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1、Adapting plans to optimize valueHealth Trends 2025 Medical developments,such as innovative treatments for obesity and shifting patterns of diagnosis for conditions like cancer,will change insurance claims patterns because of their significantly higher cost.Plan management options and approaches for

2、cost containment must move forward to keep healthcare affordable,for both employees and employers.Healthcare provision will also need to continue evolving to meet the needs of a diverse workforce.For our 2025 report,Mercer Marsh Benefits(MMB)surveyed 225 insurers across 55 markets to explore the key

3、 trends shaping employer-provided health benefits.This survey was fielded in June and July 2024.The trends outlined in this report will help employers deepen dialogue with their advisors and insurers.Exploring more innovative forms of cost containment,embracing effective new treatment regimes,and en

4、suring that medical coverage meets the needs of the whole workforce are essential as medical costs and workforce needs continue to rise.The top-line findings in our Health Trends 2025 report may sound familiar.Costly cancer claims.Widespread cardiovascular and metabolic health concerns.Unmet mental

5、health needs and medical trend pushing up costs.But behind these enduring issues,a lot is changing employers and insurers responses to these well-acknowledged themes cannot remain static.Health trends 2025:Adapting plans to optimize value23Executive summaryTrendWhat it meansKey findingManaging inten

6、sifying risksUsing new techniques to keep plans affordableMeeting persistent workforce needsThe medical conditions that drive costs have remained largely consistent over the last decade COVID-19 aside.However,the impact of these health conditions is increasing.Employers should evaluate their program

7、s to optimize their investment in employee health,balancing not just cost,but also the employee experience.82%of insurers report an increase in the incidence of cancer treatment claims over the last five years for individuals under the age of 50.Beyond traditional levers of cost control,innovative n

8、ew practices are emerging.These have yet to be widely adopted and used by insurers.Employers looking to contain cost should look beyond the obvious strategies.They should consider,request,and evaluate more aggressive approaches to include how,when,and where care is delivered.46%of insurers believe t

9、hat artificial intelligence for first-line diagnosis,imaging and/or navigation will decrease health plan costs within the next five years.Medical coverage remains narrowly defined despite the holistic health and well-being needs of a diverse workforce.This inadequacy of cover is often exacerbated by

10、 inflation,which may erode benefit maximums.As employers look to shift benefits spend towards those highly valued offerings like medical coverage,understanding unmet workforce needs and health risks will become even more vital.39%of workers indicate that virtual advice,via artificial intelligence po

11、wered chat,for anxiety,sadness,or relationship issues would be helpful.Only 15%of insurers today provide this by default.Health trends 2025:Adapting plans to optimize valueHealth trends 2025:Adapting plans to optimize value4Defining medical trendMedical trend ratesMedical trend is the year-over-year

12、 cost increase for claims under a medical plan on a per-person basis,assuming no changes to the benefits provided.This rate of growth is the result of a variety of factors,including:Medical inflation(increase in per-unit costs for the same service/supply)Altered treatment mix(for example,moving to m

13、ore expensive or advanced treatments)Utilization patterns(for example,people not accessing care due to COVID-19)Regulatory changesGlobal trend rates are projected to stabilize in 2024 and 2025.However,rates continue to be persistently high.Nearly all regions are seeing trend rates above 10%in both y

14、ears.Insurers say 2024 trend is driven by medical inflation,utilization changes,and changes to treatment mixes.Rates for 2019,2020,2021,2022,and 2023 are retrospective.Rates for 2024 and 2025 are prospective.Unweighted global averages used.This was gathered in June-July from 225 insurers,with medica

15、l trend rates submitted by insurers validated by our local teams using their own internal book of business data,country-specific insurer surveys and subjective assessments.Please note the United States is not part of the research.For more information on the rates in the US,refer to this years Nation

16、al Survey of Employer-Sponsored Health Plans.2019202020212022202320242025Global9.7%5.7%10.1%10.1%12.0%11.4%10.9%Canada6.9%3.9%7.1%7.0%9.0%9.0%10.0%Asia10.2%3.5%8.9%10.7%12.7%13.0%13.0%Europe8.0%3.5%10.9%11.4%13.0%11.7%10.4%Latin America and Caribbean13.4%8.0%11.1%10.0%10.0%10.6%10.4%Middle East and

17、Africa11.1%9.6%10.2%9.3%12.4%10.6%10.7%Pacific4.6%5.2%5.0%2.9%9.0%11.5%9.3%Figure 1:Medical trend 2019-2025Figure 2:Top three trend influencers by region.How do you expect each of the following trend components will impact your markets projected 2024 medical trend rate?(Very significant+significant)

18、.GlobalAsiaEuropeMiddle East and Africa80%64%72%81%73%73%88%68%76%79%48%62%82%56%71%Latin America and CaribbeanChanges in treatment mix(e.g.,advancements in technology leading to different treatment patterns)Medical inflation,including higher prices due to currency fluctuations,transportation,and/or

19、 labor costsUtilization changes due to changes in public system scope,quality,affordability,and/or accessUtilization changes due to higher incidence of health conditionsUS health updateTo capture developments in the US,which is outside of the scope of this survey,Mercer conducts an annual National S

20、urvey of Employer-Sponsored Health Plans.This years survey found that total health benefit cost per employee is expected to rise 5.8%,on average,in 2025,after accounting for planned cost-reduction measures.This would be a third consecutive year of cost growth above 5%,following 10 years of annual in

21、creases averaging around 3%.Increased utilization of behavioral health services and GLP-1s(expensive prescription drugs for treating diabetes and obesity)have contributed somewhat to the current trend.However,the biggest drivers may be structural issues affecting the price of services,such as health

22、care labor shortages and health system consolidation.Employers expect US health benefits cost per employee to rise 5.8%on average in 2025Health trends 2025:Adapting plans to optimize value5Managing intensifying risksPart 1Health trends 2025:Adapting plans to optimize value6Health trends 2025:Adaptin

23、g plans to optimize value7While top causes of health plan claims by dollar amount and frequency remain largely consistent with previous Health Trends reports,digging into those figures reveals significant changes.For example,instances of cancer in younger working age populations are increasing,and c

24、atastrophic claims are pushing more employees to the limit of their lifetime claims thresholds.Groundbreaking treatments for conditions like obesity could have a significant impact on cardiovascular and metabolic health,but are currently very costly.Both employers and insurers need to consider how t

