On average, employers expect after-plan healthcare costs to increase 5.0% in 2019, up from 4.7% in 2018, according to Willis Towers Watson’s 23rd annual Best Practices in Health Care Employer Survey.

Without plan changes, the increases are 5.3% for 2018 and 5.5% for 2019. This marks the 13th year in a row that employers report that they have reduced plan value to control premium and total costs.

When seeking to manage rising healthcare costs, the survey found top priorities for employers over the next three years will target clinical conditions, cited by 85% of respondents, and investing in employee well-being, cited by 82% — two strategies to contain healthcare expenses longer term and ultimately improve workforce performance. Employers report that little progress has been made in these areas in the past three years. Fewer than one-third of respondents, 30%, said they have made advancements in clinical conditions, and only 41% said the same for employee well-being.

As employers look ahead at rising costs, almost all agree that they are likely to sponsor healthcare benefits in the near term: 94% of employers are very confident that their organizations will continue to sponsor healthcare benefits in the next five years.

“Although we have seen changes in healthcare legislation and consolidation across the industry, one thing is clear: Employer-sponsored healthcare is not changing any time soon,” said Julie Stone, managing director of specialty practices and intellectual capital at Willis Towers Watson. “Employers remain dedicated to engaging employees and their family members across the continuum of healthcare needs — from improving their well-being through preventive care, to helping them manage complex illnesses.”

As older workers are more likely to put off retirement, two-thirds of employers, 65%, ranked metabolic syndrome and diabetes as the number one clinical focus area over the next three years — a condition that shows up at higher rates in older populations. Musculoskeletal and mental/behavioral health followed at 59% and 57% respectively.

Although well-being programs have been a priority for many years, employers recognize that their current policies and initiatives are falling short of expectations. Employees are not actively engaged in their well-being initiatives, as less than half of employers, 47%, reported their population participates in their well-being initiatives. And while chronic illness is cited as employers’ top priority over the next three years, only 19% said their current well-being policy is effective at reducing the impact of chronic diseases on employees and providing the support needed during critical illness.

The survey was completed by 687 US employers between June and July 2018 and reflects respondents’ 2018 health program decisions and strategies. Respondents collectively employ 11.4 million employees and operate in all major industry sectors. Results provided are based on 554 employers with at least 1,000 employees.