2021年全球医学趋势调查报告
发布时间:2020-11-21 来源: 工作总结 点击： 
G iv en
tha t
2 0 2 0
w as an
e x tr aordinar y
y ear
globally
due
to
the
pandemic,
mos t
coun tries ar e
seeing
a
decrease
in
tr end
fr om
2 0 19
to
2 0 2 0 .
S ome
coun tries
ar e
e v en
e xpecting
a nega tiv e
tr end
f or
2 0 2 0 .
About the
sur v e y
Willis
T o w ers
W a ts on
conducts
the
Global
Medic al
T r ends Surv e y
ev ery
y ear
be t w een
July and
Sep t ember .
T w o
hundr ed and
eigh ty -s ev en
leading
insur ers
r epr es en ting
7 6
coun tries participa t ed
in
our
20 21
surv e y .
Global
r esults
pr es en t ed
her e ha ve
been
weigh t ed
using
GDP
per
c apita.
The
U . S .
medical tr end
da ta
ar e
dr a wn
fr om
the
Willis
T o w ers
W a ts on
Na tional T r end
Surv e y
r es ear ch.
Figur e
1:
P ar ticipan t
pr o file
Ov er vie w
CO VID- 19
has
undoub t edly
had
a
major
impact
on
pr oject ed medical
tr ends
f or 2020
and
20 21.
Given
tha t
2020
w as an
e xtr aor dinary
y ear
globally
due
t o
the
pandemic,
mos t coun tries
ar e
s eeing
a
decr eas e
in
tr end
fr om
20 19
t o 2020 .
Some
coun tries
ar e
ev en
e xpecting
a
nega tiv e tr end
f or 2020 .
Man y
insur ers
and
emplo y ers
ar e
r eporting
a
decr easing tr end
in
claims
r a tio
in
2020 ,
as mos t
nonur gen t
tr ea tmen ts and
sur geries w er e
dela y ed
especially
be t w een
Mar ch
and
A ugus t .
In
turn,
thes e
dela y s
cr ea t ed
a
need
f or s ome priv a t e
f acilities
t o
mak e
up
f or los t
r ev enue
in
2020 .
The Willis
T o w ers
W a ts on
CO VID- 19
claims
modeler
sugges ts signific an t
vola tility
in
20 21
r esults,
which
ar e
dependen t on
the
impact
o f
CO VID- 19
and
whe ther
or no t
a
vaccine becomes
a v ailable
early
in
the
y ear ,
who
pa y s
f or it
and the
e x t en t
o f
its
a v ailability .
In
addition,
ther e
is
uncertain ty about
how
CO VID- 19
t es ting
and
tr ea tmen t
cos ts
f or 20 21 will con tinue
t o
be
split
be t w een
gov ernmen t ,
insur ers
and
emplo y ers.
F urther uncertain ty
ar ound
medical
tr end
lies
ahead
in
futur e y ears as w e
s tart
t o
s ee
the
true
impact
o f
dela y ed
tr ea tmen t in
2020
and
the
long-t erm
e ff ects
on
thos e
who
con tr act ed CO VID- 19 .
Ne v ertheless, ther e
is
a
silv er lining
her e ,
as CO VID- 19
has
gr ea tly
acceler a t ed
the
adop tion
and
us e
o f t elehealth,
which,
in
turn,
could
help
t o
o ff s e t
thos e
po t en tial
2
willis to w ers w a t son. com
higher
cos ts
and
pr ovide
a
mor e
e fficien t
w a y
f or insur eds t o
access
and
us e
health
c ar e
in
the
futur e .
It
ma y
als o ,
o f cours e ,
incr eas e
utiliza tion
due
t o
eas e
o f
access.
A sia
P acific
Ov er all,
w e
e xpect
pr ojected
global
tr end
to dr op
to
belo w
6%
in
2 0 2 0
be f or e
r ebounding back
to
abo v e
8%
f or
2 0 2 1
due
to
the
c a tch- up
on
dela y ed
tr ea tmen t ,
po ten tially
leading to
worsening
health
conditions and
some unexpected
cos t
incr eases coming
thr ough, such as those
f or
personal pr o tectiv e equipmen t
(PPE).
Figur e
2:
How
do
y ou
e xpect
the
medic al
tr end
in
y our
o v er all book
o f
busines s
to
change
o v er
the
ne x t
thr ee
y ears
compar ed to
curr en t
r a tes ?
0
Global
China .
CO VID- 19
has
no t
had
as much
impact
on
cos t
or utiliza tion
in
China
as it
has
in
o ther
coun tries.
The
cos ts
o f medical
c ar e
con tinue
t o
incr eas e
f or tr ea tmen ts,
particularly thos e
outside
the
s cope
o f
s ocial
s ecurity
cov er age .
The
cen tr al
gov ernmen t
is
planning
t o
elimina t e
the
individual medical
accoun t
and
a t
the
s ame
time
o ffer cov er age
f or outpa tien t
e xpens es
under
s ocial
s ecurity .
The
initiativ e
w as announced
in
Sep t ember
2020 ,
with
mor e
de tails
t o come
on
cov er age .
This
is
e xpect ed
t o
impact
the
cos t
o f tr ea tmen t
in
the
futur e;
how ev er ,
it
will pr obably
tak e
a
while f or the
initiativ e
t o
be
fully implemen t ed
given
the
v aria tion
in gov ernmen t
funding
a t
the
pr o vincial
le v el.
