2023 Year in Review

Our annual recap of content and insights on the topics most critical to our members including health care cost and delivery, well‐being, workforce strategy, and the regulatory landscape.


December 13, 2023

As 2023 winds down, the Business Group on Health team is recapping key employer focus areas, along with highlighting selected resources to support these topics. This summary is a representation of our unparalleled work and insights gleaned from our multistakeholder community, aimed at addressing employers’ current and future needs and opportunities.

Click on the images in this article to learn more about each resource.

Mental Health Tops Employer Priorities

Although demand for mental health services has been high for years, employers are experiencing a growing need among employees and their dependents in 2023: Our 2024 Large Employer Health Care Strategy Survey found that 77% of respondents observed an increase in demand for mental health services as a result of the pandemic. Recognizing the necessity for employers to create a comprehensive approach to this critical issue, we spearheaded a guide on mental health that provides recommendations spanning from prevention to treatment. Employers continued to seek thought leadership on emerging mental health topics that are top of mind: substance use disorders, youth mental health challenges and eating disorders, among others. These topics and more, including manager involvement, employee resource group (ERG) involvement, the food/mental health connection and the use of psychedelics for mental health treatment, appeared in our written resources, during webinars, on our podcast and on our Annual Conference stage. On all of these platforms, we presented fresh ideas and consistent thought leadership.

This year illustrated the monumental effort required to address employee and family mental health, including meeting the needs of populations around the globe. Among many efforts, we convened a forum of employers in London to tackle challenges associated with access to mental health services outside the U.S. and ideas for overcoming them.

Key Insights: 2023 Annual Conference Podcast: The Power of Trusted Messengers: Reaching Those with Substance Use Disorders Podcast: What’s Behind the Youth Mental Health Crisis? Podcast: The Truth about Eating Disorders Webinar: The Importance of Sleep and Mental Health

Employer Well-being Continues to Evolve

Our 14th Annual Employer-Sponsored Health and Well-being Survey found an increase in initiatives targeting emerging areas of well-being: social connectedness (up 12 percentage points), community (up 12 percentage points) and job satisfaction (up 7 percentage points), in addition to a persistent commitment to more traditional dimensions (physical well-being, mental health and financial well-being). This year, employers continued to evolve their well-being strategies by creating opportunities for employees to follow paths to well-being in a way that is meaningful to them and targeted to supporting a variety of life stages.

Survey: 14th Annual Employer-Sponsored Health and Well-being Survey: Well-being’s Path Forward Article: Designing Incentives and Lifestyle Spending Accounts For a Modern Workforce Guide: Fertility and Family-forming Benefits: A Guide for Employers
Article: Social Connectedness: Building Bonds in the Workplace Podcast: Menopause and Work: Thriving Through Transition Podcast: Transforming the End-of-Life Experience with Death Doulas

Unrelenting Quest for Quality and Value

Through thought leadership, conferences/meetings, programming, resources and employer-to-employer connections, we worked to advance our collective thinking and progress toward better health care quality and greater adoption of value-driven care models. While past years have shown progress in moving away from fee-for-service arrangements, there remain more opportunities and work to do in this area. Employers are balancing near-term cost management strategies with approaches that drive improved outcomes and a better patient experience. In doing so, employers expect improved sustainable overall value.

Employers came together early in the year at our Employers’ Summit on Health Care Cost & Delivery to exchange ideas on ways to address affordability, move toward value-based care, respond to the growing need for effective member navigation and increase access to quality care. Throughout the year, we developed a multitude of resources to help employers advance value-based approaches to care, including adoption of centers of excellence and communicating about value-based arrangements.

