August 25, 2022 – Cancer has overtaken musculoskeletal conditions as the top driver of large companies’ health care costs, according to the Business Group on Health’s 2023 Large Employers’ Health Care Strategy and Plan Design Survey. While the top three conditions fueling health care costs remained the same from last year – they include cardiovascular disease, in addition to cancer and musculoskeletal conditions – 13% of employers said they have seen more late-stage cancers and another 44% anticipate seeing such an increase in the future, likely due to pandemic-related delays in care. A total of 135 large employers across varied sectors, who together cover more than 18 million people in the United States, completed the survey between May 31, 2022, and July 13, 2022.
Other top areas of concern included:
- After experiencing no increase in actual health care cost from 2019 to 2020, employers experienced a significant return to rising costs, with a median 2021 cost increase of 8.2%.
- Despite rising costs, employers expect to cover 82% of the cost of employee coverage in 2022, up from 80% the year before (employer support for family coverage remains at 80% of premium). As costs increase, employers have been reluctant to shift costs to employees in the short-term and are looking at fundamental delivery system reforms, such as advanced primary care and centers of excellence for specific health conditions, to address unsustainable health care expenses and prescription drug costs.
- Large employers overwhelmingly (99%) said they were concerned about prescription drug trend. In 2021, prescription drugs accounted for a median of 21% of employers’ health care costs, with more than half of pharmacy spend going to specialty medications. Employers have opportunities to bring down costs through pharmacy program tactics, including biosimilar coverage, site of care and case management, among others.
- Long-term mental health issues, both observed and anticipated, are the leading health-related impact of the pandemic, employers said, with increases in medical services due to delayed care a close second. Some 43% have already seen this trend and another 39% anticipate such increases. In response, employers plan to keep many pandemic-related health and well-being offerings in place for the foreseeable future; 85% will do so for mental health.