Hong
K ong.
The
lo w
utiliza tion
o f
medical
s ervices
during
the pandemic
and
the
r ecession
f or ec as t ed
b y
the
gov ernmen t ar e
the
t w o
main
driv ers
o f
the
slo w do wn
in
medical
tr end
f or
Latin
Americ a
Asia
P acific
Europe
Middle
East and
A fric a
1%
3%
1%
Significantly
lowe r
4%
1%
2%
L owe r
About
the
same
2020
and
20 21.
Demand
f or medical
t ourism fr om
mainland China
has
als o
dr opped
due
t o
the
tr a v el
r es trictions
and s ocial
unr es t
in
Hong
K ong.
Higher
Significantly
higher
54%
Global
Medic al
T r end
3
30%
63 %
37 %
71%
21 %
6%
39%
49%
11%
11%
87%
The
r egion
sho w s
a
signific an t
dr op
in
tr end
t o
6 .2 % in
2020 ,
but
this
will spring back
abo ve
the
20 19
tr end t o
a
pr oject ed
8.5 %
in
20 21.
%
20%
40%
60%
80%
100%
3%
4%
Figur e
3: G lobal
a v er age
medic al
tr end
r a tes
b y
coun tr y ,
2 0 19
– 2 0 2 1
C oun tr y
G r os s
cos t
tr end
Ne t
cos t
tr end
(o f
gener al
in flation)
2 01 9
2020
2 02 1
2 01 9
2020
2 02 1
Global^
7 .1 6
5.88
8. 12
5. 13
4. 60
6 .1 7 La tin
Americ a^
10 .83
8 .97 13. 63
5 .7 5
6. 62
11. 17
North
Americ a
5.55
2 .7 6
7 .1 3
3. 65
2. 15
5.50
A sia
P acific
7. 4 7 6 .22 8.50
5.88
5. 10
6. 78
E ur ope
5.58
4.2 4
5 .7 6
4 .0 2
3.27
4. 15
Middle
Eas t/ A fric a
8. 65
8. 66
1 0.0 1
7 .39
6 .9 4
6 .9 8
L a tin
Americ a
Ar gen tina *
56 . 99
4 7 .29
60 .50
3. 44
28.85
4 7. 7 5
Barbados
and
Eas t
Caribbean
1 0.0 0
1 0.0 0
1 0.0 0
5. 90
5.54
8.39
Br azil*
11. 96
9 .38
11.5 1
8.23
5.82
8.21
Chile*
4.88
3. 18
4 .07
2. 63
-0 . 19
1. 14
Colombia *
6 .27
6. 89
6. 92
2 .7 5
3.38
3. 71
Cos ta
Ric a *
7. 00
8. 00
9 .25 4. 90
6 .4 6
7. 00
E cuador
12. 00
12. 00
12. 00
11. 73
12. 0 1
10 .84
El
Salv ador *
7. 4 3
1 0.0 0
7. 7 1
7 .35
9. 94
7 .1 1
Gua t emala *
8. 00
8.83
11.8 0
4.30
7. 00
1 0.0 2
Hondur as *
6 .1 7 7. 9 8
9 .67 1.8 0
4.83
6. 69
Me xico *
9 .30
11.50
11. 71
5. 66
8.8 0
8. 93
Nicar agua
1 0.0 0
12. 00
15. 00
4 .6 2
7 .53
11. 04
P anama *
1 0 .67 11. 00
9 .4 0
11. 0 2
11. 91
8. 90
P eru
5. 00
6 .0 0
8. 00
2.8 6
4.29
6 .21
Puert o
Rico
5. 00
-6 . 00
18. 00
4.27
-4. 45
17 .36
T rinidad
and
T obago
1 0.0 0
1 0.0 0
1 0.0 0
9 .0 0
11. 00
8. 72
V ene zuela
85. 00
150 . 00
250 . 00
- 19821. 0 2
- 14850 . 00
- 14 7 50 . 00
Nor th
Americ a
Canada
4. 17
0 .1 3
7. 0 3
2.22
- 0.4 8
5 .7 6
Unit ed
Stat es#
7. 9 1
7. 2 4
7 .30
6 .1 0
6. 62
5. 06
A sia
P acific
A us tr alia
6 .50
6 .0 0
6 .0 0
4.8 9
4.5 7 4. 18
China *
8. 68
9 .1 0
9 .32
5 .7 8
6 .0 6
6 .7 7 Hong
K ong*
8. 16
6 . 24
6 .6 8
5.30
4.2 4
4. 18
India *
7. 8 0
12. 00
1 0.0 0
3.26
8. 66
6 .38
Indonesia*
10 .33
9 .97 12. 00
7. 5 1
7 .1 0
9 .0 6
Mala y sia *
10 . 64
10 .82
12.55
9 .97 10 . 71
9 .7 5
Ne w
Z ealand
5. 60
- 2. 00
2 0.0 0
3. 98
-3.22
18. 6 2
Philippines *
7. 7 5
8.50
8.82
5.27 6. 78
5. 94
Singapor e *
7. 6 7 7. 6 7 8. 17
7 .1 0
7 .84
7. 6 5
South K or ea
7. 00
5. 00
4. 00
6. 62
4. 73
