A shortage of skilled and talented workers is the most pressing concern among American employers, displacing the perennial leading problem—rising healthcare costs—according to a survey.

The 14th annual Top Five Total Rewards Priorities survey, conducted by Deloitte Consulting LLP and the International Society of Certified Employee Benefit Specialists, finds that nearly three-quarters of human resources professionals say talent is their biggest concern.

Meanwhile, 71% say cost containment of healthcare is a top five concern this year, down from 80% in 2007.

The other leading issues are the willingness of employees to pay for an increasing portion of benefit plan coverage and to manage their own reward budget (58%), clear alignment of total rewards strategy with business strategy and brand (56%), and demonstrating appropriate return on investment for reward expenditures (42%).

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“Clearly, talent management is the top organizational challenge—higher than managing the cost of total rewards, especially health care,” says Tim Phoenix, a principal in Deloitte’s human capital service area and co-director of the survey. “We find that HR organizations around the world are becoming increasingly business-driven and strategic, shifting their focus from HR administration and cost reduction to long-term ROI and growth in a way that directly impacts the bottom line.”

This year’s survey was completed online by 413 respondents who represent a divers cross-section of the U.S.-based employer universe by industry and size.

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