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While escalating health care costs continue to be a concern for employers, the majority of large employers in the U.S. are looking beyond cost shifting and plan to invest more in the health and welfare of their employees, according to Hewitt Associates, a global human resources services company.

Hewitt's survey of approximately 450 major U.S. employers covering more than 8 million employees revealed that almost two-thirds (63 percent) plan to take more aggressive, multiyear steps to help employees improve their health by increasing education efforts, implementing condition management programs, and using data analysis and other cutting-edge programs to improve health and productivity while holding participants accountable for their behaviors. Fewer than 40 percent plan to maintain their current focus on health care benefits--primarily concentrating on annual cost mitigation.

"Employers continue to be concerned about the cost of health care benefits, but realize that in order to fundamentally improve outcomes--and effectively lower costs--they need to begin targeting the root of the issue by directly influencing the interactions between providers and patients," said Jim Winkler, practice leader of Hewitt's Health Management Consulting practice, in a prepared statement.

"We're working with an increasing number of companies that are moving beyond current-year cost sharing and passive condition management programs. Instead, they are developing multiyear, holistic health care programs that drive behavior change by targeting the health and health risk needs of their diverse workforce, recognizing the distinct differences among consumers, patients and providers, and eliminating barriers to effective understanding, prevention and treatment."

According to Hewitt's survey, most companies are not confident that employees have the appropriate skills and knowledge to make educated health care decisions. To address this issue, almost 70 percent of companies offer or plan to offer tools, resources and/or programs to help employees better manage their health, including health risk questionnaires, decision support and nurse lines.

"These tools are designed to help employees make better decisions when they are healthy consumers, and at the same time, provide them with the advocacy and support they need when they are less healthy patients in a fragmented and complex health care system," said Winkler.

An increasing number of companies are also taking a closer look at the health risks and needs of their employee population, and offering condition management and wellness programs designed to drive participation, trigger positive changes in consumer behavior, and provide patients with additional support and guidance. More than three-quarters (77 percent) of responding companies are profiling the chronic health conditions prevalent in their workforce in 2007, compared with just 43 percent in 2006, and between 65 percent and 79 percent of companies gave employees--or planned to give them in 2007--access to targeted condition management or wellness programs through health plans or focused programs.

Almost half (48 percent) also offered or planned to offer incentives to employees who participate in wellness or other health-related initiatives, compared with just 38 percent in 2006.

"Employers are applying a risk management mind-set to the asset that is employee health," said Winkler. "By obtaining insight into the health risks and chronic conditions of at-risk populations in their workforce, employers can pinpoint portions of the employee population that are the most costly and make changes to their plan designs that will drive employees to make better, more consistent decisions about their health. These types of programs not only influence healthy employee behaviors through integrated health management, but they provide companies with significant opportunities for short- and long-term cost savings."