Large U.S. employers are shuffling their employee benefits priorities for next year, according to a new survey, moving away from new mental health initiatives and instead prioritizing efforts to control rising healthcare costs.

According to the 2025 Employer Health Care Strategy Survey by the Business Group on Health, it is the first time in many years—probably at least since 2020—that investing in mental health has not been the No. 1 focus for new benefits initiatives at organizations with at least 500 employees.

With a possible recession looming and employer healthcare spending projected to hit a 15-year high next year, “it’s no surprise” that employers are focused on reducing healthcare costs, says Brenna Shebel, vice president of Business Group on Health.

According to the survey, developing strategies to tackle high-cost healthcare claims will be the top area of focus for 27% of employers next year, up from 22% and third on the list for 2024. That puts it well behind top-ranked mental health efforts (36% of employers) and second-ranked plans to boost virtual health opportunities (35%).

Use of employee benefits for mental health treatment rising

However, caring for employees’ emotional wellness remains important for employers, with 25% planning to expand access to mental health services next year, the survey shows. A quarter of employers (25%) also prioritize plans for new benefits services and solutions for employees next year, up from about 18% last year.

Rising costs, however, and care for mental health conditions are inextricably linked, Shebel says. Mental health expenses rank among the top five healthcare costs for employers, she says, with 16% ranking it as the No. 1 driver. Nearly 80% of employers also report a rise in utilization of benefits to treat mental health and substance use disorders, the survey shows.

Compounding this, 25% of employers report that mental health conditions are becoming more common among their workers.

Regardless, the survey shows that mental wellness support is still an important component of an employer’s healthcare strategy, with 97% of employers offering it this year and 100% expected to include it in their employee benefits offerings by 2027.

“Employers have been acutely focused on addressing a variety of items related to mental health over the past many years,” says Ellen Kelsay, president and CEO of Business Group on Health. “And they remain committed to ensuring that employees have access to appropriate and quality mental health resources.”

Kelsay points to Business Group on Health survey data showing that more than half of employers (56%) are taking additional steps to bolster employees’ mental health next year by expanding provider networks to include more diverse mental health and healthcare professionals. By 2027, that number is expected to rise to 75%, according to the survey.

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