More than three-quarters (77 per cent) of large U.S. employers are reporting an increase in mental-health needs among their workforces, according to a new survey by Business Group on Health.

The survey, which polled around 150 large employers employing 19 million people, found this is a 33 per cent increase compared to last year, when 44 per cent of respondents said they were seeing an increase in employees’ mental-health concerns.

“Our survey found that, in 2024 and for the near future, employers will be acutely focused on addressing employees’ mental-health needs while ensuring access and lowering cost barriers,” said Ellen Kelsay, president and chief executive officer of Business Group on Health, in a press release. “Companies will need to creatively and deftly navigate these and other challenges in the coming year, especially as they remain committed to providing high-quality health and well-being offerings while managing overall costs.”

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The survey also found half of employers cited cancer as the No. 1 driver of health-care costs, with 86 per cent of respondents ranking it in their top three drivers. Last year’s survey saw cancer overtake musculoskeletal conditions as the top driver of large organizations’ health-care costs for the first time.

In addition, 92 per cent of employers said they’re concerned about high-cost drugs in the pipeline. Alongside this finding, employers are experiencing an increase in the median percentage of health-care dollars spent on pharmacy, from 21 per cent in 2021 to 24 per cent in 2022. For 2024, employers said they plan to deploy various pharmacy management strategies.

Employers also said they plan to assess partnerships and vendors next year to ensure value and higher-quality, cost-effective services. Nearly half said they plan to require vendors to report on health equity measures, while many seek to streamline partnerships and vendor offerings.

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The majority (87 per cent) of the survey’s respondents cited transparency as a potential tool to contain costs and improve quality, enabling employees to make more educated health-care decisions. As well, 73 per cent of employers said they’ll prioritize requirements for more transparency in pharmacy benefit managers pricing and contracting, and 58 per cent expressed an interest in additional reporting and better provider quality measurement standards.

While employers continue to see virtual health as essential to their overall strategy, they’re less inclined to see virtual health as transformative on its own. In 2021, 85 per cent of employers said virtual health would impact overall delivery, compared to 74 per cent in 2022 and 64 per cent in 2023.

And the survey found employers’ approaches to health equity continue to evolve, with a focus on specific communities and populations within the workforce. In 2024, 86 per cent of respondents said they’d collaborate with employee resource groups to promote benefits and well-being initiatives to specific groups, while 61 per cent said they’d require health plan and navigation partners to maintain directories of health care and mental-health providers. The majority (85 per cent) of employers said they plan to implement at least one strategy to support the health and well-being needs of LGBTQ2S+ employees.

Read: How employers can support LGBTQ2S+ employees’ mental well-being amid challenging times