As major employers pay more for employee healthcare coverage they are looking at telehealth options to help reduce some costs, says a new study from the National Business Group on Health.

The survey by the Washington, D.C., trade group of 148 big employers finds they expect the total cost of providing medical and pharmacy benefits to rise 5% in 2018, which would make it the fifth consecutive year of rising costs. Including premiums and out-of-pocket costs for employees and dependents, the total cost of healthcare is estimated to average $13,482 per employee this year, and projected to rise to $14,156 in 2018.

Employers will cover nearly 70% of those costs and employees about 30%, or about $4247 in 2018. For the second consecutive year, employers ranked specialty pharmacy (26%) as the top reason for rising costs. Eight in ten employers ranked it among the top three cost drivers, and specialty pharmacy costs are likely to remain a top concern as new high-priced drugs come on the market, according to the survey.

To combat rising costs, many employers are prioritizing more access to telehealth programs that enable employees to see a doctor online, according to the survey. Virtually all employers (96%) will make telehealth services available in states where it is allowed next year. More than half (56%) of employers surveyed plan to offer telehealth for behavioral health services such as for counseling, more than double the percentage in 2017, according to the survey.

The use of telehealth is on the rise, with nearly 20% of employers experiencing employee utilization rates of 8% or higher, says the National Business Group on Health. Employers also are increasingly making digital tools available to workers to help them better understand, sign up for and manage their health insurance benefits.

66% of companies will offer medical decision support tools and second opinion services in 2018, an increase of 47% from this year, according to the survey. Additionally, the number of companies offering high-touch concierge services will jump from 28% this year to 36% in 2018.

“One of the most interesting findings from the survey is that employers are focused on enhancing the employee experience,” says National Business Group on Health CEO Brian Marcotte. “For example, there is a big increase in the number of employers offering decision support, concierge services and tools to help employees navigate the healthcare system.”