Aditya Kishore
Customer Success, Wellnecity
Rising Costs, New Pressures
Employer healthcare costs are poised to rise sharply. Mercer's National Survey of more than 1,700 U.S. employers projects a 6.5% year-over-year increase in total health benefit cost per employee (PEPY) for 2026 — driven largely by high-cost therapies such as GLP-1 drugs and advanced cancer treatments.
The Limits of Traditional Cost Control
Increasing employee cost-sharing and plan tweaks may ease short-term pressure, but they don't address the underlying drivers. The cost curve keeps climbing.
A Smarter Path Forward
Employers beating trend apply operating discipline and vendor accountability to flatten costs while protecting benefits. That means:
- Continuous claims monitoring with timely alerts to identify risks early and prevent avoidable costs
- Holding TPAs, PBMs, and networks accountable to contract terms and performance guarantees
- Demanding transparency and measurable results from vendor partners
Case Study: Fortune 100 Healthcare Organization, 65,000+ Employees
Our client substantially reconfigured their vendor ecosystem in 2023. Continuous monitoring and proactive improvements were essential to maximizing plan performance — cost of care, quality of care, and member satisfaction. By holding vendors accountable, improving care, and continuously improving the plan, the client has been able to:
- Beat industry projected per-employee-per-year (PEPY) costs every year by 10% on average, since 2023
- Project 2026 PEPY at a 3% increase from prior year, below Mercer's projected 6.5% increase
- Improve employee cost share by limiting premium growth to 2% — less than half of the market increase
- Achieve $320 million (projected) in accumulated savings through the end of 2025
Moving from reactive cost-shifting to proactive oversight lets employers beat trend and protect employees.
