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Health Care Costs, Benefits and Reform: What’s the Next Move for Employers?

Results of Deloitte’s 2013 Survey of U.S. Employers


Forthcoming changes to the insurance market landscape in 2014 and 2015 will bring many employers to a crossroad. As health care reform unfolds, markets evolve and costs continue to rise, employers will need to make important strategic decisions to actively manage their costs and figure out how best to respond to insurance-related provisions of the Affordable Care Act (ACA or the Act).

Deloitte’s 2013 survey of U.S. employers (50+ workers) offering health benefits shows their concern and uncertainty about ACA preparedness, health care system performance, cost-reduction strategies and the quest to find value. Among key findings:

  • U.S. health care system performance — Seeking better value and health outcomes for their investment, many employers are dissatisfied with the performance of the health care system, considering it to be costly, wasteful, underperforming and lacking in transparency.
  • Affordable Care Act — Although familiar with many of the ACA’s insurance elements, three years into implementation and facing decisions around insurance exchanges and the employer mandate, the Act remains largely a mystery to many employers.
  • Employer strategies and tactics — Employee cost-sharing tactics are in place but there is a gap between what employers are currently using and tactics they think could have high impact in managing costs.

    Many employers are sitting on the fence with respect to any radical changes in their employee health care coverage strategy. To date, most are adopting a “wait and see” position on health insurance exchanges. Some are taking steps to help employees lower their health risks and manage their consumption of health care but could do more. Few appear to be evaluating any return on investment of wellness programs or undertaking claims analyses to drive insights and decision-making.

New strategies are likely to emerge as employers weigh their options and as the implementation of the ACA impacts their thinking. What is clear is that “doing nothing” is not an option.

As used in this document, “Deloitte” means Deloitte LLP and its subsidiaries. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.


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