Managers of companies with employees in more than one country like many of the strategies U.S. employers are using to try to hold down health coverage costs.

Consultants at Towers Watson & Company, New York (NYSE:TW), have published data supporting that conclusion in a summary of results from a survey of 106 employers with at least 500 employees and “significant” operations in more than one country. About 93% of the companies are based in North America.

Although many of the multinationals operate in countries with “universal health care” systems, employers still sponsor private health plans in many of those countries, and 77% of the participating multinationals said they offer employee health programs outside the United States in place of, or in addition to, publicly provided programs in all or most of the countries in which they operate.

The companies may fill in gaps in government coverage, or provide an alternative in countries with weak public health systems, the Towers Watson consultants report.

Only 25% of participating multinationals provide disease management programs in most or all countries, and only about 30% offer health promotion, health screening and behavioral health programs in most or all countries.

About 51% of the employers told Towers Watson that non-U.S. markets lack available or reliable health care cost data, and 44% said non-U.S. markets lack the kinds of health care products and services they want to offer.