and refine the benefits strategy accordingly, and
  3. Continue to advocate better collection and sharing of data to allow anonymised and aggregated identification of workforce health trends, including coding for social factors that influence health and wellbeing.

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The survey involved 210 insurers across 59 countries, including Singapore, Malaysia, Indonesia, Thailand, India, Hong Kong, and Vietnam.


Image / Provided

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