2022 employer-sponsored health care: a year in review

Since the beginning of the pandemic, employer-sponsored health plan stakeholders have been through a lot. They’ve had to navigate unprecedented fee-for-service medical and pharmacy claims—all while having to constantly adapt to an ever-changing risk landscape.

In 2020, claims trends were historically low. Non-emergency medical utilization decreases outweighed COVID-19 testing and treatment utilization increases. Health care claims did rebound in 2021 and 2022, but to levels still less than pre-pandemic trend expectations.

Looking ahead, employers continue to face an evolving host of challenges. These also come amidst shifting workforce expectations, mental and behavioral health needs, and changes in health care economics. To face these challenges, employers should remain focused on creating positive outcomes for plan members. Building sustainable strategies to improve both the patient care experience and overall workforce health, as well as reducing the per capita cost of health care, should be a top priority. 

Fee-for-service medical and pharmacy actual vs. expected allowed claims since the beginning of the pandemic

MMA analyzed its national book of business health plan utilization with data through December 31, 2022. Below is a chart illustrating MMA’s national fee-for-service medical and Rx actual claims compared to expected claims assuming 6.0% annual claims trend: