With the opening of public exchanges, the growth of private exchanges and continuing cost pressures, we can expect to see employers scrutinize their sponsored health care benefits as never before. They will be looking for plan changes that make sense for their companies in 2014 and beyond. Their objectives — managing costs and improving worker health — remain the same, but the range of options they are analyzing has been significantly broadened by the massive scope of health care reform. From account-based plans, to health management, to premium surcharges, to payment and contracting methods, all these solutions — old and new — are now on the table.

Towers Watson’s 2013 Health Care Changes Ahead Survey results offer insights on the actions organizations have taken or plan to take to frame their health care strategies in the wake of reform. The responses of 420 midsize to large U.S. companies show that they intend to maintain health care benefits for active employees, but continue to rethink their financial commitment to retiree medical coverage. The findings also provide a snapshot of the tactics and programs they are seriously considering during this period of historic change.