Chronic disease, MSK claims could rise as pandemic wanes

The trends point to an urgent need for employers to carefully strategize their health benefit plans and be proactive about wellness among their employees.

“We know the pandemic had an impact on people’s access to health care,” said Michael Bradie, vice president of market development at Sun Life. “There’s some thought that there may be pent-up demand for screenings and treatments.

“As a result, people may not know they are living with diseases, so we’re watching that from a disability perspective.”

Apart from a spike in mental health claims, claims for chronic illnesses and MSK disorders are among the top health benefits trends on Sun Life’s radar, Bradie told Insurance Business.

MSK disorders, cancer, and cardiovascular disorders also ranked as the top three most expensive conditions for employee health benefits, according to a survey by WTW last year.

The survey, which polled more than 250 insurers worldwide, warned that employer-sponsored health benefits costs are expected to increase by a record 10% on average globally in 2023. In Canada, the cost increase is estimated at 6.3%.

Rise in chronic diseases claims

Chronic diseases such as cancer, diabetes, heart disease, and arthritis are usually detected through preliminary screenings, and progression can be halted through early intervention.

But because COVID-19 triggered delays in these screenings, more patients could find their diseases have progressed further by the time they’re able to get a diagnosis.

“There’s lot of benefit to identifying chronic diseases early and tackling them upfront, but because early diagnosis was missed or perhaps delayed because of the pandemic, there are some potential ramifications [for claims] down the line,” Bradie said.

Another Canadian provider, Medavie Blue Cross, confirmed it saw cancer claims rise abruptly in the past few years. Moreover, claims tended to be more complex and take longer to resolve.

“When we received those claims, they tended to be for more advanced [stages of illness],” said Olivier Pagé, director of group disability management operations at Medavie Blue Cross.

“We saw a trend of increase in Quebec, Ontario, and the Atlantic [region] for incidence of cancer claims in long-term and short-term disability in 2022.”

While the director said they could not pinpoint specific reasons for claims frequency rise, he noted that several factors could influence the increase apart from limited access to screenings.

“If people were more afraid to go to the hospitals for screenings due to the risk of [COVID-19] contamination, that could be another factor,” Pagé said.

“There are a few factors tweaking the rhythm at which we’re able to do screenings and put people within the healthcare pipeline.”

Return to the office

As more employees return to hybrid or full-time office work, musculoskeletal (MSK) related disabilities could also start trending upward, Bradie told Insurance Business.

“It all goes back to sort of this notion of ergonomics. Folks who have been working from home have established a predictable routine, and now that’s shifting as organizations embark on hybrid ways of working,” the Sun Life VP said.

“It’s possible that as they return to work and adopt some of those old practices, we could see an increase in musculoskeletal issues.”

Mental health link

Medavie Blue Cross, on the other hand, saw a rise in MSK disorders as part of broader mental health claims, according to Pagé. Mental health issues were more also prevalent as a secondary diagnosis for claims in general.

“We were expecting to see an increase as people went back to the physical spaces they used to work before the pandemic, but [the return to office] did not translate to that,” he said.

“However, MSK conditions were more likely to be combined with mental health conditions, and those claims also tend to be take longer to resolve as individuals required more support.”

For example, if an individual fractured their leg but also had anxiety, the MSK condition would worsen the underlying mental health issue and produce more complex claims, according to the director.

“We saw that musculoskeletal problems are more at risk of turning into a longer claim when you have an underlying mental health component,” Pagé said.

Awareness and prevention are key

Brokers and plan sponsors alike should be aware of emerging health trends, according to the executives. For employers, taking preventive measures to ensure their employees’ wellbeing is also key to planning a robust benefits plan.

“When employers think about their wellbeing strategy, [they should focus on] communicating to employees and ensuring that they’re going back to those appointments and screenings,” said Sun Life’s Bradie.

“That’s the best thing we can do at this point, in terms of ensuring that they’re keeping up with their health as things return to normal.”

Do you have any thoughts about employee benefits trends emerging in Canada? Share them in the comments.