Employee Benefits - Rethinking Health Plan Costs - Bim Group

Employee Benefits – Rethinking Health Plan Costs

READ TIME: 4 MINUTES

Healthcare spending continues to rise, prompting employers to evaluate how benefit plans are designed and managed. As 2026 approaches, cost control is being paired with a stronger focus on preventive care, cost transparency, and long-term employee health.

The Challenge: Costs That Keep Climbing

A recent survey projects a 9% increase in medical costs next year, or about 7.6% after plan adjustments.

Much of this increase stems from the growing use of obesity medications, cancer treatments, chronic condition management, and mental health services.

Demand for GLP-1 drugs has surged, with nearly 80% of employers reporting higher utilization.

While these medications are highly effective, their expense has led many organizations to require prior authorization and participation in weight management programs to promote responsible use.

The Pressure Point: Pharmacy Spending

Prescription drug costs continue to increase at a faster rate than other healthcare categories, accounting for nearly one-quarter of total healthcare spending.

Employers anticipate an 11% to 12% rise in pharmacy spending heading into 2026.

In response, organizations are seeking greater transparency from pharmacy benefit managers and exploring models that emphasize value over rebates.

This evolution reflects a broader shift toward accountability and quality, ensuring that every dollar spent supports better care and measurable results.

The Strategy: Prevention and Smarter Care

Prevention now anchors cost management, with employers broadening cancer screening coverage, removing age limits for key tests, and incentivizing recommended preventive care. These efforts control costs while demonstrating a commitment to long-term health and meaningful employee engagement.

At the same time, many organizations are enhancing navigation tools to help employees locate high-quality providers. When employees can easily identify effective care options, both outcomes and spending improve.

The Opportunity: Engagement as a Cost Strategy

Employee engagement, encouraging preventive care, increasing primary care use, and effective benefits communication drive smarter healthcare decisions. Informed employees utilize resources effectively, thereby reducing unnecessary costs and enhancing overall well-being.

The Bottom Line

Healthcare costs are rising, but targeted strategies can work. Prevention, value-based care, and transparency help manage expenses while providing coverage that improves employee health. In addition, employers deliver meaningful programs and strengthen commitment, build trust, and create stability for their employees. In any market, benefits closely aligned with employee priorities are among the most effective tools for attracting and retaining talent.

 

 

 

This information is general in nature and provided for educational purposes only. It is not intended to provide legal advice. You should not act on this information without consulting legal counsel or other knowledgeable advisors.

Recent Insights

November 11, 2025
News

Webinar: ACA Primer for Group Health Plans

Tuesday, December 9, 2025 2-3PM EST Register Now Registration Code: UBA410EW Attend this month’s webinar to gain a foundational overview of the Affordable Care Act (ACA) including historical context and political challenges to its goal of expanding healthcare coverage, improving quality, and containing costs. Key Takeaways​​ Learn about key components, such as managing variable-hour and seasonal […]
Read more
November 10, 2025
News

Getting Your Team to See the Value in Their Benefits

Most employers want to provide a comprehensive, holistic benefits package to their employees. However, with all of the other hats leadership must wear, it can be a challenge to communicate all the various facets of what is available to employees, let alone in an effective and engaging way. As a result, employees often struggle to […]
Read more
October 27, 2025
News

Making AI Adoption Part of Your Culture

READ TIME: 4 MINUTES AI is transforming organizations, but its success ultimately rests on culture rather than technology. Employees must be included in ongoing learning, understand how AI supports their goals, and trust that it enhances, not replaces, their work. When AI adoption feels exclusive or unclear, employees disengage. HR leaders who foster environments with […]
Read more
October 27, 2025
Employee Benefits, Health Care Costs

Employee Benefits – Rethinking Health Plan Costs

READ TIME: 4 MINUTES Healthcare spending continues to rise, prompting employers to evaluate how benefit plans are designed and managed. As 2026 approaches, cost control is being paired with a stronger focus on preventive care, cost transparency, and long-term employee health. The Challenge: Costs That Keep Climbing A recent survey projects a 9% increase in […]
Read more