Employers within the U.S. are projecting a median enhance of 10% in healthcare prices for 2026, a brand new survey from the Worldwide Basis of Worker Profit Plans discovered.
The Worldwide Basis of Worker Profit Plans is a nonprofit targeted on offering academic data to these working within the worker advantages business. It has greater than 31,000 employer members representing over 25 million lives.
The group’s survey, launched Thursday, was carried out between July 30 and August 7 and included responses from 150 company and single employers. The ten% projected enhance in healthcare prices is up from an identical report final 12 months that projected an 8% median enhance for 2025.
When requested what the first components contributing to the rise in medical plan prices had been for 2026, 31% stated “catastrophic claims,” a rise from 20% who stated this final 12 months. Following catastrophic claims, 23% stated specialty/expensive pharmaceuticals, 15% stated utilization as a consequence of continual situations and 11% stated medical supplier prices.
Amongst those that selected specialty/expensive pharmaceuticals as a major issue for price will increase, 59% stated that GLP-1 medicine had been a significant cause (that is down from final 12 months, when 75% stated GLP-1s had been accountable). After GLP-1s, 50% stated most cancers medicine, 21% stated cell and gene remedy and 26% stated different medicine.
To fight these rising prices in 2026, 27% of respondents stated that implementing cost-sharing initiatives — corresponding to by means of deductibles, coinsurance, copays or premium contributions — would be the most impactful. That is up from 21% who stated this final 12 months. As well as, that is according to what Mercer present in its current survey, during which 51% of enormous employers stated they’re seemingly or very more likely to shift prices to staff in 2026.
About 17% of respondents within the Worldwide Basis’s survey stated that implementing plan design initiatives will even be efficient. This consists of dependent eligibility audits, high-deductible well being plans, spousal surcharges and formulary adjustments.
One other 17% stated they’ll use buying/supplier initiatives, like telemedicine, worth transparency instruments, facilities of excellence, healthcare navigators and high quality initiatives.
Lastly, 12% of respondents reported that they’ll implement utilization management initiatives, corresponding to prior authorization, case administration, illness administration and nurse recommendation traces. It is a important lower from final 12 months, nevertheless, when 27% stated they’ll use utilization management initiatives.
“The ten% projected enhance is attributed to quite a lot of components impacting organizations’ medical plan prices, with catastrophic claims and specialty/expensive pharmaceuticals topping the listing,” stated Julie Stich, CEBS, vp of content material on the Worldwide Basis of Worker Profit Plans, in a press release. “Employers have indicated that cost-sharing, plan design and buying/supplier initiatives would be the most impactful methods to handle prices.”
Picture: Ta Nu, Getty Photos