3.55
Sri
Lank a
5. 00
5. 00
5. 00
0 .7 0
0 .34
0 .35
T aiw an *
4. 00
4. 00
4. 00
3. 46
3.50
2.50
Thailand
7. 00
7 .50
8. 00
6 .29
8.56
7. 44
Vie tnam *
12. 93
10 . 13
10 . 15
10 . 13
6 .9 3
6 .25 4
willis to w ers w a t son. com
C oun tr y
G r os s
cos t
tr end
Ne t
cos t
tr end
(o f
gener al
in flation)
2 01 9
2020
2 02 1
2 01 9
2020
2 02 1
E ur ope
B elgium
2. 00
2.50
3. 00
0 .7 5
2.25
1. 91
Cyprus 5. 00
0.0 0
1. 00
4. 44
- 0 .7 0
0.0 0
Denmark
5.50
6 .50
4.50
4 .7 7 5.8 0
3.30
F r ance
4. 17
1. 03
2.30
2.8 7 0 .7 5
1. 60
German y
5. 00
7. 00
7. 00
3. 65
6 .6 8
5.82
Gr eece
4.50
4.50
4 .7 5
3. 98
4. 96
3 . 74
Hungary
1 0.0 0
1 0.0 0
1 0.0 0
6 .6 3
6 .6 6
6 .83
Ir eland
4 .47 1. 43
8.33
3.5 9
1. 03
6 .6 3
Norw a y *
5.27 5. 99
6 .4 3
3. 10
3.5 9
4.23
P oland*
5.85
6 .50
7 .33
3.54
3.28
4 .7 5
P ortugal*
3 .7 9
- 1.83
3 .97 3. 49
- 1. 63
2 .6 2
R omania *
12. 6 2
10 .33
11.50
8 .7 9
8 .0 9
1 0.0 5
Russia
7.25 1 0.0 0
11. 00
2 .7 8
6 .9 1
8 .0 1
Serbia
7 .50
7 .50
15. 00
5. 65
6 .0 6
13. 06
Spain
2.85
1. 93
4 .7 5
2. 15
2.23
4. 10
S w eden
9 .0 0
6 .0 0
7 .50
7 .30
5.54
5 .97 S witz erland
4. 00
1.50
1. 00
3. 64
1.8 9
0.4 0
T urk e y
23.25
17 .50
16 . 00
8 .07
5.50
4. 00
Unit ed
Kingdom
5 .67 6 .33
6 .50
3.88
5. 15
4. 96
Middle
Eas t
and
A fric a
Bahr ain
7. 00
7. 00
7. 00
6 .0 0
4. 40
4.50
Burkina F as o
0 .50
15. 00
1 0.0 0
3. 73
11.8 0
7. 9 0
Camer oon *
3.50
6 .25 4. 00
1. 05
3. 45
1 .7 5
Co t e
d"Iv oir e
15. 00
15. 6 7 18.33
14. 19
14. 4 7 16 . 93
E gyp t*
12. 13
10 .88
12.33
-1 . 7 4
5.0 2
4. 10
Gabon
19 .50
21.50
25. 00
17 . 48
18.50 22. 00
Ghana
12. 17
14. 6 7 17 . 17
4. 96
5.0 1
8 .6 2
Guinea
1 0.0 0
5. 00
3. 00
0 .53
-3.50
-5. 00
Jor dan
7. 00
0.0 0
4. 00
6 .7 0
-0 .20
2. 40
Ke n y a
8.50
6 .50
9 .0 0
3.30
1. 40
4. 00
K uwait
5. 00
7 .50
1 0.0 0
3. 90
7. 00
7. 7 0
Madagas c ar
25. 00
2 0.0 0
3 0.0 0
19 .38
14.50
23.50
Mo zambique
7. 00
5. 00
5. 00
4.22
-0 . 19
-0 . 71
Nigeria
17 .33
14. 6 7 18. 6 7 5. 94
1.27
6 .30
Oman
4.50
4.50
5.50
4.3 7 3.50
2. 10
Saudi
Ar abia
1 0.0 0
1 0.0 0
12. 00
11.21
9 .1 3
1 0.04
Senegal
1 0.0 0
15. 00
15. 00
8. 98
13. 00
13. 0 8
South A fric a
6 .50
6 .0 0
6 .0 0
2.3 7 3.5 7 2.84
T ogo
5. 00
8. 00
1 0.0 0
4.31
6 .0 0
8. 00
Uganda
2 0.0 0
1 0.0 0
15. 00
17 . 13
6 .0 6
10 . 15
Unit ed
Ar ab
Emir a t es
9 .0 0
8. 00
8. 00
10 . 93
9 .0 0
6 .50
Z ambia
15. 00
2 0.0 0
25. 00
5.20
6 .6 0
12. 95
* Coun tries
with
signific an t
(5+)
participa tion.
^Due
t o
the
h yperin fla tionary
na tur e
o f
the
V ene zuelan
econom y ,
V ene zuela
has
been
e x cluded
fr om
La tin
Americ a
r egional
and
global
t o tals.
#Unit ed
Sta t es
da ta
is
fr om
v arious y ears o f
the
Willis
T o w ers
W a ts on
Na tional
T r end
Surv e y .
Global
Medic al
T r end
5
A sia
P acific
( con tin u ed)
India .
India
has
no t
s een
the
s ame
r eduction
in
tr end
as o ther coun tries
ha ve
f or 2020 .
