Health Equity, Impact of Pandemic Among Large Employers’ Top Concerns, Says 2022 Health Care Strategy and Plan Design Survey

WASHINGTON, D.C., Aug. 25 – Large U.S. employers noted five major areas of concern, including health equity and the pandemic’s long-term impact, as they modify benefits strategies and programs against the backdrop of the ongoing pandemic, according to Business Group on Health’s 2022 Large Employers’ Health Care Strategy and Plan Design Survey.

The survey, released today in Washington, D.C., also showed that top concerns include expanding access to mental health care, monitoring trends in health care delivery and preparing for an uptick in health care spending. The survey’s executive summary is located here.

The Business Group's annual survey is a unique window into how large employers plan to evolve their benefit strategies and offerings in the coming year. Employers seek information about their peers’ strategies, and survey findings offer collective guidance for companies to best support their workforces.

Ellen Kelsay, President and CEO, Business Group on Health

The 136 large employers who took part in the Business Group survey in June 2021 represent diverse sectors of industry and provide health insurance for more than 8 million people.

More details on the employers’ top areas of concern:

Anticipating COVID-19’s potential long-term impact on employees

As a result of the pandemic, doctor visits and preventive screenings were delayed or missed, while depression, anxiety and substance use disorders surged. Employers anticipate seeing an increase in medical services, late-stage cancer diagnoses and greater numbers of people with long-term mental health and substance use issues, for years to come. For instance, 94% of employers anticipate an increase in medical services due to delayed care, while 91% remain concerned about long-term mental health issues stemming from the pandemic.

Focusing on social determinants of health to boost health equity and promote systemic change

Employers are initiating far-reaching programs to better employees’ lives, including improved access to health care and financial programs. As such, they help to address the underlying social and economic challenges that influence regular health habits, overall well-being and even mortality rates, with the goal of creating systemic change.

Expanding access to mental health care

While the pandemic helped to reduce stigma surrounding mental health issues and the workplace, the year 2022 will mark the first time that a majority of employers will have an anti-stigma campaign, according to the survey. Access to mental health care is a top priority, according to more than three-quarters of large employers.

Valuing the role of on-site medical clinics, even as virtual health becomes more popular

Fully 76% of employers accelerated telehealth and virtual health offerings since the start of the pandemic, and plan to maintain these options. Employers also see a role for on-site clinics, however, both to manage COVID-19 testing and vaccinations and to track employees’ chronic conditions. While the number of employers offering on- or near-site clinics declined between 2020 and 2021, the prevalence of such clinics is expected to eventually return to pre-pandemic levels.

Preparing for health care spending to rebound in 2021 and 2022.

In 2020, the overall health care trend was 0%, though some employers experienced a negative trend, dropping to as low as -12%. In 2021, health care trend is predicted to increase to 6% both before and after plan design changes. In 2022, cost trend is expected to decline slightly, dropping from 6% to 5.8% after plan design changes.

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About Business Group on Health

Business Group on Health is the leading non-profit organization representing large employers’ perspectives on optimizing workforce strategy through innovative health, benefits and well-being solutions and on health policy issues. The Business Group keeps its membership informed of leading-edge thinking and action on health care cost and delivery, financing, affordability and experience with the health care system. Business Group members include 70 Fortune 100 companies as well as large public-sector employers, who collectively provide health and well-being programs for more than 60 million individuals in 200 countries. For more information, visit