Key Insights: Employers’ Summit on Health Care Cost & Delivery Guide: Centers of Excellence Considerations for Employers Article: Value-Based and High-Performance Networks: Five Tips for Effective Communications

Doubling Down on Pharmacy Benefit Management

Pharmacy costs continue to account for a larger portion of employers’ total health care costs, as the median percent of health care costs consumed by pharmacy has risen from 21% to 24% in 2023. The concern about cost trend is increasingly coupled with calls for greater transparency in pharmacy cost and contracting. We focused on a variety of drivers and strategies in 2023 to allay these threats to affordable health care for employers and participants. One of our top podcasts of 2023, with guest Mark Cuban, explored if we can “end ridiculous drug prices” and improve the pharmacy experience. We also published documents on specialty drugs and gene therapies in recognition of the role they play in driving health care costs presently and into the future.

This year, GLP-1s were arguably the most talked about medication throughout the industry, society and the media. Across our membership, we heard many different viewpoints about GLP-1s: the relief that effective treatments for obesity are now available but also concern about the potential cost for a large portion of the population. While most employers are covering GLP-1s for those with type 2 diabetes, some are still undecided on whether that benefit should be extended to treat obesity. We developed two key resources, the first of which was a guide to help employers in their decision making about covering GLP-1s for weight loss/management and the appropriate support for patients initiating this treatment. Our second resource was a virtual event that took a deep dive into GLP-1s and their place in employer-sponsored health plans and implications for the health care landscape.

Article: Prior Authorization: Benefits, Burdens, and Bold Ideas for Improvement Podcast: Cell and Gene Therapy: Tapping into the Potential of Curative Treatment Guide: An Employer’s Practical Playbook for Treating Obesity Article: Managing Blockbuster GLP-1 Medications: What Employers Need to Know and What they Can Do Webinar: New Treatments, New Hope, New Challenges: Employer Strategies for Managing GLP-1s

Innovation Redefined

This year, we continued our quest to uncover new and innovative ways to solve employer health care challenges. Even though some in the industry equate “innovation” with “virtual health point solutions,” the Business Group continues to amplify innovation in all areas of health care and well-being. Specifically, in 2023, there was a focus on novel approaches in several areas, including pharmacy, preventive care and artificial intelligence (AI), by a variety of stakeholders. For example, one of the ways that we highlight innovation, our Health Innovations Forum, continued its efforts to balance both showcasing promising solutions with candid discussions about “solution fatigue” and the need for better coordination among programs for employees. Along that vein, the Business Group also launched an Innovation Showcase series, with an inaugural event focused on the role of AI in health. Additionally, our aforementioned 2024 survey found that employers’ leading concerns about virtual health are rooted in the lack of integration between solutions as well as between virtual solutions and community-based providers. As a result, we published a call-to-action resource focused on curating an integrated benefits experience.

Guide: Exploring Innovation in Preventive Care Survey: 2024 Large Employer Health Care Strategy Survey Article: Artificial Intelligence: The Future of Health Care Unleashed?
Article: Impactful Interventions: The Role of Employers in Addressing Prediabetes and Diabetes Prevention Article: Integrated Benefits Experience: Four Key Considerations for Employers Meeting Insights: Artificial Intelligence: Evolve Thinking, Accelerate Health and Well-being

Addressing Health Equity Gaps

In 2023, employers continued to seek many ways to close health care gaps across the globe, including by identifying health disparities, assessing and addressing social determinants of health (SDOH), focusing on inclusion and curating an equitable employee health and benefits experience. We created a comprehensive guide that allowed members to explore recommendations across these areas of focus. In addition, we co-authored a Harvard Business Review article that detailed four critical opportunities that employers can seize to address health equity among their plans and programs. Lastly, a challenging disparity within the U.S.—maternal mortality among black birthing parents—was examined through the lens of birth doulas during a compelling podcast episode.

