8 trends employers should watch in 2026, according to Health Business Group
As employers prepare for significant increases in health care costs in 2026, many are seeking innovative strategies to deal with the impact.
This is the latest trends report from the Health Business Group, which highlights the key issues expected to impact health benefits in 2026 and how employers plan to respond.
“A complex and fragmented healthcare ecosystem has contributed to a volatile cost environment that is teetering on the edge,” Ellen Kelsay, president and CEO of the Health Business Group, said in a statement. “Employers remain committed to delivering strong health and well-being services, but they must act quickly and strategically to manage costs while improving health outcomes.”
Here are eight trends that Health Business Group believes employers should pay attention to in 2026:
1. 2026 is expected to be the most difficult affordability year in recent memory: Employers expect median health care costs to increase by 9% next year, and by 7.6% after plan design changes. This comes after two years of actual medical costs exceeding forecasts. Multinational employers may see double-digit growth in some regions.
2. Employers need to “get back to basics”: Chronic disease is a top cost driver for employers, and this is expected to continue as population health deteriorates and the workforce ages. This means an increased focus on preventive care, primary care and health screenings.
3. Drug costs will remain a challenge: Breakthroughs such as cell and gene therapies and weight loss drugs are significantly increasing pharmacy costs for self-funded employers. As a result, employers are looking to “disrupt the current role of people in the pharmaceutical supply chain and create value for employees,” such as by changing their PBMs, according to the Health Business Group.
4. Partners will face stricter scrutiny from employers: Many employers have expanded their partner programs, but these programs often lack data integration and have “inadequate clinical coordination.” That’s why employers are subjecting their supplier partners to greater scrutiny, and partners need to consistently provide evidence that they are improving outcomes. Employers may terminate partnerships with those who fail to demonstrate success.
5. Employers will begin leveraging alternative models to control costs: Employers will expect their partners to be more innovative. They will also look to shift from traditional strategies to alternative plans, such as copay-based models, virtual priority plans and primary care-focused models.
6. Artificial intelligence will have a significant impact on efficiency: AI can streamline benefits administration and improve quality and access to care, but providers using AI to optimize revenue may also drive up costs. This means employers must understand how AI can be used in clinical settings.
7. The rapidly changing health policy agenda: There have been many efforts to reform health care, including combating PBMs. Federal action could lead to greater transparency in the pharmaceutical field. Additionally, uncertainty over Medicaid cuts and the potential expiration of Affordable Care Act subsidies could indirectly impact employer plans. Finally, midterm elections could lead to changes in the majority parties in the House and Senate, which would slow the pace of legislative change.
8. Disruption is necessary: Employers need to convince their leadership and employees to “embrace change.” According to the Health Business Group, this is necessary because patients have lost trust in the healthcare system, showing the need for disruption.
Photo: rudall30, Getty Images
