With health costs still rising at twice the rate of inflation, U.S. employers are encouraging their employees to become more responsible for their own health. In doing so, employers are focusing on plan design, health improvement, education and communication to drive employee engagement and increase employees' understanding of their health care benefits. But in order to develop and implement effective solutions that control costs, employers must first understand employees' views, not only to help them change their health care behaviors but also to improve their overall health and satisfaction.

The 2007 Watson Wyatt Employee Perspectives on Health Care study reveals how employees view, learn about, use and pay for health care. It provides a counterpoint to our significant body of research into employer views on health care. And it confirms that employees, although satisfied with their coverage, are — like employers — extremely concerned about increasing costs. Key findings include:

• While the majority of employees who receive health care benefits from their employer are satisfied with their coverage, they are concerned about high health care costs. They worry about how to pay their premiums and routine out-of-pocket costs, and how to cover a potential catastrophic health event. Additionally, high health care costs have led some employees to reduce contributions to their retirement plan.
• Employees are confident about their ability to manage and change their personal health status and see the tie between good health in the present and cost savings in the future. Nearly all employees say they have made a change to improve their health or are contemplating a change.
• Many employees do not understand how their coverage works and have little knowledge of the most basic health care vocabulary. When seeking health care and benefits information, they turn to a variety of sources.
• Employees enrolled in high-deductible health plans (HDHPs) tend to be healthier but worry more about costs than employees in traditional benefit plans.
• Perhaps not surprising, employees who say they or someone in their family has a chronic condition are more concerned about costs and the need for clear communication from their employer.