25、hey will manage evolving health risks,while keeping plans affordable.Figure 3:Global top causes of claims by dollar amount and by frequencyTop causes of 2023 claims cost by dollar amountTop causes of 2023 claims cost by frequencyCancer1Diseases of the circulatory systemCancerGastro-intestinal diseas

26、es4Musculoskeletal conditions3Gastro-intestinal diseasesMusculoskeletal conditionsRespiratory conditions5Diseases of the circulatory system2Respiratory conditionsHealth trends 2025:Adapting plans to optimize value8Keeping plans affordable As health risks evolve,factors that contribute to the afforda

27、bility of healthcare plans will also shift over time.The impact of high-cost claimants is a universal worry globally,but other drivers can be region-specific and are often related to wider social and economic factors.Shifting the costs of healthcare from public to private(often employer)purchasers,a

28、nd changes in the provider landscape are major sources of cost concerns in Europe.This is the only region where these factors are a top concern,with 68%of insurers saying they had a significant impact on 2024 medical trend.This correlates with findings from our People Risk 2024 report.In Italy,for e

29、xample,healthcare system deterioration was seen as the fourth-ranked people risk,based on both the severity as well as the likelihood of the risk.Globally,healthcare system deterioration was ranked 20th.In the Latin America and the Caribbean region and in the Middle East and Africa,fraud such as bil

30、ling for services that never happened or performing unnecessary tests is a key affordability issue,ranks as a top three concern.Figure 4:Keeping plans affordable top three concerns by region*Indicates a tie for the ranking.13GlobalHigh-cost claimants(80%)Inefficient and wasteful care(61%)New cancer

31、therapies(71%)2AsiaHigh-cost claimants(87%)Inefficient and wasteful care(68%)New cancer therapies(74%)EuropeHigh-cost claimants(68%)Physician/hospital consolidation(57%)*Cost-shifting from government health programs to employer plans(57%)*Latin America and the CaribbeanNew cancer therapies(89%)Fraud

32、(62%)High-cost claimants(84%)Middle East and AfricaHigh-cost claimants(83%)*New cancer therapies(79%)Fraud(83%)*Spotlight on cardiovascular and metabolic health Metabolic and cardiovascular risk is the biggest risk factor for medical costs globally,according to our survey.The World Health Organizati

33、on(WHO)has identified cardiovascular disease as the leading global cause of death.Cardiovascular diseases(CVDs)impact the heart and vascular system,and include coronary artery disease,heart failure,heart attack,stroke,and hypertension.Metabolic risks contribute to CVDs and include high blood pressur

34、e,obesity,and high cholesterol.Smoking and physical inactivity increase these risks.Metabolic risk factors contribute to individuals being impacted by diabetes,which affects 8.5%of adults.Health trends 2025:Adapting plans to optimize valueTop risk factors on medical costs(Global)Metabolic and cardio

35、vascular risk1Endemic infectious diseases4Psychosocial risk3Tobacco smoke5Mental health risk2How employers can help manage diabetes and cardiovascular disease riskBoth diabetes and cardiovascular disease can be well managed,preventing complications and poor clinical outcomes,with appropriate support

36、 in place.This could include:Access to essential medications in both inpatient and outpatient settings Education about metabolic and cardiovascular risks and how to control them Early prevention and detection programs Access to primary care to capture risk early Digital self-management,such as apps

37、Complementary programs such as nutrition therapy,genetic profiling,plan design incentives,and mental health9Weight loss to support cardiovascular and metabolic health More than 40%of adults are overweight according to the WHO.Overweight adults are at risk of a wide range of related conditions,includ

38、ing:Sleep apnea Cardiovascular diseases such as coronary artery disease and stroke Musculoskeletal issues including chronic back and joint pain and arthritisType 2 diabetes and prediabetesMental health conditions such as depression and anxiety The GLP-1 class of drugs,historically used for diabetes,

39、are now found effective for weight loss in clinical trials.Examples of these are found under the brand names Zepbound and Wegovy.GLP-1 drugs act to control blood sugar,manage appetite,and slow digestion,which in turn leads to weight loss.As part of a clinical weight loss program,GLP-1 drugs can resu

40、lt in significant body weight reduction of between 15%to 21%in 72 weeks.These drugs,however,come at a cost.Currently there is limited insurance coverage for GLP-1 drugs globally.Fifty-three percent of insurer respondents say that typical plans do not cover prescription drugs for obesity,and a furthe

41、r 32%say that they have not changed their approach to covering these drugs for the treatment of obesity.In the Middle East and Africa,on the other hand,14%of respondents say they now cover these drugs,but only as part of a wider condition management approach.Limited coverage may be a reflection of t

42、he fact that using GLP-1 drugs for the treatment of obesity is relatively new,and their availability may be limited in certain markets.Yet,GLP-1 drug cost concerns are already emerging.More than a quarter(28%)of respondents globally said that GLP-1 drugs are a worry due to their impact on plan affor

43、dability.In Latin America and the Caribbean,and the Middle East and Africa,that figure increases to 33%and 34%respectively.There is a lot to learn about GLP-1 drugs,especially around long-term use.Based on todays knowledge,they are showing great promise to help high-risk plan members improve their h

44、ealth.This will have to be balanced against affordability and duration of use.GLP-1 drugs are prescribed to be used in conjunction with physician oversight and a more comprehensive weight management strategy,including:Close monitoring by prescribing physicians to manage side effects Utilization in c

45、ombination with other supports,such as nutrition and exercise counselingPrior authorization should also be a priority to ensure clinical appropriateness,such as,being used for clinical purposes,rather than cosmetic.Health trends 2025:Adapting plans to optimize value10Health trends 2025:Adapting plan

46、s to optimize valueSpotlight on cancerCancer remains the top global cause of insurance claims based on dollar amounts and is fourth highest based on claim frequency.The WHO projects that one in five people will develop cancer in their lifetime,with 35 million new cancer cases predicted by 2050.Conce

47、rningly,instances of cancer are increasing among younger populations globally.Insurers across all regions report increases in treatment-related cancer claims in people under 50-years old.Figure 5:Percentage of insurers that have seen increased treatment-related cancer claims for individuals aged und

