As U.S. companies continue to ask workers to shoulder a greater burden of the cost of health care consumers want their employers to do more to help them improve their health and get the most from their employer-provided health and wellness plans, according to a new survey from Aon Hewitt, The Futures Company and the National Business Group on Health.

They surveyed more than 3,000 consumers (employees and their dependents) covered by employer health plans to determine their perspectives, behaviors and attitudes toward health and wellness.

Under consistent pressure to mitigate costs and adjust to new regulations, employers continue to carefully consider the future of employer-provided health plans. However, as senior leaders adjust plan design and wellness strategies, the survey finds that many employers aren't aligning these strategies with the goals, needs and concerns of their employees.

While a majority of consumers (74%) are worried about being able to afford health care now and in the future, they understand that health improvement programs, along with well designed employer-provided health benefit plans, can help them get healthier while also holding down costs. But, the survey reveals that workers really want programs and communication that are easy to use, motivating and meaningful to them and provide personalized information and ideas.

"Employers continue to face countless challenges when it comes to offering health plans that effectively meet the needs of workers and their families, while also managing rising costs," says Helen Darling, president and CEO of the National Business Group on Health. "We hear over and over that the key to ensuring real health improvement is employee engagement, so knowing what employees want and what will motivate them is essential to success. Consumers are telling us that the one-size-fits-all approach to health and wellness isn't working for them."

Make it easy

The good news for employers is that consumers are willing to try consumer-driven health plans if the immediate cost savings are apparent. Among those with a choice, most employees (63%) select a CDHP because of the lower premium costs. Additionally, 39% choose this plan option because their employer contributes to an associated account — health savings account or health reimbursement arrangement. In fact, among those enrolled in a CDHP who have a choice, over 90% will definitely or probably re-enroll. While CDHPs are, in part, intended to encourage workers to take a more active role in their health, the survey findings indicate that they are having a mixed effect on behaviors. Forty-two percent are getting more preventive care and 40% are looking for lower cost health services options since choosing this plan. More troubling, a sizeable number of workers (35%) are sacrificing or postponing care (28%) to avoid out-of-pocket costs.

"While an eye towards cost is certainly a valid and reasonable reason for consumers to select a certain health care plan, choosing a plan that fits a worker's lifestyle and needs also ensures that people are getting the most appropriate coverage for their needs," says Cathy Tripp, managing principal Health & Benefits at Aon Hewitt and project leader for this study. "However, employers need to make sure workers aren't sacrificing health and the future costs of poor health for lower costs today." 

Make it personal

When it comes to tools to help them make health decisions, consumers want information that is tailored to their specific situation. Half of participants (50%) want a personalized plan that recommends specific actions they can take to improve their health based on their health status, up 9 percentage points from 2010. Workers are also looking for convenient, one-stop access to information with 40% expressing a preference for a wellness website and more than a third (35%) want personalized health tips and reminders.

"If companies truly want to move the needle in terms of overall health and cost, they have to stop looking at employees as one group, and start looking at the individual," says Joann Hall Swenson, principal and health engagement best practice leader at Aon Hewitt.

Make it meaningful

To improve health and productivity, employers are increasingly offering programs to both workers and their dependents such as biometric screenings, health risk assessments, onsite clinics/pharmacies and employee assistance programs. However, many employees and their dependents don't seem to be aware of many of these programs. In 2011, more than one-third (36%) of consumers did not participate in any health program or service offered by their employer. Among the programs that workers did participate in, blood tests or biometric screenings were the most popular (61% participation), followed by health risk assessments (57% participation).

Despite low participation, when workers do take part in these programs, satisfaction is extremely high. Almost all (97%) of consumers who took part in blood work/biometric screening were satisfied and 97% were happy with their on-site clinic or pharmacy.

In addition to lack of awareness, and despite the availability of health improvement programs, many consumers don't feel their employers are fully supportive in helping them get and stay healthy. A majority of workers (60%) think their company is only moderately-to-not supportive when it comes to their efforts to be healthy.

"Employers may be missing the mark when it comes to health improvement programs being offered to workers," says Tripp. "Workers need to see that their efforts to become healthy are supported by the company. Developing a culture where leaders care and support healthful living communicates to workers that this matters to the company."

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