Understanding how members are using their benefits plans and how that use has changed is central to ensuring a successful and sustainable plan. For Medavie Blue Cross, that understanding comes from data from 300,000 health-care providers encompassing 2.9 million Canadians who receive $3.5 billion in benefit claims a year.

In Atlantic Canada, as elsewhere in the country, the population is aging and the composition of the labour force is shifting significantly. According to Statistics Canada, almost 25 per cent of Canadians could be 65 or older by 2031. Only 16 per cent will be under age 15.

Read: Focus on preventative measures in fight against chronic disease

The numbers have important implications for plan sponsors, Derek Weir, manager of group benefit solutions with Medavie Blue Cross in Moncton, N.B, told participants at Benefits Canada’s 2017 Halifax Benefits Summit. “As a population gets older, it is generally less healthy and requires more health care.”

Roughly one-third of plan expenditures in Atlantic Canada go toward extended health care and two-thirds for drugs. In the past two years, the fastest-growing expense in the extended health-care category has been for continuous positive airway pressure machines.

Six of the top 10 expenditures for extended health care involve services from health-care providers: massage therapists, physiotherapists, chiropractors, psychologists and naturopaths.

Compared with other generations, baby boomers spend somewhat more than their share of extended health-care benefits and significantly more on drugs, Weir told those at the Halifax event in late September. They comprise 31 per cent of the population and 40 per cent of spending on extended health care. In the drug category, they account for 49 per cent of spending.

Read: New advances in tackling cardiovascular disease

A few key categories are driving plan spending for drugs in Atlantic Canada. While biologics are a significant factor, costs related to cardiac health are a major driver of spending. “But the biggest cost driver overall is chronic disease and related risk factors,” said Weir.

He pointed to diabetes as an example. Since 2012, per capita spending for the disease has essentially doubled to 16.2 per cent of all costs. “Yet traditionally, there are no supports in the benefit plan to help with how best to manage chronic disease,” said Weir, noting the role of chronic disease management programs that connect members to assistance in person and over the phone.

Given the challenges, it’s important to spend more time on plan design, said Weir. “We need to balance the demands of younger workers with protecting the health of older employees and we need to save money to do both.”

Read more articles from the 2017 Halifax Benefits Summit

Copyright © 2018 Transcontinental Media G.P. Originally published on benefitscanada.com

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