Top Benefit Trend Insights for Data-Driven Group Plans
Posted by Medavie Blue Cross on March 14, 2024
Top Benefit Trend Insights for Data-Driven Group Plans
Posted by Medavie Blue Cross on March 14, 2024
As Canada’s only all-benefits-line carrier with our own in-house pharmacy benefit management technology, Medavie Blue Cross has an advantage that’s unique to the industry — direct access to extensive, integrated claims data that we use to develop innovative solutions that are responsive to the trends. We led off our 2024 Insights webinar series with a report on what's trending in health benefits based on our 2023 data, which our clients can use to design and sustain their plans.
Here’s a summary of what we learned and a link to view our webcast recording:
Key Takeaways
Women's** Health
Females account for 50.2% of our members but represent 55% of our health spend.
Men's*** Mental Health
For the first time, claims for Mental Health Practitioners were in the top 10 list of health categories for males at #8.
ADHD Medication Utilization
For the first time, ADHD medication is in the top 10 list of health benefits for females, coming in at #10. It’s at #5 for males. Also, for the first time, the utilization of ADHD drugs for females to males was equal 1:1 for all generations combined.
Paramedical Utilization
In 2023, nearly 15% of paramedical claimants claimed for 3 or more types of practitioners. This is up from 12.5% in 2019 (and this number has been increasing every year since COVID).
Ozempic Utilization
The #1 contributor for the increased diabetes trend is the increased utilization of the drug Ozempic.
More from our 2023 Claims Data Report
Claim Spend Split — In 2023, 65.7% of claim spend was on Drugs and 34.3% on Extended Healthcare Benefits, a split consistent with previous years.
Leading Health Benefits — The top three health spend categories were drug costs to treat inflammatory conditions, diabetes and massage therapy.
Specialty Drugs — Specialty drugs accounted for 33% of the drug spend in 2023, slightly below the percentage of total in previous years, with 34% in 2022 and 36% in 2021.
Top Drug Categories — Inflammatory conditions led the therapeutic categories, followed by diabetes and antidepressants, while the top trend drivers were diabetes, ADHD and inflammatory conditions.
Top Disability Claim Diagnosis — Mental health conditions were the leading cause of both short-term and long-term disability claims.
Respiratory Claims Down — The dramatic increase in respiratory claims in 2022 leveled off in 2023.
EHC Costs Up — Per capita spending for Extended Health Care benefits has continued to grow over the last three years, with an 11.2% trend in 2023, driven by inflation and utilization.
Highest Ranking EHC benefits — The top three EHC benefits based on costs per capita were massage, mental health practitioners and physiotherapy.
Largest Spending Increase — Mental Health practitioners had one of the largest increases of any benefit in the Top 10 for 2023, with a 23% increase in per capita spending.
New and Enhanced Solutions
We’re continually exploring new ways to evolve our benefit offering to keep pace and better still, stay ahead of the emerging trends we detect from our data analytics.
Women’s Health
Recognizing that women encounter unique challenges in their health journey, we’ve expanded the suite of health solutions we offer to support them at all stages of life. This includes coaching services to help women adjust to menopause and midlife hormonal changes, including management of perimenopause menopausal symptoms. We also recently expanded our coverage for family building with a benefit that reimburses eligible expenses related to fertility treatments, surrogacy and adoption.
New and Enhanced Solutions
We’re continually exploring new ways to evolve our benefit offering to keep pace and better still, stay ahead of the emerging trends we detect from our data analytics.
Women’s Health
Recognizing that women encounter unique challenges in their health journey, we’ve expanded the suite of health solutions we offer to support them at all stages of life. This includes coaching services to help women adjust to menopause and midlife hormonal changes, including management of perimenopause menopausal symptoms. We also recently expanded our coverage for family building with a benefit that reimburses eligible expenses related to fertility treatments, surrogacy and adoption.
Diabetes Management
In 2023, we augmented our drug plan management program for diabetes-related conditions, adding automated prior authorization for any new claims for GLP-1 receptor agonist drugs, requiring that member history shows previous treatment for type 2 diabetes. We’ve also expanded our health coaching and education services for management of diabetes, obesity and hypertension through our 360 Total Care program.
Targeted Wellness Messaging
We’ve made enhancements to our member wellness platform, Health Connected, which features a health risk assessment tool to give users a snapshot of their health and to identify and lower their risk factors for disease. Additionally, targeted messaging is now being sent directly to members to promote their self-care and raise awareness about our disease prevention and management solutions.
Diabetes Management
In 2023, we augmented our drug plan management program for diabetes-related conditions, adding automated prior authorization for any new claims for GLP-1 receptor agonist drugs, requiring that member history shows previous treatment for type 2 diabetes. We’ve also expanded our health coaching and education services for management of diabetes, obesity and hypertension through our 360 Total Care program.
Targeted Wellness Messaging
We’ve made enhancements to our member wellness platform, Health Connected, which features a health risk assessment tool to give users a snapshot of their health and to identify and lower their risk factors for disease. Additionally, targeted messaging is now being sent directly to members to promote their self-care and raise awareness about our disease prevention and management solutions.
Get the Numbers You Need
Our account team leverages the insights we gain from our data analytics to make timely recommendations to our clients and support evidence-based decisions to achieve their organizational objectives — whether that’s improving the wellbeing of their workforce, managing their health costs, or retaining and recruiting top talent. Our service model includes a range of data reporting options to meet their needs. Connect with your Medavie Blue Cross representative to learn more about our data mining and reporting capabilities.
Watch Webinar Recording
We invite you to view to a recording of our Drive Your Plans with Data webinar in English and French.
About the Data we Presented
*The data report we shared during this webcast is from our analysis of our private, group insurance business, covering about 1.6 million members, and including all types of plan designs, industries and funding arrangements.
** Includes Women and Assigned Female at Birth (AFAB)
*** Includes Men and Assigned Male at Birth (AMAB)
Medavie Blue Cross is a premier all-in-one carrier that provides health, dental, travel, life and disability benefits and administers federal and provincial government-sponsored health programs. Together with Medavie Health Services, we are part of Medavie, a health solutions partner committed to improving the wellbeing of Canadians. We are in the...