Best Practices in Health Care Employer Survey Report

High-performance insights – best practices in health care

January 31, 2018
| United States

The 2017 22nd Annual Willis Towers Watson Best Practices in Health Care Employer Survey examines the actions employers are taking to enhance the performance of health plans for their employees and organizations.

The research focuses on a wide-array of strategies in employer-sponsored health care to reduce cost; improve efficiency; and, ultimately, achieve a healthy, high-performing workforce.

View the full interactive report using the “Download” button at the top or bottom of this page, or click here for a printer-friendly version.

Top employer priorities

Over the next three years, employers are prioritizing their efforts to improve employee health engagement and consumer experience, and measure the effectiveness of their programs.

Top employer priorities: improve health engagement
Top employer priorities: expand the use of analytics
Top employer priorities: enhance the employee experience


Key survey findings

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Confidence is strong

Despite uncertainty about health care legislation, employer confidence in offering health benefits reached its highest level since the passage of the Affordable Care Act in 2010. Ninety-two percent of employers said they are “very confident” their organization will continue to sponsor health benefits in five years.

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Cost pressures remain

Employers expect health care costs to increase by 5.5%1 in 2018, up from a 4.6% increase in 2017. They plan to step up cost management strategies over the next three years, including evaluation of emerging health care delivery solutions and improved patient navigation and health engagement.

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Creating a cost advantage

Best-performing companies have created a cost advantage of more than $2,000 per employee per year (PEPY) over the national average by adding value through a broad set of activities to control costs and improve workforce health. Their cost advantage over high-cost companies rises to more than $3,500 PEPY.

Best performers have created a cost advantage of more than $2,000 per employee per year (PEPY) over the national average

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Emphasizing clinical conditions

Employers put more emphasis on specific clinical areas – notably diabetes (76%), musculoskeletal (69%) and mental health (65%) – to improve member health and reduce costs.

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Proactive management of pharmacy benefit costs

Employers take more aggressive steps to curb pharmacy costs and utilization (particularly for specialty) by re-examining benefit contract terms and looking beyond PBMs to integrate with the medical plan.

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Prioritizing the employee health experience

Over the next three years, employers plan to improve the employee experience by adding choice, providing decision-support tools, and enhancing enrollment platforms and navigation.

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Health and well-being as a key competitive advantage

Increasingly organizations view their health and well-being programs as a key factor to attract talent, and many organizations plan to broaden their efforts to support employees’ physical, emotional and financial well-being.

About the survey

The 22nd Annual Willis Towers Watson Best Practices in Health Care Employer Survey was completed by 698 U.S. employers between June and July 2017 and reflects respondents’ 2017 health program decisions and strategies. Respondents collectively employ 11.9 million employees and operate in all major industry sectors. Results provided are based on 555 employers with at least 1,000 employees. For more information, contact us at

About the survey respondents

About best performing companies

Our research identified 47 companies that qualify as best performers based on their abilities to manage cost trends and efficiency. Best-performing companies (47 survey respondents) exhibited the following two characteristics:

  • Cost trend: Two-year average trend after plan changes (2015/2016 and 2016/2017) that is below the national norm (4.5% in 2017) and two-year average trend before plan changes (2015/2016 and 2016/2017) that is below the national norm (6.0% in 2017)
  • Efficiency: Efficiency in 2017 that is 5% or greater — roughly 60th percentile and above (see About efficiency and custom benchmarks in our downloadable report)

We selected best performers from the 395 companies that completed both the 2017 Willis Towers Watson Financial Benchmark Survey and the 2017 Willis Towers Watson Best Practices in Health Care Employer Survey with sufficient health care cost trend and efficiency information.


  1. Cost increases for 2017 and 2018 are after-plan changes; increases without plan changes are 6.0% for both 2017 and 2018. Cost trends are based on projected medical and drug claims for active employees, including both employer and employee contributions but excluding employee out-of-pocket costs.

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Employers understand that there is no single strategy for success when it comes to health care; the most effective health programs will include a broad range of strategies that manage costs for both employers and employees while also improving health outcomes.

— Catherine O’Neill, a senior health care consultant at Willis Towers Watson

Cost management of health benefit programs remains the top priority for employers. Over the next three years, they will seek to improve patient engagement, expand the use of analytics, and efficiently manage pharmacy costs and utilization.

— Julie Stone, a national health care practice leader at Willis Towers Watson