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Health care benefit costs to increase by 7.6% globally in 2019: WTW

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Employer-provided health care benefits costs are expected to increase modestly around the globe in 2019, according to the 2019 Global Medical Trends Survey of medical insurers published in November 2018 by Willis Towers Watson (WTW). Insurers blame the high cost of medical technology and the overuse and overprescribing of services as major factors in escalating costs and caution that soaring pharmacy costs will become a significant factor over the next five years.

Medical insurers project health care benefits costs to rise 7.6% globally in 2019, a slight increase over 7.1% this year. The smallest increases (5.0%) are projected in Europe, while the largest increases are expected in the Middle East and Africa, where costs are projected to jump 12.4%. The rate at which costs are rising in the U.S. is expected to decline slightly, from 8.7% this year to 7.9% next year.

In the UK, medical insurance cost increases are projected to hit 6.3% in 2019, which is a slightly lower increase compared to this year’s rise of 6.9%. Between October 2015 and June 2017, insurance premium tax (IPT) doubled from 6% to 12% and is cited as one of the contributing factors to higher costs during this period.

The study also found the outlook for cost increases over the next three years varies greatly by region. Only a third of insurers in the Americas (34%) expect higher or significantly higher medical trend costs over the next three years, however, 60% of Middle East and African insurers and 54% of insurers in Europe anticipate higher costs. Globally, nearly half of insurers (49%) expect cost increases will be higher or significantly higher.

Global medical trends: Annual cost increases, 2017 – 2019

2017 2018 2019*
Global 6.7% 7.1% 7.6%
U.S. 7.5% 8.7% 7.9%
Americas (ex. U.S.) 11.1% 11.0% 10.7%
Asia Pacific  7.1% 7.0% 7.8%
Europe  4.4% 5.0% 5.0%
United Kingdom 5.7% 6.9% 6.3%
Middle East/Africa  8.5% 9.9% 12.4%


According to the survey, European insurers predict that costs for hospital and inpatient care (52%) and behavioral and mental health care (50%) will become an increasingly significant part of medical expenses over the next five years. This is in contrast to other regions, with eight in ten insurers (80%) in the Americas and 66% of Middle East and Africa insurers expecting the bulk of medical expense increases to come from pharmacy costs over the next five years.

When asked for the most significant cost-driving factors outside the control of employers and vendors, nearly two-thirds (65%) cited the high cost of medical technology followed by providers’ profit motives (48%). Interestingly, seven in ten insurers (70%) ranked overuse of care due to medical practitioners recommending too many services as the most significant factor driving costs related to employee and provider behavior. Just over half (52%) cited overuse of care due to employees seeking inappropriate care.

Other findings from the survey include:

  • Top Three Conditions: Insurers report musculoskeletal (66%), cardiovascular (54%), and cancer (43%) as the top three conditions that cause the highest number of claims in Europe. Respondents don’t expect the situation to change in the next five years.
  • Top cost management methods: Nearly two-thirds (64%) use contracted networks, while 60% require pre-approval for scheduled inpatient services to help manage costs. Over six in 10 (64%) place limits on certain medical services to help control costs.

About the Survey

The WTW Global Medical Trends Survey was conducted between July and September 2018, and reflects responses from 307 leading medical insurers operating in 77 countries. It can be downloaded from this page without prior registration, which this publication finds quite laudable.

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