Skip to main content
Survey Report

2019 Best Practices in Health Care Employer Survey Report

Executive summary: key health care priorities and identifying best performers

Benefits Administration and Outsourcing Solutions|Health and Benefits|Talent|Total Rewards
N/A

April 3, 2020

Our research reveals that employers are focusing on understanding employee needs and expectations to shape health and wellbeing programs.

In today’s full-employment economy, employers are under pressure to offer competitive health care benefits even as health care costs continue to rise. According to the 24th Annual Willis Towers Watson Best Practices in Health Care Employer Survey, health care costs are projected to climb 4.9% in 2020 compared with 4.0% in 2019. Despite this cost increase, employers believe they will continue to sponsor health benefits over the next decade. Nearly all employers (95%) are very confident their organization will continue to sponsor health care benefits in five years.1

Looking at the longer term, employers’ confidence in sponsoring these benefits in 10 years grew to 74% — up from 69% in 2018 — reaching the highest level in the past decade.2 These employers plan to continue to provide health care benefits to support employees to be physically and mentally healthy, and thrive on the job.

As cost pressures continue, employers recognize the challenges employees face in covering both their payroll deductions and out-of-pocket costs for health care benefits. In fact, 89% of employers believe rising health care costs are a significant source of financial stress for their employees. Consequently, increasing health care affordability for employees while controlling costs for the organization is the top priority for almost all employers (93%) and the most challenging priority for almost two-thirds of employers (63%) over the next three years.

95%
of employers are very confident their organization will continue to sponsor health care benefits in 5 years.
89%
of employers believe rising health care costs are a significant source of financial stress for their employees.
93%
of employers consider increasing health care affordability for employees while controlling costs for the organization as a top priority.

Employers are increasingly putting employees at the center of their health and wellbeing strategies. They’re focusing on understanding employee needs and expectations in order to shape health and wellbeing programs that will give them a competitive edge in a tight labor market. In addition, employers recognize the financial struggles some employees face. Consequently, they are adding choice and customizing benefits in order to more efficiently deliver value to employees. With a focus on what employees value, companies are also better positioned to engage employees in programs that promote healthy behaviors and support employees in their health care decision making.

Key priorities


  1. 01

    Improving access to cost-efficient quality care

    Although two-thirds of employers say they've made progress in containing health care costs and improving affordability over the past three years, work remains to be done. To tackle the cost and affordability issue, companies are focusing on the following levers:

    • Implementing value-based designs to steer employees toward proven services that produce positive health outcomes at a lower price tag (U.S. health care costs are largely reflective of high unit prices, and there is often little correlation between unit price and quality)
    • Focusing on clinical conditions — including mental/ behavioral health, metabolic syndrome/diabetes, musculoskeletal and cancer to improve outcomes and reduce costs through such interventions as vendor point solutions, steerage to high-quality providers and centers of excellence (COEs), and programs aimed at reducing wasteful or harmful care
    • Expanding use of onsite and near-site health clinics to gain greater control over costs.
    • Encouraging greater use of virtual care models, telebehavioral health services, COEs,high-performance networks and expert medical opinion programs to help ensure cost-effective, appropriate, quality care
    • Influencing site of care for specialty drugs and promoting use of biosimilars, when available, to manage specialty drug costs
  2. 02

    Enhancing wellbeing

    Employers remain committed to wellbeing programs and are pivoting toward more holistic programs that address physical as well as financial, emotional and social wellbeing. They recognize that employees who are physically thriving, financially secure, emotionally balanced and socially connected are more engaged and drive better business outcomes.

    Employees who are physically thriving, financially secure, emotionally balanced and socially connected are more engaged and drive better business outcomes.

    However, wellbeing remains a challenging priority given traditional low engagement levels. Because the use of financial incentives in wellbeing programs is leveling off, employers are placing a greater emphasis on health culture as a way to boost engagement. They are shaping a healthy work environment and building wellbeing programs into their employee value proposition. This involves emphasizing workplace dignity, which is key to building trust with employees and successfully engaging employees in their wellbeing. Some of the initiatives employers are using to support a healthy work environment include: paid parental leave beyond what is required by law, programs that focus on stress and resiliency, financial management tools and the use of human-centered design in wellbeing programs.

    A growing number of employers are measuring the impact of wellbeing programs using a variety of financial and nonfinancial metrics. Known as value on investment, this approach enables employers to move beyond ROI metrics and evaluate such factors as employee satisfaction, participation, productivity and mitigation of health risks. Such an approach provides a more complete assessment of program impact.

  3. 03

    Delivering an employee experience that blends high tech with high touch

    Facing many competing priorities, employers have often overlooked the need for a strategic approach to designing their employee experience. But, in the next few years, more companies expect to create an employee experience strategy that is differentiated from that of their competitors and customized to meet the needs of critical employee segments. And they plan to use organizational analytics to assess the effectiveness of their strategy.

