A major new report by MAXIS Global Benefits Network (MAXIS GBN) has found that musculoskeletal (MSK) conditions are the most costly claims driver for multinational employers. MSKs accounted for 12% of private medical claims costs for multinationals worldwide, despite the global impact of COVID-19. MSK conditions were ahead of respiratory diseases (11.5%), digestive conditions (10.3%), neoplastic diseases (9.1%) and genitourinary conditions (7.1%), according to MAXIS GBN’s proprietary analysis of private medical claims.
These findings come from a new report by MAXIS GBN, The global private healthcare landscape – a story told by MAXIS claims data. The analysis is based on several years of comprehensive medical claims data from MAXIS GBN’s network of local insurance companies in more than 25 markets around the world. It looks at the top drivers of cost in diagnostic and benefits categories across the entire MAXIS claims portfolio, both at a regional level and for each individual country. It also looks at wellness trends that are shaping local ecosystems, COVID trends, top chronic disease drivers and much more.
On average, surgeries and procedures for MSK conditions cost US $629 per member per year (PMPY) compared to an average of US $615 for all other conditions. Nearly half (48%) of the total amount paid under the MSK category was for chronic issues, of which 43% were for back (or disc) disorders, while the highest unit costs for MSK conditions were inpatient procedures such as surgery.
However, MAXIS GBN believes better use of dedicated preventative measures and programmes could have a significant cost reduction impact for multinationals and lead to better results for patients. The analysis found, for instance, that the overuse of scans for lower back pain could be avoided and conservative treatments such as physical therapies can deliver better outcomes.
Dr Leena Johns, Head of Health and Wellness at MAXIS GBN, said: “MSK conditions remain a major challenge for businesses of all types, affecting employees’ health and productivity and adding significant cost to medical policies and programmes. With the shift to working from home and poor ergonomic working environments, we may find that MSKs continues to rise in 2022 and beyond. Conservative treatments for MSK conditions – such as physical therapy – could help to give better results for patients and lower costs, but access remains a problem. In 31% of countries, there is less than one practicing physical therapist per 10,000 people.”
“In the era of COVID-19, where respiratory illnesses have dominated headlines, the fact that MSKs are the biggest cost driver shows the need for an effective and dedicated approach to better care for employees with MSK conditions.”
MAXIS GBN’s study found that respiratory conditions were the second highest cost driver, accounting for 11.5% of paid claims costs. Acute respiratory conditions (including COVID-19, colds and flu, coughs and sore throats) made up over 74% of total paid claims in the entire respiratory claims category.
MAXIS GBN believes there are a number of solutions multinationals could consider to better care for their people and tackle their biggest cost drivers. For MSK conditions, options include virtual and telemedicine-based solutions so employees can access physical therapies at home – this could not only help prevent costly surgery but also reduce absenteeism and improve an employee’s productivity. Companies could also encourage second medical opinions – these are usually covered in medical plans and can help to ensure the employee is on the right treatment path.
As for reducing costs from respiratory conditions, multinationals should look to promote the use of primary care treatment as an initial response and ensure employees have the solutions they need to effectively manage these conditions.
Dr Leena Johns said: “Sharing in-depth analysis of private medical claims data means multinationals can gain insights into their biggest medical cost-drivers, understand the underlying trends that play a role in those drivers and plan their strategies accordingly. This could be done in a variety of ways from putting in place wellness and preventative programmes, adjustments to plan design and reimbursement processes, to network changes. and other new innovative healthcare cost reducing methodologies.”