48、er 50 over the past five yearsGlobalAsiaEuropeMiddle East and Africa82%80%84%88%76%Latin America and Caribbean11Health trends 2025:Adapting plans to optimize value12Preventative cancer screening enables early detection,reducing the risks of costlier claims related to later diagnosis and forming a vi

49、tal part of cost containment and improved survival rates.Globally,only 4 in 10 plans include preventative cancer screening by default,despite 50%of employees saying that these are a helpful benefit for them and their families,according to MMBs Health on Demand research.Other cancer prevention tools,

50、such as vaccinations and genetic testing,are even less likely to be covered.However,established prevention programs can be incredibly beneficial for patients.The HPV vaccination,for example,can prevent more than 90%of HPV-attributable cancers.There are many ways for employers to better support emplo

51、yees with cancer.Some employers,for example,have created cancer education materials,which provide plan participants recently diagnosed with cancer with information on benefits available from employers,the public system,and local non-profits.Figure 6:Preventative cancer measures offered as default by

52、 insurers.Related to cancer,which of the following does your company typically include for employer sponsors of private group medical insurance?(Typically included by default)Genetic testing13%5%21%13%17%Vaccines (for example,HPV)24%12%28%29%Preventative screenings(for example,mammograms,testing kit

53、s)43%26%50%EuropeGlobalLatin America and the CaribbeanMiddle East and AfricaAsia62%48%45%Health trends 2025:Adapting plans to optimize value13New treatments for cancer,autoimmune diseases,and more rare conditions are coming to market,offering hope for life-threatening conditions.However,these treatm

54、ents can be expensive.Its important to be aware of health innovations and whether theyre covered by an insurance plan as well as public health systems.If some of these expensive treatments,cancer-specific or otherwise,are covered under an employer-sponsored insured plan,prepare for more volatility i

55、n claims.If not covered,be ready to address requests for coverage exceptions.One implication of coverage for higher-cost treatments is individuals reaching their lifetime limits under insurance plans.Forty-three percent of insurers globally are reporting that they have seen a higher frequency of thi

56、s over the past five years.Figure 7:The percentage of insurers who have seen an increase in the incidence of individuals reaching lifetime limits due to catastrophic claims claims over the past five yearsGlobalAsiaEuropeMiddle East and Africa43%50%32%44%55%Latin America and CaribbeanEmployer actions

57、Health trends 2025:Adapting plans to optimize value14Where allowed by law,review your benefits philosophy related to lifetime limits;while these can support a health plans financial sustainability,they can also result in exhaustion of employee medical cover.Build a strategy for reducing cardiovascul

58、ar and metabolic health risks.Explore emerging cancer risks within your workforce,especially among younger workers,and develop prevention,detection,and support programs.123Using new techniques to keep plans affordable AIPart 2Health trends 2025:Adapting plans to optimize value15Our People Risk 2024

59、report showed that increasing health and benefits costs is the number one risk for HR and risk managers globally.However,just 31%of HR and risk managers report having effective cost containment strategies to manage benefit costs.While rising costs in health plans might be inevitable,they are also ma

60、nageable.Three core elements of an effective cost management strategy are:Utilization:Design coverage to balance economics and empathy.Consider eligibility,benefit limits,cost sharing,and how private plans maximize public health resources and offerings.Health:Improve health outcomes through data-dri

61、ven interventions.This could include building a culture of health in the workplace or supporting well-being,preventative care,and condition management.Suppliers:Drive financing and vendor management efficiencies.Work with vendors on packaged fees,bundled pricing,or alternative financing,such as self

62、-insurance,including captive insurer financing.Carry out provider audits and ensure effective use of digital health and centers of excellence.Health trends 2025:Adapting plans to optimize value16Health trends 2025:Adapting plans to optimize valueExploring more proactive approaches to plan management

63、,such as steering employees to high quality virtual-first care,are a part of active plan management.There is more that both insurers and employers can do.Cost containment factors,such as negotiating bundled pricing for example,fixed pricing for different components of a hospital stay,including the c

64、ost of potential complications and procedure pre-authorization are widely used in most regions,either as a part of core plan design,or on request.Asia is the exception because these features are less likely to be included as standard.Figure 8:Cost containment(%of insurers)Pre-authorization focused o

65、n assessing reasonableness of procedure/supply costGlobalAsiaEuropeLACMEANegotiated packaged or bundles pricing for specific proceduresGlobalAsiaEuropeLACMEA615350876920252192410141539815435847607169223115182411149931081623Not typically included and not available upon requestNot typically included b

66、ut available upon requestTypically includedNot sureLatin America and the Caribbean(LAC).Middle East and Africa(MEA).17Health trends 2025:Adapting plans to optimize value18Employers and vendors can work together to encourage plan members to make cost-effective decisions,using techniques such as incen

67、tives,navigation,or advocacy.This may result in more targeted care and better cost management,and ensure that people get the best quality support for their needs.This is rarely done in Europe and Asia in particular,so there is significant opportunity to better use these strategies to influence membe

68、r behavior in these regions.Educating plan members to be smarter health care consumers is fundamental,but only 46%of insurers globally currently include this by default in their standard plans.Figure 9:Steering members to effective solutions(%of insurers)Steering members to high quality care (e.g.,n

69、arrow networks,centers of excellence)through plan design incentives GlobalAsiaEuropeLACMEA4026415852323631243816261637121212117Steering members to quality care (e.g.,narrow networks,centers of excellence),through a navigation or advocacy service GlobalAsiaEuropeLACMEA37273256482834213131222929910121

70、018410Steering members away from unproven or unnecessary treatments or technologies GlobalAsiaEuropeLACMEA4940496059212722728151815187151415167Education to make plan members smarter consumers of health care GlobalAsiaEuropeLACMEA4644384276334332312110515181081593Not typically included and not availa

71、ble upon requestNot typically included but available upon requestTypically includedNot sureLatin America and the Caribbean(LAC).Middle East and Africa(MEA).19A tiered approach to coinsurance and copays can help ensure members maximize their coverage if they opt for preferred treatments,providers,or

72、virtual-first care.This can also help to manage plan costs and streamline providers over time.Figure 10:Coinsurance structures(%of insurers)Tiered coinsurance/copays(claims sharing)to incentivize virtual-first care GlobalAsiaEuropeLACMEA22102936213340242948313429292414161877Not typically included an