While
utiliza tion
decr eas ed
during part
o f
the
y ear
(April
t o
July ),
India
is
curr en tly
in
a
situa tion with
lo w
claim
fr equency
and
a v er age
cos t
o f
pr ocedur es incr easing
( due
t o
the
cos t
impact
o f
CO VID- 19
pr ec autions on
non-CO VID- 19
claims).
A t
the
s ame
time ,
the
tr ea tmen t and
pricing
pr o t ocol
o f
medical
c ar e
is
no t
r egula t ed
in
India, and
hospital
billing
pr actices
con tinue
t o
pos e
a
challenge .
The
gov ernmen t
did,
how ev er ,
tak e
s ome
small
measur es t o
issue
guidelines
ar ound
pricing
f or CO VID- 19
t es ts
and
tr ea tmen ts,
which
helped
with
cos t
managemen t
t o
an
e x t en t .
The
y ear
20 21
could
s ee
an
incr eas ed
r a t e
o f
tr end,
higher than
pr o visionally
r eport ed,
as utiliza tion
s tarts
t o
r e turn t o
normal
le v els;
how ev er ,
w e
als o
ma y
s ee
an
incr eas ed a w ar eness
in
the
ar eas
o f
pr ev en tion
and
w ellbeing,
and a
rising
tr end
in
f a v or o f
home
c ar e
r a ther
than
immedia t e hospitalization
f or medical
tr ea tmen ts,
which
could
help mitiga t e
a
lar ger
po t en tial
incr eas e .
Indonesia .
Medic al
tr end
r a t es
in
Indonesia
ar e
pr oject ed
t o be
sligh tly
lo w er in
2020 ,
no t
only
bec aus e
o f
the
impact
o f CO VID- 19
on
r educed
electiv e
pr ocedur es
but
als o
due
t o v arious o ther
f act ors,
including
the
incr eas ed
utiliza tion
o f BP JS
K es eha tan
( univ ers al
health
insur ance)
especially
f or chr onic / critic al
illness es
and
ongoing
cos tly
tr ea tmen ts.
This allow s
insur ers
t o
split
their
risk
with
the
gov ernmen t
and
will help
s tabiliz e
futur e
medical
tr end
r a t es. The
BP JS
K es eha tan als o
pr o vides
cov er age
o f
all
medical
tr ea tmen ts
r ela t ed
t o CO VID- 19 ,
which
helps
t o
s tabiliz e
the
tr end
r a t es
despit e
the e xpect ed
con tinued
demand
f or priv a t e
health
c ar e .
Mala y sia .
Medic al
tr end
in
Mala y sia
is
e xpect ed
t o
con tinue its
ris e
albeit
a t
a
slo w er pace
compar ed
with
pr e vious y ears.
F or 2020 ,
the
number
o f
doct or visits
and
admissions dr opped
signific an tly
during
Mar ch
and
April
due
t o
the
gov ernmen t -impos ed
lock do wn
(MCO),
which
has
c aus ed
the o v er all
tr end
t o
decr eas e .
During
this
period,
man y
electiv e sur geries w er e
pos tponed.
F or outpa tien t
c ar e ,
ther e
has been
a
big
dr op
in
specialis t
c ar e
visits;
a t
the
primary
c ar e le v el,
ther e
has
been
a
dr op
in
less
acute
visits,
with
pa tien ts turning
t o
t elemedicine .
F or pa tien ts
with
chr onic
conditions, the
le v el
o f
visits
has
been
lar gely
main tained,
as thes e
ar e gener ally
“una voidable .”
All o f
this
means
tha t
ther e
is
a
paus e
in
2020
tr end compar ed
with
20 19 ,
but
an
up tick
is
e xpect ed
in
Q4 2020 and
in
20 21
t o
c a t ch
up
on
dela y ed
pr ocedur es.
6
willis to w ers w a t son. com
Medic al
tr end
in
E ur ope
has
decr eas ed
t o
4.2 %
f or 2020 ,
but
a
r ebound
is
e xpect ed
in
20 21
t o
a
tr end r a t e
clos e
t o
the
20 19
le v el
o f
5.8%.
Philippines .
Priv a t e
medical
c ar e
in
the
Philippines
is
lar gely domina t ed
b y
an
HMO
model,
which
accoun ts
f or 8 0%
o f plans.
While
the
fr equency
o f
inpa tien t
and
outpa tien t
claims has
de finit ely
decr eas ed
in
2020 ,
the
a v er age
amoun ts
per inpa tien t
and
outpa tien t
claims
ar e
rising.
In
addition,
v arious ph ysician
or ganiza tions
nego tia t ed
with
HMO
ass ocia tions and
w er e
gr an t ed
a
50%
incr eas e
in
f ees
commencing
Ma y 27 ,
2020 ,
os t ensibly
t o
cov er the
cos t
o f
PPE .
This
cos t incr eas e
is
e xpect ed
t o
r emain
in
place
f or the
dur a tion
o f
the pandemic.
Ph ysician
f ees
ar e
r oughly
30%
o f
t o tal
spend.
Ov er all
this
helps
e xplain
wh y
tr end
r a t es
in
the
Philippines ha ve
edged
up
f or 2020
t o
8.5 %
fr om
7 .8%
in
20 19
and
ar e pr oject ed
t o
con tinue
incr easing
f or 20 21,
although
con tinued dela y
in
tr ea tmen t
in
2020
could
mean
an
ev en
lar ger incr eas e
in
20 21
than
pr oject ed.
