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Survey Report

How top employers are controlling health care costs, focusing on wellbeing

High-performance insights: Best Practices in Health Care Employer Survey Executive Summary

October 9, 2018

Find out how U.S. employers are managing health care costs and addressing employee wellbeing to achieve a healthy, high-performing workforce.
Health and Benefits|Wellbeing|Total Rewards|Benefits Administration and Outsourcing Solutions

Looking to mitigate future cost increases and connect benefit programs to workforce culture, 82% of employers are investing in wellbeing initiatives, or plan to over the next three years. Despite current participation challenges, employers remain committed to improving employee wellbeing.

Employers also recognize that workers are more productive when they are healthier and emotionally and financially secure, and wellbeing is evolving accordingly as employers seek to align the work environment and company culture with their overall health and wellbeing initiatives. Currently 53% of employers report aligning company culture with health benefits, and that number is expected to rise to 76% over the next two years.

employees investing in wellbeing programs over the next three years
employers reporting aligned company culture with health benefits

However, engagement remains a challenge for wellbeing and health care programs. The use of financial incentives for participating in wellbeing programs has plateaued. To improve engagement, there is growing emphasis on connecting the workplace environment and leadership involvement to the many aspects of wellbeing. Some of the initiatives at the workplace that address physical, emotional and social wellbeing include:

  • Flexible work arrangements
  • Paid parental leave
  • Diversity and inclusion initiatives
  • Events that give back to the local community, such as food drives

Organizations with increased health engagement are focused on improving the employee experience by connecting to the company’s culture and ultimately providing tools and resources that support employees when they need it most.

Today’s workforce demands greater choice among plan offerings that better address all career stages, whether it’s starting a first job or preparing to retire. Employers are addressing these issues by:

  • Offering choice of health plan options or insurers
  • Expanding the menu of voluntary and supplemental benefits
  • Making workforce perks such as childcare services, time off to volunteer and onsite services a core part of the EVP

To support the growing number and complexity of programs being offered, employers need to have tools not only to support enrollment but also to support health care decisions. Employers are adopting new technology and partnering with innovative companies to improve health care navigation, increase wellbeing, improve the delivery of health care and better connect members with chronic condition management.


  1. 01

    Increasing health care costs

    Companies expect a slight upswing in health care cost increases over the next two years, but cost trends remain at or below 5% (after plan changes). Cost shifting appears to have slowed partly due to the maturing of ABHPs.

  2. 02

    ABHP sponsorship possibly peaking

    ABHP sponsorship and the advance toward total replacement have leveled off. In fact, one in five companies with a total replacement strategy has reversed course and reintroduced low point-of-care cost programs.

  3. 03

    Financial incentives leveling off

    Use of financial incentives around wellbeing activities have plateaued, especially the use of penalties and outcomes-based incentives. Instead, employers focus on building a healthy work environment and creating a personalized experience to drive engagement.

  4. 04

    Confidence in offering health benefits rises

    Employer confidence in offering health benefits in 10 years remains strong, nearing its highest levels in 15 years.

  5. 05

    Controlling pharmacy costs

    Employers proactively manage pharmacy benefit costs with particular emphasis on specialty pharmacy utilization, but significant opportunities remain to adjust plan designs and implement coverage changes.

  6. 06

    Prioritizing health technology solutions

    Over half of companies prioritize health technology solutions — connected devices, enhanced enrollment and an integrated platform — as important over the next three years to improve the delivery of care, health analytics and the consumer experience, and onequarter of companies are actively looking for the best technology or plan to pilot solutions.

  7. 07

    Focus on employees’ wants and needs

    Over the next three years, companies will emphasize targeting specific clinical conditions and enhancing the employee experience. At the center, employers place a growing emphasis on understanding employees’ wants and needs, and refine program designs and activities around a consumer-centric approach.

  8. 08

    Strong commitment to wellbeing initiatives

    Employee engagement in health and wellbeing initiatives is a persistent challenge and top opportunity, but employer commitment to wellbeing has never been stronger.

  9. 09

    Tools for supporting decisions

    Employers plan to significantly expand the offering of various tools to support employees’ decisions and monitor their health and wellbeing while looking for superior technology to enhance the enrollment experience.

  10. 10

    Growing interest in value-based designs

    Employers plan to increasingly incorporate value-based designs and expand the use of high-performance networks and services to enhance care delivery (e.g., expert medical opinion, concierge services).

  11. 11

    Aligning wellbeing initiatives with corporate culture

    Employers look to engage in a broad set of activities to support the physical, emotional, financial and social wellbeing across their workforces, and there is growing emphasis to align wellbeing with their EVPs and support the connections among all aspects of wellbeing, the workplace environment, health culture and leadership involvement.

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