73、d not available upon requestNot typically included but available upon requestTypically includedNot sureLatin America and the Caribbean(LAC).Middle East and Africa(MEA).Tiered coinsurance/copays(claims sharing)for preferred vs.non-preferred treatments or providers GlobalAsiaEuropeLACMEA32262649383444

74、22333424223721108157711Health trends 2025:Adapting plans to optimize valueHealth trends 2025:Adapting plans to optimize value20Spotlight on virtual care Virtual care the diagnosis,treatment and/or monitoring of health conditions through digital channels is evolving fast.According to our Health on De

75、mand research,45%of employees rate telemedicine as helpful for themselves and their families;85%of insurers offer telemedicine options.Incentivizing plan members to access virtual-first care is typically included in around 22%of plans globally and available on request in an additional 33%.This could

76、 include such things as a requirement or incentive through coinsurance or copays to use telemedicine ahead of an in-person visit.Its important that virtual care used in these arrangements is truly effective and does not lead to outcomes like repetition of care or inappropriate referrals to specialis

77、ts or emergency rooms.Although the range of services and treatments that can be delivered virtually is expanding,the current inclusions encompass:Acute primary careMental health support Nutritional counselling and healthy living coaching Maintenance visits with specialistsChronic condition monitorin

78、gThe employee and employer perspective on virtual care Employers benefit because access to healthcare is enhanced across the workforce,particularly in locations where in-person care is limited or involves delays.Also,plan members can be directed to quality providers and solutions and site-of-care de

79、livery can be optimized.Eight questions employers should ask about virtual care:1.Where does virtual care fit into our benefits strategy?2.Who is eligible for this care?3.Who delivers virtual care?4.How is it integrated into the health plan?5.How can we incentivize its use?6.What types of care can b

80、e delivered virtually?7.How do we monitor for quality and appropriate outcomes?8.How is the utilization of virtual care affecting medical plan costs?Employees benefit because virtual care is available at times and in locations that suit their needs and are generally at a lower cost for plan members.

81、AI is impacting health and benefits 48%46%20%16%From improving claims analysis to detecting cancer types and predicting survival rates,artificial intelligence(AI)is powering improvements across many areas of healthcare provision.Insurers are responding.To date,focus has been on process enhancements,

82、such as fraud detection(used by 48%of insurers)but there is great future potential to expand into member-facing opportunities such as health risk management programs(offered by 20%).Detection of fraud,waste and abuseAnalytics to enhance claims analysis provided to employersAI-driven health risk mana

83、gement programsPlan member benefit/policy navigationFigure 11:Insurers are beginning to adopt AI for use in employer sponsored medical plansPercentage of insurers globally on how they use AI for employer-sponsored group medical plansHealth trends 2025:Adapting plans to optimize value21Health trends

84、2025:Adapting plans to optimize value22AI impactson benefitsAI impacton healthAdvanced analyticsHelp benefit professionals make informed strategic decisions and manage fraud,waste,and abuseOperational efficiencyAutomate healthcare administration,triage,and deliveryClinical care&imagingDecipher large

85、 quantities of scans to better identify and treat diseasesPersonalized medicineDeliver treatment plans tailored to individualsPredictive analyticsEstimate the likelihood of future outcomes based on patterns of historical dataBenefit navigationCreate personalized recommendations on how to interact wi

86、th the benefits ecosystemCommunicationProduce pieces written in employer voiceCustomer serviceAugment support models to address first-line questionsLack of human reasoningManage AI risksSecurity/data vulnerabilitiesErrors/misinformation/biasMore broadly,plan providers and employers will need to navi

87、gate the risks and impacts of emerging AI use in terms of its effect on health provision and benefits design.Figure 12:Navigating health and benefits AI risks and impacts(a sample list)Learning lessons from enterprise risk management The processes and frameworks of enterprise risk management align w

88、ell with active health plan management.Good governance around policies and procedures,identifying risk tolerance,and ongoing oversight are as relevant to plan management as they are to risk management.Similarly,getting the right resources and infrastructure in place around tools,systems and data,ide

89、ntifying rules and responsibilities,and driving a culture of risk management across the workforce are all areas where plan management can follow enterprise risk management principles.Health trends 2025:Adapting plans to optimize value23IdentifyAnalyze and assessRespond and controlMonitor and reviewF

90、igure 13:Applying an enterprise risk management framework to active plan managementMap cost escalation risks by creating a multi-disciplinary committee,including HR,risk,finance,health and safety,and line managers.Consider a wide spectrum of risks,including supply chain risks,population health risk,

91、utilization risks,and financing.Take a data-driven approach to assess historic and future underlying risks of benefit programs to allocate capital and conduct budgeting.Data sources include:insured medical,disability,life,as well as well-being program utilization,biometrics,onsite clinic data,and em

92、ployee demographics and sick leave.Treat:Implement chronic disease management programs for NCDs to support employee in managing health conditions while optimizing care;create plan designs that incentivize the right employee behavior.Terminate:End support for low value care Transfer:Explore financing

93、 mechanisms such as use of captives and stop loss.Tolerate:For lower risk benefits,evaluate self-insurance to minimize profit and admin costs.Ensure risks are monitored and reported regularly to allow for adjustments to cost containment levers.Consider how to best communicate ongoing performance.Con

94、duct periodic and independent specialist benefits reviews to identify gaps and inefficiencies.Health trends 2025:Adapting plans to optimize value24Health trends 2025:Adapting plans to optimize value25Employer actionsHealth trends 2025:Adapting plans to optimize value25Look beyond obvious containment

95、 measures to manage costs such as steering members to centers of excellence and rethinking claims sharing arrangements.Understand how your insurers are using AI,both in terms of capturing healthcare opportunities and managing health plan and employee health risks.Introduce or expand effective virtua

96、l care support to help improve access to services and manage cost.123Meeting persistent workforce needs Part 3Health trends 2025:Adapting plans to optimize value26Our Health Trends 2025 report found that there continue to be entrenched gaps between services insurers typically cover and the needs of

97、a diverse workforce.Addressing these gaps and meeting persistent workforce needs is crucial if employers are to move the dial on employee health.As an example,although our Health on Demand research found that 42%of employees would find menopause care and support helpful for them or their family,only