Singapor e.
Insur ers
ha ve
tak en
quit e
a
conserv a tiv e
vie w
on medical
in fla tion
f or 2020
and
20 21,
mainly
due
t o
dela y ed electiv e
sur gic al
pr ocedur es
and
an
emplo y er f ocus
on men tal
health,
wellbeing
and
virtual
s olutions.
Ov er all
tr end
is s till
ho v ering
in
the
7 %
t o
8%
r ange
f or 2020
and
20 21.
W ellbeing
s olutions
include
ensuring
emplo y ees
ar e
able t o
w ork
e ff ectiv ely
fr om
home ,
and
quality
t elehealth
has become
one
o f
the
k e y
priorities
tha t
emplo y ers
ar e
k een t o
in tr oduce
t o
their
w ork -fr om-home
emplo yees.
Some medical
pr o viders ar e
o ff ering
home
health
s cr eenings
and v accina tions
t o
emplo y ees
as w ell
as their
dependen ts.
E ur ope
F r ance.
A
signific an t
dr op
in
utiliza tion
and
medical
claims
in
2020
c an
be
a t tribut ed
t o
the
April
lock do wn
period. Although
utiliza tion
has
s tart ed
t o
ris e
again,
o v er all
w e e xpect
a
r eduction
o f
5 %
in
medical
claims
b y
the
end
o f 2020 .
This
is
r e flect ed
in
the
decr eas e
in
medical
tr end
fr om 4.2 %
in
20 19
t o
1%
in
2020 .
Ne v ertheless, insur ers
pr oject tha t
this
r a t e
will s tart
t o
incr eas e
in
20 21,
rising
t o
2.3%.
Utiliza tion
is
e xpect ed
t o
ris e
in
20 21
due
t o
the
impact
o f dela y ed
s ervices
and
pr ocedur es
in
2020 .
In
addition,
o ther f act ors
ar e
po t en tially
driving
an
incr eas e
in
20 21
medical tr end,
including
the
in tr oduction
o f
a
CO VID- 19
tax,
which
the
gov ernmen t
has
decided
insur ers
should
pa y
as a
ne w additional
tax.
This
tax
o f
2. 6%
f or 2020
and
1.3%
f or 20 21
is bas ed
on
claims
paid
in
thes e
t w o
y ears.
W e
e xpect
insur ers will w an t
emplo y ers
t o
finance
this
tax,
which
could
lead
t o further pr emium
incr eas es
in
20 21.
Ther e
is
als o
the
impact
o f
“portability ,”
which
allow s
dismiss ed
emplo y ees
t o
main tain their
medical
cov er age
f or 12
mon ths
af t er lea ving
a
compan y . This
is
a
legal
arr angemen t
financed
b y
activ e
w orkers,
which could
lead
t o
incr eas ed
con tributions.
Las tly
the
s o-c alled “ 100%
San t é ”
legal
change
( elimina ting
out -o f -pock e t
cos ts f or den tal,
op tic al
and
audit ory c ar e)
w as implemen t ed
on January
1,
2020 ,
and
will be
deplo y ed
within
the
ne x t
s ev er al mon ths
f or hearing
aids.
This
will lead
t o
an
incr eas e
in
claim r eimburs emen t
and
a
po t en tial
incr eas e
in
tr end.
Nor w a y .
Medic al
tr end
in
Norw a y
con tinues t o
edge
up w ar d f or 2020
and
20 21.
In
part ,
this
is
driv en
b y
us e
o f
mor e e xpensiv e
tr ea tmen ts
and
o v erus e
o f
c ar e .
Otherwis e
w e s ee
a
rising
us e
o f
ps y chologic al
s ervices
with
the
incr easing a w ar eness
o f
men tal
and
beha vior al
health
conditions.
Ho w ev er ,
ther e
is
hope
tha t
the
gr o wing
us e
o f
digital s olutions
and
online
s ervices
will help
mitiga t e
s ome
o f
the futur e
incr eas e
in
tr end.
In
addition,
s ome
o f
the
insur ers
in the
Norw egian
mark e t
ar e
considering
o ff ering
diff er en tia t ed pr oducts
t o
diff er en t
age
gr oups
t o
mee t
the
challenge
o f o v erus e
o f
s ervices
in
certain
age
gr oups.
P or tugal.
Ther e
is
a
signific an t
dr op
in
utiliza tion
in
P ortugal driv en
b y
CO VID- 19 ,
with
a
lar ge
majority
o f
the
cov er ed popula tion
de f erring
doct or consulta tions, tr ea tmen ts
and e x ams.
This
is
r esulting
in
a
nega tiv e
tr end
r a t e
in
2020 .
Ne v ertheless, medical
tr end
is
e xpect ed
t o
r e turn t o
20 19 le v els
in
20 21,
as cov er ed
emplo y ees
r es chedule
dela y ed pr ocedur es
and
tr ea tmen ts.
The
po t en tial
e xis ts
f or health complic a tions
and
incr eas ed
cos ts
in
futur e
y ears due
t o
the dela y ed
tr ea tmen ts
and
ther apies.
T urk e y .
A side
fr om
the
impact
o f
CO VID- 19 ,
the
loc al curr ency
r emains
w eak .
