Mental health is top of mind for large employers heading into 2024, survey finds

The latest annual report from the progressive Business Group on Health examines how evolving views on health and wellbeing, health care delivery, pharmacy trends, and costs will drive 2024 health care strategies for large employers.

Mental health challenges emerged as the top area of significant prolonged impact resulting from the COVID-19 pandemic, according to the “2024 Large Employer Health Care Strategy Survey.”

“In recent years, employers saw an increase in mental health needs, such as depression, anxiety, and substance use disorder, and this year, that trend accelerated,” the study’s authors note. “Whereas last year, 44% of employers saw an increase in mental health concerns, this year, 77% of employers reported an increase, with another 16% anticipating such an increase in the future. To address this in 2024, employers are highly focused on access to mental health services — more so than any other mental health concern.”

Among the ways employers are increasing access to mental health services is by providing more options for support and lowering cost barriers to care. “Those concerns appear to be well-founded, as employers experienced an increase in the median percentage of health care dollars spent on pharmacy, from 21% in 2021 to 24% in 2022,” according to the report, which notes such strategies as implementing a transparent pharmacy benefit manager (PBM) and changing plan designs to address high-price medicine and treatment are underway by some employers for 2024.

The high cost of mental health and the growing demand for benefits supporting working parents beyond childcare is backed up by a recent RethinkFirst survey indicating that nearly three-quarters of working parents miss work to address their kids’ mental health or academic performance.

Cancer costs

Half of responding employers say cancer is the top driver of health care costs, while 86% rank it among their top three. “Employers are taking steps to address this by focusing on advanced screening measures and maintaining 100% coverage for recommended prevention and screening services,” according to the report.

“Employers are also keeping an eye on clinical advancements in oncology, including biomarker testing and immunotherapies, and are focused on guiding members to high-quality care, in hopes of improving health outcomes for patients affected by cancer. Fifty-three percent of employers will offer a cancer-focused center of excellence approach in 2024, with an additional 23% considering this approach by 2026.”

Musculoskeletal care, diabetes, and mental health round out the top four health care costs.

Tracking transparency

Transparency in drug pricing is important to employers. As such, they are prioritizing greater transparency of cost and quality data to help their employees make informed decisions.

“Employers are supportive of engagement platforms as a tool for employees to find needed information to identify the best solutions for their health care needs,” the report states. “In addition, 73% of employers see requirements for more transparency in PBM pricing and contracting as a priority, and 58% would like to see additional reporting and better provider quality measurement standards.”

Related: Beyond the numbers: Why price transparency isn’t the whole story

Conducted in June and July, the “2024 Large Employer Health Care Strategy Survey” was completed by 152 large employers that cover more than 19 million lives in the United States.