98、 22%of insurers include this by default.Some employers are evaluating standalone programs focused on this area.Plan improvements and cost management Despite a clear case for plan improvements,insurers anticipate half of employers will want to reduce plan coverage to manage costs in the coming year.O

99、ur Health Trends 2025 report findings extend a trend from previous years of insurers expecting plan coverage to reduce on grounds of cost.There are positives to take from this trend.Given the series of crises that have engulfed businesses over the last five years,it is encouraging that insurers stil

100、l expect half of employers to make plan improvements.As we have seen above,well-executed and active plan management can control costs without reducing plan scope.Global 202550%50%Global 202443%57%Global 202332%68%Making plan improvements to help address attraction,retention,and engagementReducing pl

101、an coverage to manage costFigure 14:Making plan improvements vs.reducing coverageHealth trends 2025:Adapting plans to optimize value27Health trends 2025:Adapting plans to optimize valueCreating inclusive benefitsAlthough some inclusive benefits have been embraced by insurers as part of core plan des

102、ign or by request,other practices and measures are barely being recognized and have gained little traction from previous years.For example,67%of insurers globally do not collect data on members race or ethnicity to help address health disparities.While feasibility may be limited by legislation in ma

103、ny markets,this practice,if properly executed and deployed,could provide important insights into health challenges faced.Despite growing awareness of neurodivergence,around a third(31%)do not support comprehensive care,such as diagnosis,therapies,and occupational therapy,for neurodivergent individua

104、ls or their caretakers.Figure 15:Top five inclusive benefits either typically included or available on requestCovering same sex/gender partners or spouses71%Providing regular trainings for your member service teams to increase cultural competency and inclusion69%Assuring plan member communications a

105、re accessible and inclusive for all,including those who are visually or hearing impaired61%Providing comprehensive care(diagnosis,therapies,occupational health)to support ageing individuals and caretakers52%Allowing coverage for segments of the workforce who may not be permanent full-time76%28Health

106、 trends 2025:Adapting plans to optimize value29Spotlight on mental health supportThe WHO estimates that 12 billion working days globally are lost every year to depression and anxiety,at a cost of US$1 trillion per year in lost productivity.Recognition of the importance of mental well-being,the cost

107、to employers of poor mental health,and the role that employers have in facilitating positive emotional well-being through culture,work design,and psychological safety has grown significantly over the last decade.MMBs People Risk report found that employers are aware of the risks associated with ment

108、al health deterioration;it was ranked as the second most severe people risk of 25 risks by HR and risk managers.Improved support for and coverage of mental health in healthcare plans has been a slow-growing success story,with 88%of insurers globally either offering coverage for counselling as standa

109、rd(47%),or upon request(41%).However,many mental health-related services are still not offered by default.In Asia in particular,coverage for in-person or virtual counselling,which is a standard included offering elsewhere,may only be available upon request.Figure 16:Top five mental health services o

110、ffered(global)GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AsiaTypically includedAvailable upon requestTypically includedAvailable upon requestTypically includedAvailable upon requestTypically includedAvailable upon requestTypically includedAvailable upon requestCoverage for psycho

111、logical and/or psychiatric counselling sessions(outpatient)47%41%18%65%54%34%67%20%62%34%Inpatient treatment43%28%35%48%37%13%56%18%62%24%Virtual mental health counseling via video chat with a therapist to manage anxiety,sadness or personal relationship issues33%35%16%56%44%19%38%24%34%38%Coverage f

112、or prescription medications prescribed for mental health(outpatient)33%44%19%61%22%43%42%29%66%31%Education,resources and tools on mental health topics such as self-care,anti-stigma,mindfulness and resilience30%41%21%57%34%31%27%38%38%38%Health trends 2025:Adapting plans to optimize valueCounting th

113、e cost of counselling Although counselling is well established as either a default or an additional option for coverage,the number of sessions covered in a year appears to be dropping.The decrease in coverage may be the result of increased(inflationary)costs per counselling session,in combination wi

114、th frozen dollar limits for mental health within plans.Figure 17:Number of one-hour counselling sessions covered by a typical plan per year(global)Less that 55 to 1011 to 20More than 20/unlimited17%28%35%31%14%14%34%27%2024202530Health trends 2025:Adapting plans to optimize value31Mental health bene

115、fits that meet employee needsEmployees%of employees who find the benefit helpful for them or their family (Health on Demand-global)44%27%42%21%41%33%39%15%38%30%38%20%Insurers%of insurers including under typical plans as a default (Health Trends-global)Comparing Health on Demand data with our Health

116、 Trends 2025 findings shows some mismatches between benefits that employees find helpful and those that are offered as a default by insurers.For example,38%of employees find substance abuse benefits helpful,but only 20%of insurers typically include this benefit under their plans by default.Coverage

117、for targeted services for children,teenagers,and parents to assist with mental health,socialization,and learning issues faced by youthTraining to recognize and address own and others mental health challenges (e.g.,mental health first aid)Virtual mental health counseling via video chat with a therapi

118、st to manage anxiety,sadness,or personal relationship issuesVirtual advice via chat,powered by artificial intelligence(no human involved),for anxiety,sadness,or relationship issuesEducation,resources and tools on mental health topics such as self-care,anti-stigma,mindfulness,and resilienceSubstance

119、use/abuse treatmentsFigure 18:Some of the mental health therapies that are valued by employees arent always offered by insurersHealth trends 2025:Adapting plans to optimize value32Spotlight on reproductive benefitsFamily building Cover for reproductive health benefits for employees and their partner

120、s remains limited,despite the pervasiveness of related challenges,including family building,high-risk pregnancies,and menopause support.These challenges impact productivity addressing them can impact employee attraction and retention.Services including IVF coverage,egg or sperm freezing,and contrace

121、ption access are poorly supported globally,with little difference between regions.Although 41%of employees said that fertility support would be helpful for them or their family,only 5%of insurers offer it as a default in a typical plan,with 25%providing it as an option.Of course,local culture and re

122、gulations are both contributing factors to variability in cover.Figure 19:Percentage of insurers that do not cover services,or not applicableFamily building services not available or not applicable*GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AsiaSurrogacy support/coverage72%75%76%

123、69%66%Egg/sperm freezing72%75%72%73%66%Pre-conception family planning56%53%57%56%55%Contraception access/coverage56%58%54%56%52%Fertility support(for example,coverage for IVF or IUIs)52%52%49%60%55%*Figures represent the percentage of insurers that say they are not covering the service or the servic

