As the rate of increase in health care costs falls, employers are embracing initiatives that seek to increase employee accountability, promote appropriate use of services and improve employee health. The companies that are succeeding at controlling cost increases are using a wide range of tools and programs. These best performers take a far broader view of consumerism than just high-deductible plans.

The 11th annual National Business Group on Health/ Watson Wyatt study details current trends and best practices in employer-sponsored health care benefit programs. Key findings include:

• Best-performing companies have a two-year median cost increase of only 3 percent compared with an 11.5 percent increase for their poor-performing peers. The median two-year increase for all employers is 8 percent.

• Best performers are significantly more likely to have implemented strategies that consider provider quality, focus on improving the health of their workers, use data and hard evidence and encourage appropriate use of medical services. In addition, they are more successful at increasing employee understanding of how health care costs affect business earnings.

• Employer interest in consumer-driven health plans is continuing to grow. Twenty-nine percent of employers now offer a high-deductible plan with a reimbursement arrangement (e.g., health savings account), and 33 percent plan to add one for 2007. However, these plan designs have relatively low participation and by themselves are not effective at reducing costs. To achieve cost savings, they must be used in combination with other practices.