Large U.S. employers expect to pay 6% more for health benefits in 2009, the same rate of increase as 2007 and 2008, according to preliminary findings of a survey by Watson Wyatt Worldwide and the National Business Group on Health.

The cost increases were partially tempered by the growing use of consumer-driven health plans, which are now offered by 51% of employers, up from 47% in 2008, according to the survey.

Employers where at least half of their workers enrolled in a CDHP have a two-year cost trend that is 25% lower than non-CDHP sponsors, the survey found.

While the rate of increase in health care costs has held steady for the past three years, it is still nearly twice the inflation rate, and that is prompting many employers to rethink their benefit strategies, according to the survey. For example, 30% have revamped their health care strategies and another 30% are planning to do so in 2009.

Rising costs are also shaking employers' confidence in their ability to provide health benefits 10 years from now. Just 62% said they are very confident in their ability provide such benefits 10 years from now, down from 73% a year ago.

About two-thirds of employers, 67%, cite the poor health habits of their employees as a major challenge to their ability curbing health care cost increases, while 42% cite underuse of preventive care services, 36% attribute the problem to the high cost of catastrophic and end-of-life care and 30% blame poor employee understanding of how to use their health plans cost-effectively.

"Cost increases have stabilized, but the financial crisis is causing many companies to re-evaluate their health plan strategies," said Ted Nussbaum, director, group and healthcare consulting, North America at Watson Wyatt. "While large-scale changes appear unlikely, economic realities are leading companies to adopt strategies that emphasize greater personal health accountability to their workers."

The final survey will be published in mid-March and released at the NBGH's annual Business Health Agenda, which will be held in Washington March 11-13.