E conomic
indic a t ors
pr edict con tinued
incr eas e
in
gener al
in fla tion
and
fluctua tion
in curr ency
r a t es. This
has
a
dir ect
e ff ect
on
medical
s ervices pricing
and
could
mean
the
actual
tr end
is
higher
than
wha t
is being
r eport ed.
Global
Medic al
T r end
7
This
r egion
has
the
highes t
medical
tr end
numbers f or 2020
and
20 21.
E v en
e x cluding
the
en vir onmen t o f
h yperin fla tion
in
V ene zuela,
w e
s ee
pr oject ed
tr end numbers
o f
9 . 0%
f or 2020
and
a
lar ge
jump
t o
13. 6% in
20 21.
T elemedicine
f or outpa tien t
c ar e
w as implemen t ed
b y a
f e w
big
insur ers
during
the
pandemic.
CO VID- 19
w as initially
e x cluded
fr om
health
insur ance
policies;
how ev er , af t er the
gov ernmen t
declar ed
the
priv a t e
hospitals as pandemic
hospitals in
April
and
insur ers
made
the
decision t o
cov er CO VID- 19
tr ea tmen ts
a t
priv a t e
hospitals ( as a complemen tary
cov er age
t o
s ocial
s ecurity ),
T urkish
citiz ens with
priv a t e
health
insur ance
policies
s tart ed
using
the
priv a t e hospitals f or tr ea tmen t .
A s
o f
July 2020 ,
the
gov ernmen t
has now
paus ed
the
us e
o f
priv a t e
f acilities
in
this
w a y ;
how ev er ,
it
is
e xpect ed
tha t
the
gov ernmen t
ma y
r eimplemen t
this appr oach.
With
pr o fit -sharing
in
place ,
man y
clien ts
could
r eceive dividends
or e xperience
r a ting
r e funds
f or the
2020
policy y ear .
Some
insur eds
ar e
looking
t o
add
additional
bene fits
lik e limit ed
ps y chologic al
ther ap y
s essions
or die tician
s ervices; how ev er ,
thes e
additions
will need
t o
be
balanced
agains t po t en tial
utiliza tion
incr eas es
in
20 21.
U .K .
Medic al
tr end
in
the
U .K .
con tinues t o
edge
up w ar d despit e
the
impact
o f
CO VID- 19
in
2020 .
Con tributing
f act ors include
a
ma turing
insur ed
demogr aphic
and
aging
w orkf or ce as w ell
as incr eas ed
demand
f or priv a t e
health
c ar e
as a r esult
o f
challenges
with
accessing
the
na tional
health
s ervice (NHS).
In
addition,
w e
ar e
s eeing
the
impact
o f
high-cos t tr ea tmen ts,
such
as ne w
gener a tion
c ancer
drug
ther apies and
wider
a v ailability
o f
mor e
comple x
medical
tr ea tmen ts.
The
impact
o f
CO VID- 19
on
bo th
c apacity
and
demand
in 2020
and
the
an ticipa t ed
c a t ch-up
in
20 21
r emain
unclear . It
is
e xpect ed
tha t
con tinued
pos tponemen t
o f
nonur gen t tr ea tmen ts
and
gr o wing
waiting
lis ts
ar e
possible in
the NHS ,
r esulting
in
incr eas ed
utiliza tion
o f
priv a t e
health
c ar e pr o viders and
plans.
A dditional
CO VID- 19
cos ts
s till
t o
be
consider ed
include
PPE
cos ts,
additional
cleaning
pr ocedur es and
higher
sur gic al
cos ts
per
tr ea tmen t
t o
o ff s e t
the
r educed number
o f
pr ocedur es
perf ormed
in
2020 .
L a tin
Americ a
Ar gen tina .
High
in fla tion
con tinues t o
be
one
o f
the
k e y f act ors
driving
medical
tr end
in
Ar gen tina.
In
addition,
the de valua tion
o f
the
Ar gen tine
curr ency
agains t
the
U . S .
dollar and
health
c ar e
s alary
gr o w th
ar e
t w o
o ther
f act ors
tha t
ha ve had
a
mark ed
impact
on
the
incr eas e
in
medical
cos ts
during the
pas t
f e w
y ears.
The
es tima t ed
2020
medical
tr end
is
lo w er than
20 19 and
pr oject ed
20 21,
r e flecting
the
impact
o f
CO VID- 19
on utiliza tion
in
2020
as w ell
as the
slo wing
o f
s ome
o f
the health
c ar e
s alary
incr eas es
due
t o
economic
challenges in
2020 .
Br azil. Similar
t o
o ther
coun tries,
ther e
w as a
signific an t r eduction
in
the
utiliza tion
o f
health
r es ources
in
2020
due
t o CO VID- 19 ,
i. e .,
f e w er electiv e
appoin tmen ts
and
emer gency r oom
visits,
ther apies,
e x ams
and
hospitaliza tions. This
r esults in
a
single-digit
tr end
number
o f
9 . 4 %
f or 2020 ,
s ome thing tha t
has
no t
been
s een
in
a
long
while
in
Br azil.
Insur ers
ha ve
been
r equir ed
b y
the
ANS
(Health
Na tional
A gency )
t o cov er cos ts
r ela t ed
t o
CO VID- 19
and
t o
apply
a
fr ee z e
t o
an y pr emium
adjus tmen ts
fr om
Sep t ember
2020
un til
the
end
o f
2020 .
