A new survey suggests employers are looking to employees to helpcut rising health care costs, some offering incentives to encouragehealthier behavior, or implementing penalties if goals are notmet.

According to the survey by global human resource consultingcompany Aon Hewitt, employers’ top health care goals for this yearare improving employeehealth habits, lowering health care costs, decreasing workerhealth risk, increasing employee awareness of health issues andimproving participation in health improvement and diseasemanagement programs.

However, 56 percent of employers say that motivating employeesto change unhealthy behaviors will be their biggest challenge tothese healthcare goals. About a quarter are concerned about employees’reluctance to change and the unpredictability of costs. Twenty-twopercent said regulations and compliance issues were a challenge,and about the same named the aging workforce as a concern.

“Despite reform, organizations still face rising costs andworsening population health,” said John Zern, Americas Health &Benefits Practice leader with Aon Hewitt. “It’s clear thattraditional annual trend mitigation tactics alone won’t work. As aresult, leading employers are implementing a ‘house money, houserules’ environment, using a mix of incentives, penalties andtargeted messaging to reward healthy behaviors.”

Many employers not prepared for increases

The survey also revealed that 42 percent of organizations havenot yet budgeted for future health care trend increases. Thirtypercent have budgeted an annual increase between 4 percent and 7percent from 2011 to 2015, and 22 percent have budgeted an increaseof more than 8 percent during that time.

“Employers are spending millions of dollars annually on healthcare, and yet many report they do not have a specific plan for howbest to manage that investment," notes Jim Winkler, Large EmployerSegment leader in the Health & Benefits Practice with AonHewitt. "Given the risks and opportunities presented by health carereform, it is imperative that employers develop a written strategyfor controlling cost and improving health."

Rewards and penalties

Twenty-two percent of employers say they will have rewardprograms in place by the end of the year for those who achievespecific health outcomes, and 10 percent will develop programs topenalize those with unhealthy outcomes, according to the survey.Within five years, 64 percent of organizations said they will addprograms that reward for good health, and 46 percent said they willadd programs that penalize for unhealthy outcomes.