124、e is not applicable;these insurers are also not considering adding the coverage.Health trends 2025:Adapting plans to optimize value33Giving birth Support for high-risk pregnancies,post-partum care,and maternity coverage is near universal in Latin America and the Caribbean as well as the Middle East

125、and Africa.It is significantly less common in Europe,where there may be greater dependency on public health services.New parenting services,such as lactation equipment and support,are less often covered,with 61%of insurers globally excluding this from cover entirely and only 12%providing it by defau

126、lt in a typical plan.However,this is a potentially valuable service for women preparing to return to the workplace after birth;34%of employees in our Health on Demand report said that it would be helpful for their families.Figure 20:Percentage of insurers that do not cover services,or not applicable

127、Giving birth services not available or applicable*GlobalAsiaEuropeLatin Ameri-ca and the CaribbeanMiddle East and AsiaLactation equipment and support(coaching,pump,hygienic storage)61%66%69%56%38%Post-partum care30%34%46%9%10%Comprehensive coverage for high-risk pregnancies and pregnancy loss26%31%4

128、0%4%3%Maternity coverage(pre-natal care and delivery)16%17%28%2%0%Mid-life services not available or applicable*GlobalAsiaEuropeLatin Ameri-ca and the CaribbeanMiddle East and AsiaMenopause care and support45%52%49%38%28%Mid-life The effect of menopause on the female workforce and on employers is be

129、coming more widely recognized.Impacts can include losing senior employees if they are not well supported and discrimination claims if workplace adjustments are not made.MMBs Heath on Demand 2023 found that 42%of employees said menopause care and support would be helpful for them or their family.Insu

130、rers are beginning to recognize the significance of menopause from a coverage perspective;over half globally offer care and support,but only 22%do so as a default.Figure 21:Percentage of insurers that do not cover services,or not applicable*Figures represent the percentage of insurers that say they

131、are not covering the service or the service is not applicable;these insurers are also not considering adding the coverage.*Figures represent the percentage of insurers that say they are not covering the service or the service is not applicable;these insurers are also not considering adding the cover

132、age.Health trends 2025:Adapting plans to optimize value34Employer actionsHealth trends 2025:Adapting plans to optimize value34Be proactive in plan management to best balance cost containment and plan coverage.Understand and address where there are benefits gaps,such as reproductive health.Understand

133、 how insurers are allocating costs for mental health support such as counselling is this achieved on a per-session basis,or with a capped limit?123ConclusionHealth trends 2025:Adapting plans to optimize value35Ingrained healthcare concerns,from substantial plan cost increases driven by medical trend

134、 to enduring high-cost claims such as cancer and gaps in coverage,dominate this years Health Trends report.Within these consistent themes there has been significant evolution.New treatments for conditions like obesity and emerging digital health services that could reduce costs are among the positiv

135、e stories.They could help improve employee health and plan inclusivity in the future.Concerningly,increasing cases of cancer,especially among younger workers,and persistent gaps in cover translate into true unmet needs.More than ever,employers should develop a regular,meaningful benefits strategy.Th

136、ey should also engage in dialogue with stakeholders including advisors and insurers to understand available options within plans and how to tailor support to their workforce.They should also engage in active plan management that balances coverage adequacy and cost sustainability.Among the actions yo

137、u can take:Prepare for double-digit cost increases,as medical trend is persistently high in many markets,although it is expected to stabilize in the coming year.Be aware of intensifying risks,such as increased cancer diagnoses in younger employees,through data analytics.Address plan design to suppor

138、t prevention,which will help with long term cost containment.Develop a digital healthcare strategy,which should address both the opportunities and risks posed by emerging tools,such as AI,to support both cost containment and efficient,inclusive care.Continue dialogue with advisors and insurers to un

139、derstand the options available within your plan that may not be provided as a default.Be bold in asking for what your workforce needs.Create inclusive healthcare offerings that address gaps in cover,such as reproductive health,and consider how to manage these within your plan at reasonable cost.1234

140、5Health trends 2025:Adapting plans to optimize value36Appendix AMedical trend rates by countryCountry/Region2023 actual medical trend rate12023 actual inflation rate22024 forecast medical trend rate12024 forecast inflation rate22025 forecast medical trend rate12025 forecast inflation rate2Global:wit

141、hout US12.0%6.4%11.4%4.0%10.9%3.3%Global:with US311.9%6.3%11.3%4.0%10.8%3.3%Global:expat(IPMI)411.9%N/A11.0%N/A10.8%N/ANorth America7.1%4.0%7.1%2.8%7.9%1.9%Canada9.0%3.9%9.0%2.6%10.0%1.9%United States5.2%4.1%5.2%2.9%5.8%2.0%Asia12.7%3.2%13.0%2.6%13.0%2.5%China13.5%0.2%9.0%1.0%8.7%2.0%Hong Kong10.0%2

142、.1%12.0%2.3%9.0%2.3%India9.6%5.4%11.0%4.6%9.9%4.2%Important notices1 This document does not constitute or form part of any offer or solicitation or invitation to sell by either Marsh or Mercer to provide any regulated services or products in any country in which either Marsh or Mercer has not been a

143、uthorized or licensed to provide such regulated services or products.You accept this document on the understanding and agreement that it does not form the basis of any contract,and Mercer and Marsh shall have no liability in respect of any reliance on,or decisions based on,the content of this docume

144、nt.The availability,nature and provider of any services or products,as described herein,and applicable terms and conditions may therefore vary in certain countries as a result of applicable legal and regulatory restrictions and requirements.Please consult your Marsh or Mercer consultants regarding a

145、ny restrictions that may be applicable to the ability of Marsh or Mercer to provide regulated services or products to you in your country.2 Inflation rates are sourced from the International Monetary Fund,World Economic Outlook Database,June 2024.Inflation rate information is strictly for general re

146、ference purpose;Marsh and Mercer give no guarantees as to their accuracy and will not accept liability for decisions based on them.3 US rates come from the National Survey of Employer Sponsored Health Plans report,and are reflective of costs after making changes to current plans.4 Expat rates were c

147、alculated by taking a straight average of 13 expat(IPMI)insurer responses.These rates are excluded from the global averages.5 Market was not included in regional or global averages,which are not weighted by factors such as national health expenditure or economy size.6 Argentina and Venezuela were no

