A number of factors will need to be considered in terms of employee health care for 2025, according to a recent survey, Trends to Watch in 2025, from the Business Group on Health.
“As employers head into the new year, they face formidable challenges stemming from climbing health care costs, which are putting pressure on how employers manage their overall health and well-being programs,” said Ellen Kelsay, CEO of Business Group on Health, a statement.
The following are a few of the issues. (excerpted from the report):
Employers may need to defend physical well-being programs.
With rates of chronic conditions and health care costs rising worldwide, the current model to improve physical well-being is being called into question. Notably, the prevalence of chronic disease—especially in the areas of obesity, cardiovascular, musculoskeletal and autoimmune conditions—has seen steady increases with no signs of abating. In 2025, HR leaders will be called upon by senior leaders to produce conclusive data on the value of investing in well-being.
2025 presents an opportunity for HR leaders to address questions about the company’s investment in and impact of its well-being initiatives. To do so, employers will use data to showcase how programs and benefits are performing from a clinical, experience and/or financial standpoint. When and where possible, employers can also demonstrate ways well-being programs are helping employees flourish—experiencing and evaluating their home and work lives positively—and contributing to business outcomes like productivity and retention. As a part of this process, employers must also be prepared to improve the efficacy of well-being strategies and partnerships.
Weight management programs are a likely topic within this broader conversation due to the prevalence of obesity and the costs associated with GLP-1s. To be successful, weight management programs must incorporate the best evidence, integrate other types of treatment (e.g., anti-obesity medications) and services (e.g., mental health) into their care models, and ultimately bridge the divide between traditional behavior change programs and health care benefits.
In working in close collaboration, finance and benefit teams can position their company’s programs for success by insisting on outcomes-based contracts from vendors. These agreements should require that vendors demonstrate improvement in health outcomes and deliver promised returns.
Progress has been made in mental health, yet more challenges lie ahead for employers.
While employers have gained ground in mental health, particularly with regard to reducing stigma and increasing care access, this dimension of well-being continues to present new challenges. Mental health conditions were among employers’ top five conditions driving costs, an indirect validation that more employees are accessing mental health support than ever before.
While mental health services have been integrated into primary care, offered directly at the worksite and made widely available virtually, there is more to do. Numerous mental health challenges have been identified as important to tackle (e.g., child and adolescent mental health, maternal mental health, loneliness, substance use disorder, suicide).
New or revamped programs and benefits may address some of these serious and important issues, but employers must continue to look beyond specific solutions as a means of supporting mental health and focus on workplace policies, practices and norms to protect mental health and reduce risk factors.
It’s critical that employers and their vendors enable employees to find the right support at the right time (and price.)
Over the past few years, we have witnessed a surge of specialty solutions that provide clinical support for patients with conditions like diabetes, musculoskeletal, digestive health, autoimmune and more. However, the mere existence of solutions does not eliminate care gaps, especially as employers struggle to reach employees in need of integrated subspecialty care.
In fact, the introduction of these solutions has produced an unintended effect of increasing care fragmentation. To address access gaps and to better integrate virtual care and in-person care, many health plans have expanded their networks to include digital health providers, yet, utilization of those programs remains inadequate.
We call this the “Lost in Network” phenomenon, and in 2025 employers will be keenly focused on holding health plans, specialty solutions and navigation partners accountable for solving it. The first and most critical step is to address the lack of awareness of these new network-based solutions among employers as well as employees. Many employers may not be aware that these solutions are already part of the health plans’ networks as a standard offering.
In 2025, navigators of all forms will continue to advance. “Macro navigators” who help employees navigate a wide range of benefits and care options will adopt technology like generative artificial intelligence (AI) to provide more timely and precise recommendations. In addition, it’s anticipated that “micro navigators,” such as those that specialize in a subset of patients with a common set of needs (e.g., oncology, mental health, obesity), have the potential to make connections between providers of all types within that specialty.
Furthermore, in response to growing employer cost and waning patient satisfaction, pharmacy navigation will emerge as a solution to address high-cost conditions emanating from poor population health. While all these navigator types are filling critical gaps in support, the breadth of options will ironically compound fragmentation concerns.
See the full list of Trends to Watch in 2025