It
is
pr oject ed
tha t
the
tr end
will r e turn t o
double
digits in 20 21
as demand
and
utiliza tion
incr eas e;
how ev er ,
the
r a t e
o f tr end
is
no t
e xpect ed
t o
r each
the
s ame
le v els
as prior y ears
8
willis to w ers w a t son. com
This
r egion
w as the
only
one
no t
t o
sho w
a
major decr eas e
in
medical
tr end
f or 2020
compar ed
with
20 19 . The
tr end
f or 2020
is
e xpect ed
t o
be
8.7 %,
the
s ame
as f or 20 19 .
F or 20 21
w e
e xpect
an
incr eas e
t o
10%.
due
t o
s ev er al
f act ors.
One
f act or is
the
economic
r ecession and
ano ther
is
the
in tr oduction
o f
t elehealth.
Appr o v ed
as a t empor ary
pr o vision this
y ear ,
t elehealth
is
e xpect ed
t o
be made
permanen t
and
impr o ve
utiliza tion
and
access
f or s ome while
helping
manage
cos ts.
One
o ther
f act or is
tha t
the
ANS will be
r e vie wing
the
minimum
obliga t ory cov er ages
in
medical plans,
which
ma y
impact
tr end.
Chile.
The
incr eas e
in
health
c ar e
cos ts
f or 20 21
is
pr oject ed a t
4. 1%.
This
r epr es en ts
a
lo w er tr end
than
tha t
obs erv ed
in 20 19
( 4. 9%)
and
higher
than
the
2020
tr end
wher e
medical cos ts
ha ve
been
signific an tly
aff ect ed
b y
the
CO VID- 19 pandemic.
F or 2020 ,
f ace-t o-f ace
medical
and
den tal
consulta tions
ha ve
decr eas ed,
with
a
50%
dr op
in
the
fr equency
o f
thes e activities
compar ed
with
the
s ame
period
in
20 19 .
A dditionally , certain
lo w -risk
hospital
pr ocedur es
w er e
pos tponed, especially
in
the
firs t
mon ths
o f
the
pandemic.
Mor eov er , t elehealth
s ervices
and
online
men tal
health
s ervices
ha ve
incr eas ed.
Ho w ev er ,
f or 20 21,
it
is
e xpect ed
tha t
the
incr eas e
in
medical cos ts
will r e turn t o
20 19
le v els. This
r e flects the
an ticipa t ed impact
o f
adv ances
in
medical
t echnology
and,
in
particular , the
e xpect ed
pr o vision o f
an
e ff ectiv e
vaccine
agains t CO VID- 19 .
Me xico .
Me xico
has
no t
y e t
s een
the
full
e ff ect
o f
CO VID- 19 on
medical
tr end.
This
ma y
come
in
the
firs t
mon ths
o f
20 21. Ov er all,
the
medical
tr end
r a t e
is
s till
pr oject ed
t o
incr eas e in
2020
compar ed
with
20 19 .
The
number
o f
pa tien ts
using hospital
s ervices
has
decr eas ed
sligh tly
in
20 20;
how ev er , the
depr ecia tion
o f
the
Me xic an
pes o
v ersus
the
U . S .
dollar signific an tly
aff ect ed
cos ts
o f
import ed
medical
de vices
and hospital
supplies,
which
con tinue
t o
driv e
tr end.
In
addition,
demand
f or priv a t e
health
c ar e
r emains
high, particularly
as the
public
health
s y s t em
has
been
besieged
b y CO VID- 19
c as es
and
als o
bec aus e
o f
a
shortage
o f
medicines in
the
public
s ect or .
A gr eemen ts
ha ve
been
made
t o
allow s ome
pa tien ts
fr om
the
public
s y s t em
t o
r eceive
medical a tt en tion
in
priv a t e
hospitals due
t o
the
lack
o f
a v ailable
beds in
public
hospitals.
A s
a
r esult ,
cos ts
and
tr end
in
the
priv a t e health
s ect or con tinue
t o
incr eas e
and
ar e
e xpect ed
t o
ris e
t o double
digits in
2020
and
20 21.
Middle
Eas t
and
A fric a
E gyp t .
E gyp t’ s
tr end
r emains
in
the
double
digits.
While 2020
sho w s
a
slight
r eduction
in
tr end
compar ed
with
20 19 , it
is
no t
as lar ge
as tha t
o f
s ome
o ther
coun tries
tha t
ar e s eeing
a
decr eas e
in
tr end
due
t o
the
impact
o f
CO VID- 19 . The
E gyp tian
gov ernmen t
has
es tablished
a
fund
t o
cov er CO VID- 19 ,
which
limits
the
e ff ects
o f
the
pandemic
on
medical tr end.
Ins t ead,
gener al
in fla tion
con tinues t o
be
the
major f act or driving
medical
tr end.
While
the
economic
situa tion
is s tabilizing,
it
is
s till
pr oject ed
tha t
tr end
will r e turn t o
a
r a t e
in e x cess
o f
12 %
f or 20 21.
Gulf
coun tries
(Gulf
C ooper a tion
C ouncil
coun tries : B ahr ain,
K uw ait ,
Oman,
Saudi
Ar abia ,
United
Ar ab Emir a tes).
