2023 Large Employers’ Health Care Strategy and Plan Design Survey Released

In August 2022, the Business Group on Health released the 2023 Large Employers’ Health Care Strategy and Plan Design Survey, covering large employers’ perspectives on critical health care topics. Some of the topics covered in the survey include the lasting impact of COVID-19 and what role health and well-being play in overall workforce strategy. The information gathered from the survey was then used to create aggregate findings on how employer-sponsored healthcare may shift in the coming year.

The survey was conducted between May 31, 2022, and July 13, 2022, and 135 large employers participating, representing more than 18 million patient lives in the United States. 27% of respondents had less than 10,000 employees; 25% had between 10,000 and 24,999 employees, 19% had between 25,000 and 49,999 employees, 16% had between 50,000 and 99,999 employees, and 13% had more than 100,000 employees. 13% of respondents were involved in the technology/telecommunications industry and another 13% were involved in the manufacturing industry. 11% were from the retail/hospitality/food services sector while 10% from the banking/financial services/securities. Less than 10% of respondents were involved in each of the following industries: consumer products and grocery (9%), insurance (8%), energy production and utilities (7%), health care (7%), pharmaceuticals and medical products (6%), transportation and shipping (4%), aerospace/defense (4%), and other (7%).

“Survey findings function as a ‘collective snapshot’ that can guide employers as they determine how to maximize employee benefits,” said Ellen Kelsay, president and CEO of Business Group on Health. “Employers shared that they are deeply concerned about unsustainable health care costs, the devastating effects of the pandemic on employee health, and the need to work creatively with their partners toward a more positive and sustainable health care experience, among other issues.”

Areas of Focus for Employers

The following two topics were among the highest-ranked focus areas among the surveyed employers: (1) a dramatic increase in the importance of health and well-being to workforce strategy due to many factors (including COVID-19) and (2) the need to assess and improve upon virtual health options are important.

65% of employers noted that their health and well-being strategy plays an “integral role in workforce strategy,” up from 42% in prior years. The health and well-being strategy is a wide-ranging collection of ideas from supporting employees overall health and well-being to the ability to attract and retain talent through benefits and other offerings.

Related to that is the idea that virtual health has become so prevalent as a result of the COVID-19 pandemic. 74% of those surveyed “believe that virtual health will have a significant impact on how care is delivered in the future,” and 84% of employers “believe that integrating virtual health and in-person care delivery is essential and the most important action their partners can take.”

Rising Health Care Costs

After no increase in actual health care costs from 2019 to 2020, employers had a significant increase in costs last year, with a median 2021 cost increase of 8.2%.

The same three conditions that drove increased health care costs last year remained the same this year: cardiovascular disease, cancer, and musculoskeletal conditions. However, 13% of employers said that they saw more late-stage cancers, with 44% of employers anticipating a continued increase into the future, likely related to pandemic-related delays in health care.

Additionally, despite the rising costs, employers expect to continue to cover the cost of employee coverage, with employers expecting to cover 82% of the cost in 2022, up from 80% the year before. Employers are hesitant to pass on increased cost to employees and are instead focused on delivery system reforms to address the increased expenses.

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