    To improve the employee experience, employers will focus on several key priorities:

    • Enhancing the enrollment experience
    • Integrating wellbeing vendors to provide a more unified experience across physical, financial, emotional and social dimensions
    • Adding more choice in all benefits
    • Offering care advocacy/navigation services

    To understand their employees’ perspective regarding these issues and better meet their needs, employers plan to use a range of feedback channels, including surveys, focus groups and town hall meetings. And they will focus on technology solutions to address these issues and deliver an improved employee experience throughout the health care journey. These solutions include decision support tools to provide enrollment recommendations and to support treatment decisions. In this way, companies provide a high-tech, high-touch employee experience.

    Companies understand that to put employees at the center of their health care strategy, they will need to sharpen their understanding of employees’ diverse needs.

    Companies understand that in order to put employees at the center of their health care strategy, they will need to sharpen their understanding of employees’ diverse needs and use the resulting insights to craft solutions that drive greater engagement and improved health care decision making. By refining program design and delivery solutions, and offering wellbeing programs and a more relevant, personalized employee experience, employers will unlock opportunities to improve affordability for employees while controlling costs for the organization.


Table of Contents


  1. 2019 Best Practices in Health Care Employer Survey Highlights

    Best Practices in Health Care Employer Survey Report Highlights provide insights into employers’ current and future health and wellbeing strategies.


  2. Making health care affordable and controlling costs

    Employers must continue to improve health experiences and health outcomes while seeking ways to mitigate the impact of cost increases.


  3. Steering employees toward highest-quality affordable care

    As health care costs continue to rise employers face the challenge of changing plan design while keeping health care premiums and out-of-pocket costs affordable for employees.


  4. Encouraging higher-value, lower-cost health care network and delivery solutions

    Some employers are finding that competing organizational priorities and administrative challenges are hindering their efforts to shift to a value-based health care delivery model.


  5. Targeting specialty drug costs and utilization

    The 2019 Best Practices in Health Care Employer Survey reveals some of the top strategies that organizations are planning or considering to help address the rise of pharmacy spend.


  6. Enhancing physical, financial, emotional and social wellbeing

    Organizations with higher levels of wellbeing achieve better business outcomes; higher levels of employee engagement, improved revenue, greater customer satisfaction and fewer safety incidents.


  7. Delivering a high-tech, high-touch employee experience

    Companies are looking for a deeper understanding of the needs and expectations of their workforce and are placing greater emphasis on health technology solutions.


  8. Measuring the impact of health and wellbeing programs

    A commitment to metrics enables companies to better identify employee needs and target programs to different individuals or employee groups.


  9. How your organization can become a best performer

    Our research enables us to identify key actions and practices of best-performing companies to help jump start your ability to deliver enhanced health care experiences.


Identifying the best performers

Our research identified 44 companies that qualify as best performers based on their ability to manage cost trends and efficiency (see page 16 of the 24th Annual Best Practices in Health Care Survey Report). Best-performing companies exhibited the following two characteristics:

  • Efficiency: efficiency in 2019 that is 5% or greater (roughly 60th percentile and above)
  • Cost trend: two-year average trend after plan changes (2017/2018 and 2018/2019) that is at or below the national norm (4%) and two-year average trend before plan changes (2017/2018 and 2018/2019) that is at or below the national norm (5%)

We selected best performers from the 454 companies that completed the 2019 Willis Towers Watson Financial Benchmarks Survey and the 2019 Willis Towers Watson Best Practices in Health Care Employer Survey with sufficient health care cost trend and efficiency information. These best performers gain significant competitive advantage by creating and leveraging best practices that improve access to cost-efficient quality care, enhance wellbeing and improve the employee experience.

About the survey

The 24th Annual Willis Towers Watson Best Practices in Health Care Employer Survey was completed by U.S. employers between June and July 2019, and reflects respondents' 2019 health program decisions and strategies, and expected changes for 2020 and 2021. Respondents collectively employ 11.3 million employees and operate in all major industry sectors. Results provided are based on 610 employers with at least 100 employees.

icon: 3 buildings
610 employers (with at least 100 employees responded to the survey)
icon: 3 people
11.3M employees at responding organizations

Employer size-100-999, 19%; 1,000-4,999, 28%; 5,000-9,999, 15%; 10,000-24,999, 20%; 25,000+, 17%
Industries included Manufacturing, 22%; Health care, 15%; Financial services, 14%; General services, 13%; IT and telecom, 12%; Wholesale and retail, 11%; Energy and utilities, 7%; Public sector and education, 6%.
Figure 1. About the 24th Annual Best Practices in Health Care Employer Survey

Note: Percentages may not add up to 100% due to rounding.

Footnotes

Sample: Companies with at least 1,000 employees
Ibid., 1.

 


Related Capabilities

Contact Us