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 instructional info 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 analogous report final yr that projected an 8% median enhance for 2025.
When requested what the first components contributing to the rise in medical plan prices have been for 2026, 31% mentioned “catastrophic claims,” a rise from 20% who mentioned this final yr. Following catastrophic claims, 23% mentioned specialty/pricey pharmaceuticals, 15% mentioned utilization resulting from persistent situations and 11% mentioned medical supplier prices.
Amongst those that selected specialty/pricey pharmaceuticals as a major issue for price will increase, 59% mentioned that GLP-1 medicine have been a significant purpose (that is down from final yr, when 75% mentioned GLP-1s have been accountable). After GLP-1s, 50% mentioned most cancers medicine, 21% mentioned cell and gene remedy and 26% mentioned different medicine.
To fight these rising prices in 2026, 27% of respondents mentioned that implementing cost-sharing initiatives — reminiscent of via deductibles, coinsurance, copays or premium contributions — would be the most impactful. That is up from 21% who mentioned this final yr. As well as, that is in line with what Mercer present in its latest surveythrough which 51% of enormous employers mentioned they’re seemingly or very more likely to shift prices to staff in 2026.
About 17% of respondents within the Worldwide Basis’s survey mentioned that implementing plan design initiatives can even be efficient. This consists of dependent eligibility audits, high-deductible well being plans, spousal surcharges and formulary adjustments.
One other 17% mentioned 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, reminiscent of prior authorization, case administration, illness administration and nurse recommendation traces. It is a important lower from final yr, nonetheless, when 27% mentioned they’ll use utilization management initiatives.
“The ten% projected enhance is attributed to a wide range of components impacting organizations’ medical plan prices, with catastrophic claims and specialty/pricey pharmaceuticals topping the checklist,” mentioned Julie Stich, CEBS, vice chairman of content material on the Worldwide Basis of Worker Profit Plans, in an announcement. “Employers have indicated that cost-sharing, plan design and buying/supplier initiatives would be the most impactful methods to handle prices.”
Photograph: Ta Nu, Getty Photos
