The Business Group on Health 2025 Employer Health Care Strategy Survey explored ways employers address health care costs and key benefit strategy considerations in the near future and long-term. Among inflationary pressures in the health care sector, worsening chronic condition burden in the population and the demand for many ground breaking – albeit expensive – treatments, employers are juggling many priorities. Strategies to lower costs, improve outcomes and strengthen the employee experience were explored in this survey.

Fielded between June 3 and July 12, the survey was completed by 125 employers that cover more than 17.1 million lives in the United States. Companies that completed the survey represent a broad range of industries and are diverse in size.

The role of a HR/Benefits leader has never been more complex and demanding. The 2025 survey results highlight the challenges employers face. Based on the findings of this survey, the following emerged as top focus areas among employers.

– – Health care costs are expected to grow at the highest rate in a decade. Since 2022, the projected increase in health care trend, before plan design changes, rose from 6% in 2022 to almost 8% for 2025.
– – Pharmacy costs are largely responsible for overall increases and consume a growing share of the health care budget. Between 2021 and 2023, the median percentage of health care dollars spent on pharmacy has jumped from 21% to 27%, suggesting that nearly all of the health care cost increase noted above is related to pharmacy cost.
– – Employers are seeing cost pressures from GLP-1 medications (which regulates blood sugar, appetite, and digestion), which are considered a top driver of health care costs this year. Seventy-nine percent of employers have seen an increase in interest in obesity medications – including GLP-1s – among their covered members.
– – Managing and reassessing vendor partnerships are at the center of employers’ plans to address costs and improve performance. Employers are reassessing the quality and effectiveness of their partnerships and looking to integrate their benefits to reduce costs and simplify the member experience.
– – Cancer remains the top condition driving cost; however, more employers say that cardiovascular conditions are among their top three cost drivers. Concerns about the cost of cancer care may be further fueled by increased prevalence in younger populations. Furthermore, the growing cost of cancer treatments, including gene and cell therapies currently in the pipeline, leaves employers questioning how their plans will be impacted.
– – Protecting ERISA preemption is employers’ highest priority for the Administration and Congress. This finding reflects the importance of ERISA to employers, which allows them to offer their employees comprehensive benefits in a nationally consistent and competitive manner.
– – Mental health continues to be a priority for employers, with a focus on access and ways to eliminate cost barriers. Seventy-nine percent of employers say that access is one of their top three mental health priorities for 2025. To address access and costs, employers continue to pursue strategies, such as virtual counseling, eliminating out-of-network barriers and using on-site counselors.
– – Employers remain committed to health equity efforts that address disparities. Employers continue to pursue a number of targeted approaches to narrow health disparities within their plans and programs. Holistically, the most common tactic found in the survey is collaborating with employee resource groups (ERGs) to promote benefits and well-being initiatives to specific groups.

Business Group on Health CEO Ellen Kelsay expects employers to react by being more selective about the care that people receive. They also will try to manage the use of expensive treatments for obesity and diabetes. The CEO spoke recently with The Associated Press, and answered questions about implementation of expected strategies by employers.

Business Group on Health 2025 Employer Health Care Strategy Survey