While
medical
tr end
in
the
Gulf
coun tries
has decr eas ed,
w e
e xpect
t o
s ee
a
gr ea t er impact
fr om
CO VID- 19 due
t o
suspension o f
electiv e
sur geries in
2020 ,
f ollo w ed
b y
a
higher
r ebound
in
20 21,
particularly
in
the
Kingdom
o f Saudi
Ar abia
(K S A)
and
Bahr ain.
W e
do
e xpect
an
incr eas e
in hospital
unit
cos ts
in
20 21
due
t o
CO VID- 19
e xpens es
r ela t ed t o
PPE
supplies,
ne w
pr ocedur es
and
the
need
t o
oper a t e
a t
lo w er c apacity
as a
r esult
o f
s ocial
dis tancing.
The
us e o f
t elehealth
has
incr eas ed
in
the
r egion,
which
ma y
help
t o o ff s e t
s ome
o f
the
unit
cos t
incr eas es.
Other
f act ors
t o
consider
going
f orw ar d
include
whe ther or no t
the
gov ernmen ts
will absorb
the
cos t
o f
CO VID- 19 s cr eening,
diagnosis,
tr ea tmen t
and
v accines.
The
U . A .E . gov ernmen t
had
initially
abs orbed
the
cos t
o f
CO VID- 19
tr ea tmen t ,
but
in
s ome
c ases, it
is
now
passing
this
cos t
on
t o insur ers,
whereas
the
K S A
gov ernmen t
is
curr en tly
abs orbing all
tr ea tmen t
cos ts.
Other
signific an t
legislativ e
initiativ es
t o w a t ch
include
the
de tails
and
timing
o f
the
planned
launch
o f manda t ory medical
insur ance
in
Bahr ain
and
Oman
as w ell
as the
lik ely
con tinued
ev olution
o f
manda t ory medical
insur ance in
the
U . A .E .
( specific ally
in
Abu
Dhabi
and
Dubai
with
the possible addition
o f
o ther
Emir a t es)
and
K S A .
Finally ,
ther e
is the
e xpect ed
legislation
in
K S A
on
the
dispensing
o f
generic
drugs.
Global
Medic al
T r end
9
A fric a
— Anglophone
coun tries .
B ec aus e
Nigeria
and
Ghana ha ve
fluctua ting
curr encies
and
do
import
medical
supplies or drugs,
w e
s ee
a
tr end
driv en
lar gely
b y
gener al
in fla tion
and utiliza tion
changes.
F or Nigeria
and
K en y a,
w e
ar e
s eeing
a utiliza tion
decr eas e
in
2020
due
t o
CO VID- 19 ,
which
driv es medical
tr end
do wn
fr om
20 19
le v els. But
tr end
r ebounds
t o ev en
higher
le v els
in
20 21:
18. 7 %
in
Nigeria
and
9%
in
K en y a. Ghana
does
no t
sho w
the
s ame
decr eas e
in
medical
tr end
f or 2020
but
r a ther
a
con tinued
incr eas e
fr om
20 19
t o
20 21.
W e ha ve
als o
s een
an
acceler a tion
in
us e
o f
t elehealth
in
Ghana, Nigeria
and
Uganda
in
2020 .
It
is
s till
early
da y s
f or t elehealth in
thes e
coun tries,
but
w e
e xpect
t o
s ee
mor e
and
mor e o fferings and
pr o viders.
A fric a
— F r ancophone
coun tries .
In
the
F r ancophone coun tries
(Camer oon,
Cô t e
d’Iv oir e ,
Gabon,
Guinea, Madagas c ar ,
Senegal
and
T ogo )
w e
don ’t
y e t
obs erv e widespr ead
us e
o f
t elehealth.
Nor ha ve
w e
s een
the
s ame le v el
o f
r eduction
in
tr end
f or 2020
in
thes e
coun tries
as in
s ome
o ther
A fric an
coun tries.
Camer oon,
Cô t e
d’Iv oir e , Gabon
and
Senegal
sho w
incr eas es
in
medical
tr end
fr om 20 19
t o
2020 .
In
Camer oon
medical
tr end
is
slo wing
f or 20 21,
perhaps
r e flecting
a
dela y
in
the
impact
o f
CO VID- 19 . In
addition,
Camer oon
has
s ome
o f
the
lo w es t
medical
claim cos ts
in
the
r egion
(pr obably
link ed
t o
the
r ange
o f
s ervices a v ailable
in
coun try )
and
a
tr end
r a t e
o f
only
4 %
t o
6%.
Nor th
Americ a
f or 20 19 ,
this
r esults
in
a
high
e xpect ed
y ear -o v er - y ear
tr end v alue
when
the
e xpect ed
20 21
cos t
is
compar ed
with
the e xpect ed
2020
cos t .
A f t er normalizing
f or the
e ff ects
o f
CO VID- 19 ,
health
c ar e cos ts
in
Canada
ha ve
con tinued
t o
incr eas e
a t
a
r a t e
gr ea t er than
the
r a t e
o f
gener al
in fla tion.
Some
k e y
f act ors
driving cos ts
up w ar d
include
the
ongoing
emer gence
o f
high-cos t biologic s/ specialty
drugs and
r apid
adv ancemen ts
o f
health c ar e
t echnologies
(i. e .,
pharmacogenomic s).
Thes e
up w ar d f or ces
ma y
be
mitiga t ed
b y
implemen ting
e fficien t
drug...
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