Their health in your hands

Global organisations are facing a pivotal moment in how they manage workforce health. Costs are climbing, access pressures are growing and employee expectations are rising faster than many benefit structures can keep up with.

Howden’s latest Global Employee Health Report shows how sharply the landscape is changing. Medical trend continues to far outpace inflation, driven by rising utilisation, new high-cost treatments and widening gaps in public provision. Employees also want faster access, broader cover and more personalised support.

These pressures converge as workforces become more dispersed, diverse and vocal about their needs. Adam Harding, executive director, international benefits at Howden Employee Benefits, says: “Healthcare challenges are no longer regional. They are global challenges that employers everywhere are having to respond to.”

This increasingly requires long-term planning, consistent global frameworks and a clearer understanding of how benefits influence talent, productivity and organisational resilience.

“One of the statistics that stood out to me was that 41% of employees have paid for treatment out of their own pocket just to move to the next step in their care”

Harding says that one of the most significant shifts is how employees are thinking about healthcare. When public systems cannot provide timely access, employees expect employers to fill the gap. Delays to diagnosis and treatment correlate with lower satisfaction and poorer outcomes. In many markets this drives people to self-fund care even when they have insurance.

“People do not view health insurance as insurance anymore,” he says. “They see it as a right to have access to good-quality healthcare.”

“One of the statistics that stood out to me was that 41% of employees have paid for treatment out of their own pocket just to move to the next step in their care,” Harding says. “This raises questions about affordability, fairness and how benefits can meaningfully reduce burden rather than shift it.”

RICHER BENEFITS, RISING EXPECTATIONS

The report highlights a broadening of what employees now expect from their health benefits. Demand is rising across mental health, reproductive health, menopause, neurodiversity and chronic condition support. Medical innovation is accelerating, with new cancer therapies, metabolic treatments such as GLP-1 drugs and personalised medicines reshaping cost patterns and creating new governance challenges for employers.

GLP-1 therapies illustrate this shift clearly. These treatments carry significant potential for improving metabolic health, but access and regulation differ sharply by country. In some markets, individuals can buy the medication directly without clinical oversight. In others, insurer coverage is limited or evolving. This variation requires employers to take a more deliberate, globally coordinated approach to safety, equity and affordability.

“If an employer wants to demonstrate that they are genuinely invested in their employees’ wellbeing, then they need to consider covering these kinds of treatments”

Insurers are also adjusting their products in response to changing expectations. Conditions that were historically excluded, like behavioural disorders, infertility treatment and hormone replacement therapy, are now being added to policies in competitive markets. This creates differentiation for employers but also brings cost pressures that require structured oversight.

Harding says: “If an employer wants to demonstrate that they are genuinely invested in their employees’ wellbeing, then they need to consider covering these kinds of treatments.” But achieving this sustainably requires clear principles on coverage, communication and consistency so that benefits remain fair and manageable across multiple geographies. 

ONE PHILOSOPHY, MANY MARKETS

Regulations, funding models and cultural norms vary widely, making global consistency difficult. International medical insurance supports organisations entering new markets, but Harding notes it should be used judiciously.

“It might be appropriate to offer richer international cover to new employees in the early years,” he says. “But as the organisation grows, it may no longer be affordable or appropriate to maintain that level of coverage.”

Expectation management is crucial. Without clear communication, employees may see enhanced international cover as permanent rather than transitional.

Healthcare is increasingly central to how organisations compete for talent. Rising costs make reactive decision-making unsustainable, while employees expect a more human approach to health. Harding believes organisations must become more deliberate.

“Employers want to differentiate themselves and retain the best talent”

“You need to understand where your costs are coming from, which populations are at risk, and which interventions will have the biggest impact.”

Workforce health touches HR, finance, procurement and risk. Cross-functional governance is essential to balance cost, equity and resilience.

“Employers want to differentiate themselves and retain the best talent,” Harding says. “They need to think seriously about how they support people’s health. It is about being a caring employer, but also building resilience for the future.”

• Download the Global Employee Health Report.
• Visit the website to learn how Howden is rethinking the world of employee benefits.