Healthcare Becomes Strategic

The inclusion of healthcare provision in corporate welfare plans is experiencing a boom due to employees' growing need for social protection. These interventions fuel the private healthcare spending component, which had traditionally been relatively marginal. Generally, corporate welfare plans have been favored by the 2016 tax reform, which provided incentives for the conversion of productivity bonuses into welfare goods and services for employees. Over three-quarters of companies that have structured welfare plans offer healthcare benefits, often through industry funds or supplemental insurance coverage (Censis-Confindustria, 2024). Among SMEs, health provision increased from 22% of firms in 2020 to 30.8% in 2024, while additional insurance coverage was present in 43.4% of firms (Welfare Index PMI, 2024). In addition to complementary health insurance, the provision of direct services is growing: check-ups, agreements with healthcare facilities, telemedicine, prevention programs and psychological support.

The pandemic has heightened the need for health services not only related to the management of work-related illnesses, also for household members (e.g. care for the elderly). Furthermore, new service delivery methods were launched during that phase: in 2020, approximately 14.7 million workers and family members become enrolled in supplementary health funds (Ministry of Health, 2023), and many companies introduced digital prevention and assistance packages, some of which were maintained even after the Covid emergency.

On the demand side, 80% of welfare credits are actually spent by beneficiaries, while 38% of employees consider healthcare services among the most useful, second only to meal vouchers (Edenred Welfare Observatory – 2024). Healthcare has become a key factor in choosing a job and an indicator of the social role of companies that serve the "working community."

These dynamics are part of a broader trend that sees the hybridization of healthcare systems. As highlighted by the SDA Bocconi Observatory on Private Healthcare Consumption (OASI Report 2023), the boundary between public and private is increasingly porous: total health spending is apportioned by government, households and businesses, generating a "hybrid system" in which the various components are intertwined. In this context, corporate welfare does not replace public healthcare provision, but complements it, expanding access to services not always covered by the National Health Service, particularly in areas such as dentistry, diagnostics or mental health.

The expansion of corporate welfare brings both opportunities and risks with it. On the one hand, it strengthens the social role of firms, with positive effects on motivation and loyalty. On the other, it risks widening the gap between those who work for large companies and those who work in SMEs or the public sector, if this social innovation is not accompanied by adequate regulatory and inclusion tools.

In short, health services in corporate welfare plans are now a significant component of private spending on healthcare. Their growth is part of a structural process of hybridization that is redefining the balance between public and private sectors. The challenge is to ensure that admixture contributes to strengthening the mission of the National Health Service, and does not create new inequalities, so that corporate welfare acts as a lever for sustainability and innovation.