While Cammack commented that the administration is under great pressure to alter or eliminate the tax, its survey demonstrated the high degree of concern hospitals have about triggering the costly tax.

Health care reform's requirements for providing coverage to employees who work more than 30 hours a week—the new full-time employee—has motivated hospitals to keep  a closer eye on  hours worked.

"Since the ACA went into effect, most respondents are now tracking the number hours worked by employees, and offering coverage accordingly. Hospitals have adopted a number of measures to avoid penalties," the report said.

Hospitals are taking other steps to control increasing health benefits costs. Among them:

• An upswing in spousal surcharges, among other cost-controlling measures;

• An increase in RX plans that charge 100 percent of drug costs when employees go outside of a formulary;

• Increased presence of what is known as "steerage" in plan design, which incentivizes employees to use hospital facilities and physicians rather than go outside of the hospital network for services;

• In the arena of wellness incentives, more hospitals are moving towards outcomes-based measures, but the majority still reward participation regardless of outcome.

"Though the methods of dealing with the impending changes vary, every employer is grappling with the increasingly worrisome reality that the PPACA will increase costs before it manages to reduce them," the report said. "From the provider perspective, hospitals also face cuts to reimbursement impacting their ability to offer benefits, with or without a Cadillac tax. This leads many hospitals to wonder where their own employee health benefit cost increases are coming from. Time will tell who manages to remain unscathed by the coming changes."