The cost of employer-provided health care benefits at large U.S. employers is expected to rise another 7 percent in 2013. In response, employers are considering cost-control measures including asking workers to pay a larger portion of premiums and increasing financial rewards to engage workers in healthy lifestyles, according to a survey from the National Business Group on Health.

Although next year's increase in cost matches this year's increase, 60 percent of employers plan to increase the percentage of the premium paid by employees. Most of those employers indicated that the increase would be less than 5 percent. Additionally, 40 percent plan to increase in-network deductibles; 33 percent will increase out-of-network deductibles; and 32 percent will increase out-of-pocket maximums.

In a change from last year, survey respondents consider consumer-directed health plans and wellness initiatives to be more effective at curbing costs than shifting costs to employees. According to the survey, 43 percent cited a CDHP as the most effective cost-control tactic followed by wellness programs. Only 9 percent reported increasing employee cost-sharing as most effective.

Survey respondents continue to experiment with and perfect incentive-driven wellness programs. While 48 percent of respondents use incentives to encourage participation, some employers are basing incentives on specific health outcomes. For example, 44 percent provide an incentive based on tobacco-use status while 29 percent base awards on achievement of outcomes such as body mass index or cholesterol levels. Twenty-two percent of employers take a different tack and apply surcharges to employees for not participating in certain programs.

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