Global Benefits Consistency to Address Employee Needs Worldwide

Multinational employers understand the complexity of offering health and well-being benefits across borders. In 2023, many employers accelerated their efforts to provide a more consistent set of benefits for employees, regardless of their home or work country. Some viewed this in lockstep with their health equity efforts – identifying gaps in offerings and addressing populations that don’t have the same level of access compared to their fellow employees. This approach was presented at our Global Summit, which pinpointed coverage gaps and preexisting exclusions as examples of opportunities to address. Based on the direction of leading employers and guidance from survey data, we created a set of resources to foster a global consistency approach – from creating an inventory of benefits offered by country to a step-by-step approach to achieve consistency. With these tools in hand, our global members were able to set course on this strategy, ultimately bringing equity to offerings to employees around the world. We also published resources that compared market practices across select countries in two specific areas of focus – the global prevalence of obesity and the use of perquisites and additional benefits.

Survey: Global Inventory Survey Article: Maximizing the Value of Global Inventories Guide Update: Creating a Globally Consistent Benefits Strategy
Key Insights: 2023 Global Summit Guide: Global Guide to Obesity Survey: Perquisites and Additional Benefits: Profiles of Eight Countries

Advocating for Employers: Policy, Legislation and Regulation

Throughout 2023, we worked on behalf of Business Group members to represent employer interests before the Administration, regulators, legislators and other key stakeholders. We demonstrated the value and importance of employer engagement in Washington.

We began 2023 focused on helping employers understand the plan implications of the end of the COVID-19 national and public health emergencies, proceeded to advocate for greater employer flexibility in distributing electronic health and welfare plan documents and pushed for reasonable and workable Mental Health Parity and Addiction Equity Act (MHPAEA) standards for employer plan sponsors. We continued fighting for ERISA preemption and advocated for telehealth/virtual care extensions and coverage expansion for high-deductible health plans and health savings accounts (HDHPs/HSAs) throughout the year. In the lead-up to an undoubtedly busy election season, we updated position statements on salient topics such as preserving ERISA, taxation of benefits, prescription drug pricing paid leave laws and transparency.

Both individually and in collaboration with other stakeholders, the Business Group substantively engaged in dozens of legislative and executive branch meetings, including numerous invitation-only closed-door discussions with Congressional and Administration leaders and top staff on MHPAEA requirements, No Surprises Act implementation, pharmacy supply chain reforms, access to reproductive health and contraceptive items and services and the importance of protecting ERISA preemption. Looking ahead to 2024 and a presidential election, Business Group on Health will continue to advocate to protect and empower employer plan sponsors and the vital support and programs they provide to employees and their families.

Power Through Community

Throughout the year and in a variety of formats, we convened members to network, learn from each other, hear from experts and collaborate on high-priority topics. Both virtually and in-person, members had extensive opportunities to participate and engage. The following are representative events:

Annual Conference

Nearly 700 people attended the 2023 Annual Conference in Washington, DC. The 3-day event highlighted winning strategies that were impactful, innovative and inclusive. Our carefully curated agenda, featuring compelling sessions and speakers, spanned an array of the most critical employer-sponsored health and well-being issues. This highly coveted and uniquely positioned forum, which often sells out, is the hub of employer and industry connection and learning for the year.

Employers’ Summit on Health Care Cost & Delivery

Held in DC in January, employers came together to address emerging issues in health and benefits, including ways to transform the health care delivery system. Attendees underscored the importance of improving affordability and navigation, as well as promoting integration and access to quality care. Actionable insights were gleaned from small group discussions of employers and fireside chats between industry thought leaders.

Global Summit

This year’s Global Summit brought global benefits leaders and industry partners together in September in Washington, DC, to share best practices and challenges related to global consistency, health equity, mental health, cost and communication. The summit provided a world of opportunities to consider in developing strategies to make an impact across the globe.

Innovation Showcase

In December, we hosted our inaugural Innovation Showcase, with active participation from employers and health industry partners. The showcase focused on the role of AI in health care, featuring thought leadership perspectives, presentations from innovative companies leaning into their solutions and employer (link forthcoming) discussions of AI adoption in health and benefits.

28 webinars were held in 2023 with over 1,574 unique participants from over 321 member companies.

