Managing rising health benefits costs has surpassed talent retention as the top strategic priority for health systems in 2025, according to Aon’s twentieth annual Benefits Survey of Hospitals.
The report includes insights from 155 health systems, representing more than 1,500 hospitals and 3.6 million employees nationwide.
Ten notes:
1. In 2025, 93% of health systems identified cost management as their primary concern, with median per employee per year spend rising 9.2% due to inflation, high-cost therapies and the growing complexity of chronic conditions.
2. Only 14% of systems believe their employees understand the value of their total benefits package, down from 25% the previous year. To maximize ROI from benefits investments, systems need to balance robust employee listening with targeted modifications to communications and engagement strategies.
3. Systems continue to prioritize employee affordability, using strategies like salary-based contributions, company-paid supplemental benefits, and financial needs programs for low-wage earners. There’s a growing emphasis on addressing the needs of a diverse, multigenerational workforce to ensure benefits are inclusive.
4. The cost of GLP-1 medications now makes up 50% of the top 10 drugs by spend. Systems are implementing tighter formularies, exclusions and clinical management programs to manage pharmacy costs. The rise of biosimilars is also helping reduce spending on legacy high-cost drugs.
5. 63% of systems now offer high-deductible health plans, though enrollment remains lower than other plans. These plans often come with salary-based contributions. Nearly three-quarters of systems offer at least three tiers of coverage, with steerage to in-network, system-owned facilities, physicians and pharmacies being a key strategy for cost management and clinically integrated care.
6. Health systems are refining employee contributions in their benefit programs, with notable variability in cost‑share based on plan design, employee tier and salary, to help balance affordability and cost‑management strategies.
7. Medical claims over $100,000 continue to make up a disproportionate percentage of overall costs. Systems are leveraging case management, predictive analytics and stop-loss insurance to better manage these high-cost claimants.
8. Family-building benefits, paid parental leave, and expanded mental health support are increasingly common. Half of systems offer financial incentives for employees to engage with wellbeing programs.
9. Systems are adapting benefits to include more telemedicine and digital health services. Digital tools are playing an increasing role in care management and are being integrated into benefits packages to enhance accessibility and engagement.
10. Systems are increasingly implementing financial assistance programs, including company-paid supplemental benefits and salary-based contributions, to support low-wage employees.
