October 07, 2021

Many employers continue to juggle parallel efforts – supporting their workforce through the twists and turns of the ever-changing pandemic while simultaneously maintaining long-term strategic health and well-being efforts. On September 22, a group of large employers came together to learn and discuss pertinent findings from the 2022 Large Employers’ Health Care Strategy and Plan Design Survey. This set of Key Insights summarizes the data presented and provides a sample of employer examples shared on the call.

Role of Health and Well-being in Workforce Strategy

Forty-two percent of employers view health and well-being as an integral part of their workforce strategy; 45% see it as a consideration. Both numbers have slightly declined since last year, likely due to the increased attention on other priorities like safety and worker productivity.

• One employer on the call attested to the importance of health and well-being as an integral part of its workforce strategy – a change that took place a few years before the pandemic. Due to COVID-19, there has been a greater emphasis placed on virtual solutions and mental health. The company focuses on where and how employees are working to design benefits and programs to meet them where they are.
• Another employer shared that it contributes to the greater “moonshot” workforce goals, which had to be reconsidered during the pandemic. These goals focus on women in the workforce, new workers, diverse workers, and sustainability components, to name a few. Benefits like mental health support, wellness and digital solutions are viewed as enablers of these goals, tools to use to make it easier to advocate for new benefits.

View the recording from our our First Look at Changes to Large Employer Health Care Strategies and Benefits Programs: 2022 Survey Findings webinar .

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The Impact of COVID-19

While the pandemic has had many silver linings, employers express concern for the negative impacts. The top long-term impact on employers’ minds are increases in medical services due to delayed care (94%,) followed by long-term mental health issues (91%) and higher chronic condition management needs (67%). Some employers, anticipating these pressures, instituted some pandemic-related programs. Programs like telehealth and virtual health are likely to stay after the pandemic is over; others like emergency leave are expected to phase out, if they haven’t already.

• Some employers are working to push employees to schedule needed preventive visits, even during the pandemic. One employer shared that it is sending preventive care reminders to get employees back in for checkups (including dental exams).
• Related to this, some employers are providing higher levels of support to employees with cancer. One employer shared its new “cancer guardian” benefit that offers more in-depth support to help employees through the cancer process. Prevention also plays a role in this program; genetic testing is offered to determine employees’ cancer risk based on genetic traits/predispositions.
• Even before the pandemic, mental health access and quality were priorities for large employers. Two employers on the call shared their approach for increasing availability of mental health support, including a digital mental health platform, providing more employee assistance program (EAP) visits and conducting pilots with smaller mental health vendors to provide acute care to those in need.

Virtual Health

Virtual health offerings are expected to increase across the board. Telehealth and telemental services are a mainstay, now adopted by 97% and 94% of employers in 2022, respectively. Condition-specific tools are also available, and those targeting musculoskeletal care, cardiac care management and fertility care are expected to rise considerably by 2024.

• The conversation on the call focused on mental health virtual offerings. One employer is putting in a behavioral health navigator in the U.S. but would ideally prefer a health navigator for employees across the globe. This employer has seen variation in how different locations/countries have reacted to mental health stigma.
• Another employer is addressing stress in a different way – by providing virtual support in areas that could create stress for employees at home. Examples of this support include fertility programs and pregnancy programs to aid employees looking to grow their families and resources for family members with neurodiverse learning abilities.

Mental Health

The top three mental health priorities named by employers are 1) access, 2) stigma and 3) appropriate treatment. The most common way to increase access is through online resources like apps, articles, videos and webinars, with 97% of employers doing so in 2022. More employers will offer manager training on mental health (74%) and conduct anti-stigma campaigns (70%) in 2022 than ever before.

• Employers shared a myriad of benefits offered to employees, including an internally run EAP, Workplace Options for international employees, Sanvello and Headspace.
• One employer shared its plan for World Mental Health Day. Employees will be able to watch a fireside chat between a leader passionate about mental health and a dynamic clinician from its telehealth provider. Burnout will be the topic of focus; one session will target managers/leaders, and another will be for all team members. As part of this effort, this employer will also roll out a mental health toolkit.
• When asked about the significant health care changes it is making in 2022, another member company is using a behavioral health care navigator in an effort to expand access. Several other employers also expressed interest in this approach to increase engagement with mental health care services.

On-site Clinics

While previously mentioned data showed upward growth, some remained steady. On-site clinics will be made available by 44% of employers in 2021 into 2022. It’s not until 2023/2024 that clinic availability will pick back up; the lag time is heavily driven by clinic closures during the pandemic and the uncertainty about when remote workers will return to the worksite. Conversely, on-site clinics that stayed open during the pandemic played a critical role by performing COVID-19 testing, screenings and/or vaccinations or providing services under a virtual model.

• By and large, the trends seen among on-site clinic offerings resonated with the employers on the call. Some agreed that on-site services can’t be determined until their organizations can decide on return-to-worksite process and timing.
• Some employers have employees that have been reporting to work all along – at specific locations or enterprise-wide. With the way of working drastically impacted by the pandemic, on-site services are expected to follow suit.
• Several large employers that kept their on-site clinics open did so to fill gaps in care and ensure the safety of the workers who still had to come to the worksite regularly to perform their duties (e.g., manufacturing, consumer products, retail). On the other hand, the on-site strategy for those with more office-based work and/or corporate-level employees focused more exclusively on transitioning applicable on-site services to a virtual model wherever possible. For example, one employee noted that it shifted its on-site gym to a virtual physical fitness class and experienced huge rates of engagement and positive remarks from employees.

Health Care Cost Trends

The year 2020 was an anomaly for health care cost increases: actual health care trend came in at net zero in costs due to employees delaying or missing health care visits and procedures, along with increased provider shutdowns during the pandemic. In 2021 into 2022, employers are expecting moderate increases – 6.0% before plan design changes are considered.

• Employers on the call reported moderate cost increases. One employer that typically targets a 3% increase ended up seeing 4-5% increase for 2020. Another is anticipating a 3.9% increase in 2022.

A few employers shared their priorities for the coming year, all reflected in the survey data:

• Behavioral health navigator to expand access to services;
• Digital diabetes management solution;
• Health care quality focus via virtual health, mental health and high-cost claims;
• New EAP/navigator, among other changes; and
• Expanding centers of excellence (COEs) to include access to affordable and quality care for more conditions.

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