148、t included in the table due to current socioeconomic conditions.2024 Mercer LLC.Health trends 2025:Adapting plans to optimize value37Country/Region2023 actual medical trend rate12023 actual inflation rate22024 forecast medical trend rate12024 forecast inflation rate22025 forecast medical trend rate1

149、2025 forecast inflation rate2Indonesia14.6%3.7%17.9%2.6%19.0%2.6%Malaysia13.0%2.5%14.0%2.8%15.0%2.5%Philippines24.0%6.0%21.0%3.6%21.0%3.0%Singapore12.0%4.8%12.0%3.0%11.0%2.5%South Korea9.5%3.6%10.2%2.5%11.0%2.0%Taiwan11.2%2.5%10.4%1.9%12.2%1.6%Thailand12.5%1.2%11.1%0.7%11.4%1.2%Vietnam9.5%3.3%15.0%3

150、.7%15.0%3.4%Pacific9.0%5.7%11.5%3.3%9.3%2.8%Australia2.9%5.6%3.0%3.5%3.5%3.0%New Zealand15.0%5.7%20.0%3.1%15.0%2.5%Europe13.0%7.2%11.7%3.1%10.4%2.5%Austria7.0%7.7%5.0%3.9%3.5%2.8%Belgium8.9%2.3%6.4%3.6%10.2%2.0%Bulgaria25.0%8.6%21.0%3.4%20.0%2.7%Denmark7.0%3.4%7.0%1.5%5.0%2.0%Estonia11.6%9.1%8.0%4.2

151、%5.0%2.5%France4.6%5.7%3.1%2.4%5.0%1.8%Greece8.0%4.2%9.0%2.7%8.0%2.1%Hungary20.0%17.1%15.0%3.7%15.0%3.5%Ireland10.4%5.2%9.0%2.4%7.0%2.0%Health trends 2025:Adapting plans to optimize value38Country/Region2023 actual medical trend rate12023 actual inflation rate22024 forecast medical trend rate12024 f

152、orecast inflation rate22025 forecast medical trend rate12025 forecast inflation rate2Italy11.0%5.9%13.0%1.7%10.0%2.0%Lithuania23.0%8.7%18.0%1.5%15.0%2.3%Netherlands6.6%4.1%8.5%2.7%8.0%2.1%Norway10.0%5.5%12.0%3.3%12.0%2.6%Poland26.6%11.4%27.7%5.0%20.0%5.0%Portugal15.0%5.3%13.5%2.2%11.0%2.0%Romania19.

153、0%10.4%15.0%6.0%15.0%4.0%Serbia15.0%12.4%13.8%4.8%15.0%3.1%Spain8.4%3.4%9.3%2.7%9.5%2.4%Sweden7.0%5.9%8.0%2.6%7.0%2.0%Turkey5110.0%53.9%90.0%59.5%75.0%38.4%United Kingdom15.3%7.3%10.9%2.5%7.7%2.0%Middle East and Africa12.4%8.8%10.6%7.1%10.7%5.7%Angola530.0%13.6%25.0%22.0%25.0%12.8%Bahrain8.0%0.1%7.5

154、%1.4%8.0%1.8%Egypt529.0%24.4%30.0%32.5%35.0%25.7%Ghana37.5%37.5%22.0%22.3%12.0%11.5%Kenya10.0%7.7%7.0%6.6%6.0%5.5%Mauritius7.0%7.0%5.0%4.9%4.0%3.6%Morocco2.5%6.1%3.0%2.2%3.5%2.5%Mozambique8.5%6.1%8.0%4.4%6.5%5.5%Health trends 2025:Adapting plans to optimize value39Country/Region2023 actual medical t

155、rend rate12023 actual inflation rate22024 forecast medical trend rate12024 forecast inflation rate22025 forecast medical trend rate12025 forecast inflation rate2Nigeria19.5%24.7%25.0%26.3%30.0%23.0%Oman8.0%0.9%9.0%1.3%12.0%1.5%Qatar7.0%3.1%5.0%2.6%8.5%2.4%Saudi Arabia16.0%2.3%15.0%2.3%15.0%2.0%South

156、 Africa9.0%5.9%9.0%4.9%9.5%4.5%United Arab Emirates10.0%1.6%10.5%2.1%11.0%2.0%Zambia18.0%11.0%12.0%11.4%13.0%7.8%Latin America and the Caribbean610.0%5.6%10.6%3.5%10.4%3.2%Brazil11.8%4.6%12.5%4.1%12.7%3.0%Chile5.0%7.6%7.5%3.2%7.5%3.0%Colombia13.5%11.7%15.0%6.4%14.0%3.6%Costa Rica11.0%0.5%11.0%0.3%11

157、.0%2.9%Dominican Republic8.0%4.8%7.5%4.2%8.5%4.0%Guatemala10.5%6.2%11.5%4.0%10.3%4.0%Honduras11.0%6.7%11.0%4.4%11.0%4.1%Mexico14.7%5.5%15.3%4.0%14.0%3.3%Nicaragua11.5%8.4%12.0%5.0%10.5%4.0%Panama10.0%1.5%10.8%1.7%10.0%2.0%Peru6.9%6.3%5.4%2.3%6.2%2.0%Puerto Rico6.5%2.8%8.0%1.9%9.0%2.3%Health trends 2

158、025:Adapting plans to optimize value40Appendix BParticipating insurersWe would like to thank all the insurer respondents for participating in this research.We are very grateful to them for sharing their important perspectives,insights and outlooks.Below are the insurers that allowed us to disclose t

159、heir participation in the survey.CountryInsurerAngolaNOVA SOCIEDADE DE SEGUROS DE ANGOLA,SABelgiumAG InsuranceAXA BelgiumBrazilCare PlusUnimed NacionalBulgariaBulgaria Insurance PLCGroupama ZastrahovaneUNIQA Life plcCanadaEquitable Life Insurance Company of CanadaMedavie Blue CrossRBC Life Insurance

160、 CompanyChinaCITIC Prudential Life InsuranceFosun United Health Insurance Co.LtdGeneali China Life InsuranceICBC-AXAMedilink(Beijing)TPA Services Co.,Ltd.MSH China Enterprise Service Co.,LtdPICC Health Insurance Co.,Ltd.Shanghai BranchTaiping Pension Co.,Ltd.New China Life Insurance Co.,Litd.Shaingh

