Reports and Surveys | December 9, 2021
From 2009 to 2019, medical plan cost increases gradually slowed. In 2020, actual trends decreased dramatically for the three medical plan types because people chose to defer and/or eliminate care during the pandemic.
For the same reason, actual trend for dental provider organization plans also declined to a negative rate.
That’s the first time in the 25 years Segal has conducted an annual survey of health plan cost trends that actual trends were negative.
In sharp contrast to medical and dental plan experience, the actual trend for outpatient prescription drugs jumped in 2020. High-cost specialty drugs, drug price inflation and increased utilization of both mail-order pharmacies and drugs to treat behavioral health conditions were the drivers.
According to managed care organizations, health insurers, PBMs and TPAs surveyed, how do 2022 trend projections compare to 2021 projections? They’re similar.
However, for 2022, the projected cost trend for outpatient prescription drug plans is higher than the 2021 projection. The main driver is the cost of specialty drugs. These drugs have a higher projected double-digit trend for 2022 than for 2021: 13.4 percent, up from 11.5 percent. Specialty drugs now account for more than half of Rx spending.
To see illustrations of how health plan cost trends have changed since 2009 and how they’re projected to change for 2022, watch this video:
During the summer of 2021, managed care organizations, health insurers, PBMs and TPAs participated in the 2022 Segal Health Plan Cost Trend Survey. Collectively, they represent more than 80 percent of the commercially insured and self-insured market.
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