9 Employer-to-Employer Discussion with over 300 representatives from nearly 150 employer member companies.

22 podcast episodes on a variety of topics, from cell and gene therapies, menopause and circadian rhythm to health misinformation, youth mental health and disability inclusion.

31 Institute, Committee and Forum meetings with over 700 participants from approximately 250 member companies.

Over 600 employer members belong to the Employer Community, our online forum for employer members to connect on all health and well-being topics and get questions answered in real-time, directly from other employer members. In 2023, the Community had over 12,641 views and 575 original posts/replies on a wide array of topics.

A Look to 2024

On behalf of our members, we will continue to focus on a myriad of fronts – the necessary improvements to health care quality, affordability, cost, mental health, health equity, pharmacy benefits, integration, patient experience and well-being as a whole. Layered on to this pursuit, we will continuously monitor the policy and regulatory landscape, including the implications of the run-up to, and outcomes from the U.S. election. Our robust and vibrant membership community—representing over 60 million lives in 200 countries—allows us to provide unparalleled insights and thought leadership. In serving you in the year ahead, we are eager to continue representing employers’ perspectives on optimizing workforce strategy through innovative health, benefits and well-being solutions and on health policy issues.

Health Care and Well-being Trends to Watch in 2024

  • Health care costs are climbing – bringing heightened vigilance by employers.
  • Access to mental health and substance use disorder services remains a priority, with a growing focus on emerging areas of concern.
  • Employers double down on cancer and other serious or chronic conditions.
  • Employers express growing alarm over the sustainability of and lack of transparency in drug pricing.
  • Employers place heightened expectations on their partners to deliver.
  • Global employers implement strategies focused on greater consistency across countries while adapting to local regulations and cultural appropriateness.
  • The role of well-being continues to evolve.
  • The U.S. presidential election is impending, and it is uncertain how health care will be impacted.
  • As ERISA turns 50, preemption is even more important for self-insured employers.

We look forward to seeing you in 2024

Annual Conference

The 2024 Annual Conference will bring employers and industry experts to Tucson, Arizona, for several days of thoughtful discussion and immersive experiences. Through collaborative learning experiences and unique networking opportunities centered around the evolving landscape of employer-sponsored benefits, attendees will explore the latest trends in health care cost and delivery, well‐being and workforce strategy.

Registration and accommodations are expected to sell out early, so don’t delay in reserving your spot!

Regional Events outside the U.S:

As more of our members seek opportunities to engage with peers focused on health and well-being concerns outside the U.S., we are expanding our efforts to convene our members, with events planned in 2024 focused on EMEA/UK, Latin America and Asia Pacific. These events will be open to all Business Group employer members, with an option to join virtually.

Innovations Showcase

After a fruitful kick-off in December 2023, we will continue hosting virtual showcases to explore emerging areas of innovation. Each showcase will feature industry experts and visionary employers engaging in discussions about a specific area of innovation in health and well-being.

Employer-to-Employer Sharing calls

Building on the momentum of 2023, we will continue to host monthly discussions exclusive to employers on a variety of topics. These connections will prove to be critical for employers looking to tackle a variety of challenges in administering health and well-being initiatives. Registration will be posted to this page throughout the year.

And more! See full events listing here to find ways to get involved in 2024.

You can download the Year in Review by clicking the button below.

2023 Year in Review

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Articles & Guides icon_right_chevron_dark Social Determinants of Health icon_right_chevron_dark Mental and Emotional Well-being icon_right_chevron_dark Health Equity icon_right_chevron_dark
More in Benefits Strategy


  1. Mental Health Tops Employer Priorities
  2. Employer Well-being Continues to Evolve
  3. Unrelenting Quest for Quality and Value
  4. Doubling Down on Pharmacy Benefit Management
  5. Innovation Redefined
  6. Addressing Health Equity Gaps
  7. Global Benefits Consistency to Address Employee Needs Worldwide
  8. Advocating for Employers: Policy, Legislation and Regulation
  9. Power Through Community
  10. A Look to 2024
  11. Download Year in Review