161、ai BranchCountryInsurerColombiaAXA COLPATRIACompaa de Medicina Prepagada Colsanita S.A.Costa RicaAseguradora del Istmo Adisa S.A.ASSA Compaa de Seguros,S.A.Pan American Life Insurance de Costa RicaDenmarkEuro AccidentPFA PensionDominicaHumano SegurosDominican RepublicARS Yunen SEGUROS RESERVASEgyptM

162、ETLIFEFranceALLIANZ AXA FranceGreeceAllianz European Reliance Generali HellasGROUPAMA ASFALISTIKINN HellasHealth trends 2025:Adapting plans to optimize value41CountryInsurerGuatemalaAseguradora GeneralMAPFRE|Seguros Guatemala,S.A.PAN-AMERICAN LIFE INSURANCE DE GUATEMALASeguros El Roble S.A.Seguros G

163、&T,S.A.HondurasSeguros CrefisaBrazilCare PlusUnimed NacionalHong KongAsia Insurance Company LimitedAXACigna Worldwide General Insurance Company Limited-HKManulife(International)LimitedHungaryAllianz HungaryGroupama Biztost Zrt.IndiaCARE HEALTH INSURANCEReliance General Insurance Co LtdThe Oriental I

164、nsurance Co LtdIndonesiaASURANSI JIWA MANULIFE INDONESIAPT AIA FINANCIALPT Asuransi Astra BuanaPT LIPPO GENERAL INSURANCE TBKPT.Asuransi Sinar MasPT.Great Eastern Life IndonesiaIrelandIrish Life Health dacLaya HealthcareVhi HealthcareCountryInsurerItalyAXAGENERALI ITALIAMETLIFEZurich Insurance Europ

165、e AG LithuaniaCompensa Life Vienna Insurance group SE Lithuanian BranchMalawiWELLA MEDICAL AID SOCIETY LTDMalaysiaAIA Bhd.AmMetLife Insurance BerhadMexicoAllianz Mxico Compaa de SegurosGrupo Nacional ProvincialMAPFRE SEGUROSSeguros Atlas,S.A.MozambiqueLiberty Health(Pty)LtdNicaraguaASSA Compaa de Se

166、guros,S.A.MAPFRE SEGUROS NICARAGUANigeriaLeadway Health Limited Total Health Trust LtdNorwayDNB Livsforsikring ASEuro AccidentIf Skadeforsikring ABOmanAl Madina Insurance company SAOGLiva Insurance Company SAOCOman Qatar Insurance CompanyOman United Insurance CompanyTakaful Oman Insurance Co.SAOGHea

167、lth trends 2025:Adapting plans to optimize value42CountryInsurerPanamaPan-American Life Insurance de PanamPeruMapfre PeruPhilippinesFIRST LIFE FINANCIAL CO.Generali Life Assurance Philippines,Inc.Insular Health Care,Inc.Maxicare Healthcare CorporationMedicard Philippines IncThe Insular Life Assuranc

168、e Co.Ltd.United Coconut Planters Life Assurance Corp.PolandCompensa Towarzystwo Ubezpiecze S.A.Vienna Insurance GroupTowarzystwo Ubezpiecze ZDROWIE SAPortugalAdvanceCare S.A.Multicare-Seguros de Sade,SAUna Seguros SAVICTORIA-Seguros,SA.QatarSeib Insurance&ReinsuranceRomaniaGROUPAMA ASIGURARI S.A.ROM

169、ANIASIGNAL IDUNA ROMANIAUniqa Asigurari SASingaporeRaffles Health Insurance Pte LtdSingapore Life LtdSpainAXA Seguros GeneralesCigna Life Insurance Company of Europe,SASANITAS SEGUROS S.A.SegurCaixa AdeslasCountryInsurerSwedenLnsfrskringarTaiwan,Province Of ChinaCathay LifeTAIWAN LIFE INSURANCE CO.,

170、LTD.Prudential Life Insurance Company,Ltd.ThailandGenerali Life Assurance(Thailand)Plc.LMG Insurance Co.,Ltd.Muang Thai Life Assurance(MTL)Thai Life Insurance PCL.Tokio Marine Life Insurance(Thailand)PCLTurkeyANADOLU ANON?M TRK S?GORTA ?RKET?United Arab EmiratesAbu Dhabi National Insurance CompanyOr

171、ient InsuranceQatar Insurance Company Sukoon Insurance Company United KingdomAviva plcAXA HealthVenezuelaHumanitas Administradora de Riesgos,S.A.MAPFRE LA SEGURIDAD,C.A.DE SEGUROSSEGUROS PIRAMIDE C.AVietnamAAA Insurance CorporationBao Hiem Bao Viet-Bao Viet InsuranceGENERALI VIETNAM LIFE INSURANCE L

172、LCZambiaLiberty Life Insurance Zambia LimitedOne Life Assurance Limited 2024 Marsh McLennan.All right reserved.For further information,please contact your local Mercer Marsh Benefits office.Marsh McLennan businesses provide a range of solutions to help you build a resilient workforce and business,in

173、cluding:Benefits strategy,broking,design,financing and delivery Health and well-being,including mental health and longevity Global benefits Business continuity Enterprise risk management Business resiliency and crisis management Cybersecurity risk management Environmental,social and governance(ESG)D

174、iversity,equity and inclusion Workforce communications Flexible working and work design Employee experience,listening and total rewards Living wage RetirementAbout Mercer Marsh Benefits Mercer Marsh Benefits provides clients with a single source for managing the costs,people risks,and complexities o

175、f employee benefits.The network is a combination of Mercer and Marsh local offices around the world,plus country correspondents who have been selected based on specific criteria.Our benefits experts,located in 73 countries and servicing clients in more than 150 countries,are deeply knowledgeable abo

176、ut their local markets.Through our locally established businesses,we have a unique common platform,which allows us to serve clients with global consistency and locally unique solutions.Mercer and Marsh are two businesses of Marsh McLennan(NYSE:MMC),the worlds leading professional services firm in the areas of risk,strategy and people,with 85,000 colleagues and annual revenue of over$20 billion.Through its market-leading businesses including Guy Carpenter and Oliver Wyman,Marsh McLennan helps clients navigate an increasingly dynamic and complex environment.