Medical cost trend: Behind the numbers 2025
Commercial health care spending is projected to grow significantly in 2025, driven by inflation, prescription drug costs, and increased behavioral health utilization, marking the highest growth rates in over a decade.
(Generated with the help of GPT-4)
| Quick Facts | |
|---|---|
| Report location: | source PDF |
| Publication date: | 2024 |
| Language: | English |
| Publisher: | Pricewaterhouse Coopers |
| Authors: | Hamna Hasan, Jiahui Zhou, Julian Levin, Nachum Sash, Philip Song, Sam Cayemberg, Shubhankar Yadav, Derek Skoog |
| Time horizon: | 2025 |
| Geographic focus: | United States |
Methods
The research method involved surveying and interviewing actuaries from over 20 US health plans, which collectively cover more than 100 million employer-sponsored members and 10 million ACA marketplace members. The data collected was used to estimate medical cost trends for 2024-2025.
(Generated with the help of GPT-4)
Key Insights
The report forecasts a medical cost trend of 8.0% for Group plans and 7.5% for Individual plans in 2025, reflecting the highest levels seen in 13 years. This increase is attributed to persistent inflationary pressures, particularly in healthcare, alongside rising prescription drug costs and greater utilization of behavioral health services. The report highlights that the healthcare industry has been experiencing inflation since 2022, which is expected to continue into 2025 as providers pass on rising operational costs to health plans. The utilization of GLP-1 drugs for diabetes and weight management is also rising, contributing to overall medical costs. The report indicates that while some new cost-saving measures, such as biosimilars, may offer relief, they are insufficient to counterbalance the inflationary forces. The report is based on surveys and interviews with over 20 US health plans covering more than 100 million members, indicating a pressing need for healthcare organizations to rethink their strategies to manage total care costs effectively.
(Generated with the help of GPT-4)
Additional Viewpoints
Categories: 2020s time horizon | 2025 time horizon | 2024 publication year | English publication language | United States geographic scope | behavioral health | biosimilars | cost-saving measures | generative ai | health plan strategies | healthcare spending | inflation | medical cost trend | no surprises act | prescription drugs