A new survey from the National Alliance of Healthcare Purchaser (National Alliance) Coalitions underscores the ongoing tension between employers and the insurers and providers that partner with them for health and other benefits.

The "Pulse of the Purchaser" report looked at a wide range of benefit areas and the concerns that employers have as they sponsor plans and benefits. The report found that concerns about cost continue to increase, and at the same time employers have growing concerns about the integrity of services and fees charged by their partners in providing benefits.

"Employers are frustrated that the health care system is designed to enrich the middlemen and is not delivering improvements in affordability, access or quality for purchasers or employees and their families," said Michael Thompson, National Alliance president and CEO. "Increasingly the fox is guarding the henhouse, and both are exploiting a dysfunctional system at the expense of making it better. Employers are starting to take actions, both on the market and policy fronts, to realign the system to reduce conflicts and improve value."