Employers continue to boost deductibles, particularly for out-of-network services, as health care costs show no signs of easing, according to a survey released Wednesday.

Twenty-two percent of employers imposed deductibles of at least $1,000 this year for in-network services for their health care plans that had the largest enrollment, up from 16% last year and just 8% in 2008, according to PricewaterhouseCoopers L.L.P.

Double that percentage of employers—44%—imposed deductibles of at least $1,000 for out-of-network services, up from 29% in 2010. As recently as 2008, only about 20% of employers imposed deductibles of $1,000 or higher on out-of-network services, according to the survey of more than 1,700 employers.

“The biggest change in the past two years has been the increase in cost-sharing with employees,” said Michael Thompson, a PwC principal in New York. Increased cost-shifting has come as health care cost increases continue to outstrip increases in corporate profits as well as employee wages, he said.

Rising health care costs add pressure on employers already affected by the difficult economy, but boosting employee cost-sharing may make employees more careful consumers of services, Mr. Thompson said.

Premium contributions

On the other hand, employers have limited increasing employees’ premiums. For example, 31% of employers require employees to pay less than 20% of the total premium for family coverage this year, virtually unchanged from last year, according to the survey.

“Employers have been careful not to shift premium costs to employees, but have decided that the better way to shift costs is to require those who use health care services to pay more,” Mr. Thompson said.

The survey also found a surge in employees enrolling in high-deductible, consumer-driven health care plans.

This year, 17% of employers reported that the greatest percentage of their employees was enrolled in high-deductible plans, up from 13% in 2010 and 8% in 2009. By contrast, 57% of employers reported that traditional preferred provider organizations had the highest enrollment this year, down from 63% last year.