MEDICAL INFLATION REACHES 10% AS CLAIMS INCREASE
Company medical plans may have to undergo similar changes experienced by company pension schemes if medical inflation continues at its current rate, says Mercer. According to proprietary data analysed by the company, medical inflation is currently running at 10% a year. If this rate of inflation continues, a medical plan costing an employer £1 million in 2008 will, measured by compound inflation, cost around 60% more in five years’ time.
Mercer’s health & benefits business is the UK’s largest intermediary for corporate medical expenses plans. In 2007, the company carried out a survey of historical claims of over 250 companies, with a combined annual claims spend of £142m.
According to the data, the claim cost per life – the cost of providing medical cover for a group of employees and their dependants – has risen by six per cent since 1999. This is an average compound medical inflation rate of just over six per cent annually. In comparison, the UK’s Retail Price Index has risen an average of 2.75% a year over the same period while the National Average Earnings have risen by just under four per cent annually.
Steve Clements, principal in Mercer’s health & benefits business, said: “The current rate of inflation isn’t sustainable. In spite of increased NHS funding over the last few years, medical inflation in the private sector has not been quelled. Companies still face massive inflation demands in this sector compared to other business costs. It’s proving an increasing challenge for companies to maintain current levels of cover irrespective of how much their employees value it.”
“If the current rate of inflation continues, we may see medical plans undergoing the same process experienced by pension schemes in the move from defined benefit to defined contribution arrangements. Employers will move to cap liabilities. We have already seen larger medical plans unbundling different elements of cost and services. Now we are beginning to see increasing interest in the UK and the US over the viability of personal account-based medical plans.”
According to the report, until January 2003, medical inflation was mainly driven by an increase in the incidence of claims as employees looked to company plans to avoid NHS waiting lists. Since then a key driver has been the introduction of new treatments and drugs, in particular relating to complex medical treatments such as cancer.
In 1997, fewer than six per cent of all claims were registered as ‘high claims’ with an average cost of over £10,000. These remained fairly constant until 2003, when they rose to eight per cent. In 2005 and 2008, the proportion of high claims rose even further to 9.5% and 11%, respectively.
According to Mercer, some companies are responding to change by linking access to treatment with NHS waiting times and so reducing workplace absence by accelerating access to care. Others are increasing employee and dependant contribution levels either through premium sharing or at the point of claim, or both. Some are introducing medical underwriting to exclude pre-existing conditions from cover or introducing annual maxima for all treatment or for specific high cost conditions.
Clements concluded: “We are also seeing companies offer greater financial incentives for using the NHS, while other organisations restrict cover by excluding psychiatric conditions and reducing out-patient cover levels. Some companies are even changing the eligibility criteria for plan membership.
“Moreover, there is increasing focus on health risk management including wellness programmes to improve employees’ overall health and motivate them to live in a healthier manner.”
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