Big companies are increasingly incorporating virtual technology and care options into employee-benefit plans to combat the rising health care costs that long have been corporate America's bugaboo, according to the annual survey of the National Business Group on Health.

The No. 1 goal for employers in 2020 is to implement more virtual-care provisions. This includes things like behavioral health over video chat, digital coaching, condition management and sleep therapies, according to the NBGH, a research group that represents large employers.

"Virtual solutions are scalable. They improve convenience and access," said Brian Marcotte, president and chief executive of NBGH.

Overall, health care costs are projected to rise 5% for 2020, the survey said. In past years, especially during the 2008 recession, that number had been about double, Marcotte said.

Actual costs may be rising at a slower pace than that 5% forecast indicates, since employers typically add in a cushion, Marcotte said. For instance, cost inflation for 2018 turned out to be just 3.6% for 2018, while the projection was 6%.

Even as the price of care, particularly drugs, has increased, costs have been held in check because usage of health care benefits has not gone up — largely achieved by raising policyholders' deductibles.

Virtual-care programs reduce use of emergency services by getting front-line care to people without access, such as rural communities, and to people, like shift workers, who have trouble making in-person appointments.

"It's not about too much money being spent, but that too many people have needs that are not being met by outpatient services," said Jeff Levin-Scherz, health management practice co-leader at Willis Towers Watson, a benefits consultant.

A separate survey by Willis Towers Watson found that 81% of employers offer or plan to offer tele-behavioral health services by 2020.

More choice

Another trend for 2020: Large companies that shifted to only high-deductible offerings are starting to add back choice options.

In 2018, 40% of large companies offered only high-deductible plan options. In 2019, that dropped to 30%, and NBGH forecasts it will fall to 25% in 2020.

Marcotte attributes the reversal to companies no longer worried about the effect of the so-called "Cadillac tax," which would have imposed fees on the most generous benefit plans.

Low unemployment is also a driving factor, given that companies now have to compete to retain workers.

Beth Pinsker writes for Reuters.