Recently, Green Shield Canada (GSC) came out with their 2014 Health Study.  This was an innovative look at the trends this large Insurer is seeing in their block of business.  The results have been sorted by age bands and includes health claims data; in addition to the more familiar drug data.  High level, we learned that 5% of claimants drive 36% of costs  and 20% of claimants drive 63% of costs.

The study also pointed to a huge problem with drug adherence,  ie only 63% of those with high blood pressure, 57% with cholesterol, 45% with depression and 55%  with diabetes took their medications as prescribed by their doctor.  Not only does this create issues with wastage, but with hospitalization, missed days, etc. Here are the study highlights:

0 – 10 Year Olds:

Babies are getting chiropractic services. Although some of the usage is driven by accidents and injuries, the single highest usage and cost for chiropractic services is for under one-year-olds. Unfortunately, misinformation surrounding chiropractic services for the treatment of colic and ear infections seems to be the biggest culprit.

11-19 Year Olds:

A claiming pattern emerges that continues throughout the age bands. GSC refers to it as “the three amigos” of health claim volumes because, from here on in, three health benefits come together as an almost inseparable trio: massage, chiropractic services, and physiotherapy. Together they result in the highest-usage and highest-cost health benefits.

Teenage girls use of massage rose 543% from the previous age band. Clearly, the fact that massages can help people relax, relieve aching muscles and ‘temporarily lift a person’s mood‘ is clearly a factor in this gender specific spike.

Oral Contraceptives (11.89%) and mental health drugs (24.92%) of volume for ADHD, Depression, Anxiety and Psychiatry form the majority of drug claims in this group.

21-40 Year Olds:

The three amigos are well entrenched with massage as the number one cost driver—it is the single most costly health benefit between the ages of 26 and 52. It is also during these years that female spend begins to radically outpace male spend. In their 20’s, females spend over 80% more than men on health benefits. In the 30’s, it is 73%, dropping to a still significant 47% in the 40’s. While this is consistent with female-male trends in drug and dental spends, it is more pronounced in health benefits, and with the societal trend of a spa on every corner, females are being expressly marketed to for some of these services.  The fact that there is no evidence based reason to believe massage has an impact on disease, the rise in its usage is suspect.

In the 30’s antidepressants, oral contraception and treatment for pains and strains dominate the coverage list.

41-60 Year Olds:

The three amigos still lead the charge in terms of top health benefits usage, but now plan members are facing the complex challenges associated with managing chronic conditions whose seeds were sown during their 20’s and 30’s. Once again massage continues to hold the top cost position in the 40’s and 50’s—just like the 20’s… and the 30’s… and the 40’s.

The data suggests that 25% of claimants had massage and chiropractic services at the same location.  As well, people that used massage were actually more likely to use drug therapies.

60 – 70 Year Olds:

The disease states continue to look like a roll call of chronic diseases, and also like the 50’s, chiropractic services and physiotherapy make the list of the top health benefits. We also see age-related benefits entering the scene in the 60’s and 70’s; like home support services and long term care. The 60’s is the first age group with a diminishing impact of massage; this is likely because massage is probably not ingrained in the lifestyle of this older generation— something we certainly can’t say regarding the younger generations where massage is king and may continue to be throughout their lives.

For over 20 years, Chris Pryce of Human Capital Benefits has been advising employers on all aspects of managing employee benefits programs and related products. If you have any questions, you can contact Chris at 416.924.8280 or by email at