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 info to these working within the worker advantages trade. 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 the same 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 because of persistent circumstances and 11% stated medical supplier prices.
Amongst those that selected specialty/expensive pharmaceuticals as a main issue for value will increase, 59% stated that GLP-1 medication had been a significant purpose (that is down from final 12 months, when 75% stated GLP-1s had been accountable). After GLP-1s, 50% stated most cancers medication, 21% stated cell and gene remedy and 26% stated different medication.
To fight these rising prices in 2026, 27% of respondents stated that implementing cost-sharing initiatives — similar to via 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 recent survey, during which 51% of huge employers stated they’re possible or very more likely to shift prices to workers in 2026.
About 17% of respondents within the Worldwide Basis’s survey stated that implementing plan design initiatives can even be efficient. This contains dependent eligibility audits, high-deductible well being plans, spousal surcharges and formulary modifications.
One other 17% stated they’ll use buying/supplier initiatives, like telemedicine, value transparency instruments, facilities of excellence, healthcare navigators and high quality initiatives.
Lastly, 12% of respondents reported that they’ll implement utilization management initiatives, similar to prior authorization, case administration, illness administration and nurse recommendation strains. It is a important lower from final 12 months, nonetheless, when 27% stated 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/expensive pharmaceuticals topping the record,” stated Julie Stich, CEBS, vice chairman 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.”
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