How top employers are controlling health care costs, focusing on wellbeing: Best Practices in Health Care Employer Survey

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

October 9, 2018
| United States
Woman on a run looking at her fitness tracker

What are U.S. employers doing to control health care costs and help employees improve their wellbeing? How does your company’s health benefit strategy compare with best practices?

The Willis Towers Watson 2018 Best Practices in Health Care Employer Survey Report explores employers' current actions and future plans for employer-sponsored health benefits and provides insights regarding strategies employers are pursuing to reduce cost; improve efficiency; and ultimately achieve a healthy, high-performing workforce. These strategies cover key areas, including:

  • Employee experience (employee engagement, health technology, work environment)
  • Health care delivery (vendor/partner strategies, new delivery options, health care access)
  • Pharmacy management
  • Integrated wellbeing (physical, financial, emotional and social)
  • Measurement, and health and wellbeing analytics

View the report’s Executive Summary now using the "Download" button. (The full report will be posted later in 2018.)

Top employer priorities

Over the next three years, employers are prioritizing their efforts to zero-in on clinical conditions, invest in employee wellbeing and enhance the employee experience.

Top employer priorities: clinical conditions

Clinical conditions: 85%
Improve the health and reduce the costs for key clinical areas such as cancer, diabetes, maternity/fertility, mental health and musculoskeletal disease.

Top employer priorities: employee well-being

Employee wellbeing: 82%
Enhance employees' total wellbeing in the areas of physical, emotional, financial and social wellbeing.

Top employer priorities: enhance the employee experience

Employee experience: 72%
Increase employee perceptions about the workplace culture, and technological and physical environments.


Key findings

  • Rising 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 account-based health plans (ABHP).

  • Confidence in offering health benefits steadily rises

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

  • 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.

  • 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.

  • Strong commitment to employee wellbeing

    Employers look to engage in a broad set of activities to support the physical, emotional, financial and social wellbeing across their workforces. Although employee engagement in health and wellbeing initiatives is a persistent challenge and top opportunity, employer commitment to wellbeing has never been stronger.

  • Prioritizing health technology

    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.

  • Measuring success

    The employers that measure the impact of their health and wellbeing initiatives (currently only 46% have a measurement strategy) will gain momentum and advantage to achieve a healthy, high-performing workforce.

About the survey

The 23rd Annual Willis Towers Watson Best Practices in Health Care Employer Survey was completed by 687 U.S. employers between June and July 2018 and reflects respondents’ 2018 health program decisions and strategies. Respondents collectively employ 11.4 million employees and operate in all major industry sectors. Results provided are based on 554 employers with at least 1,000 employees.

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Percentage of full-time workers employed by respondents Click to enlarge
Percentage of respondents by industry groups Click to enlarge


Source: 2018 Willis Towers Watson Best Practices in Health Care Employer Survey