EBN's Best of 2025: Leaders confront climbing healthcare costs

• Key Insight: Discover how AI-enabled, physician-led asynchronous care can lower costs and increase access.
• What's at Stake: Rising employer healthcare costs risk eroding benefits and productivity without strategic plan redesign.
• Supporting Data: Median medical cost trend projected at 9% for 2026, 7.6% after plan changes.
• Source: Bullets generated by AI with editorial review

We're rounding up what benefit leaders had to say about the top workplace trends of 2025. See part 1 on RTO mandates here.

Healthcare costs are rising at their fastest pace in more than a decade, and 2025 shaped up to be another year of significant financial pressure for employers. 

Between the continued demand for specialty drugs and the impacts of delayed preventive care, among other factors, organizations are bracing for cost increases that outpace general inflation as they prepare for 2026. For benefit leaders, the challenge isn't just absorbing these expenses — it's finding strategic, sustainable ways to protect both their budgets and their workforce's well-being.

"In certain ways, 2026 is going to be enormously challenging," says Cooper Zelnick, CEO of addiction recovery service Groups Recover Together. "However, I do believe that this is an opportunity to innovate and do right by patients and build value based models that really drive impact."

Read more: Marathon Health's benefits redesign led to a 30% increase in usage

As employee expectations shift toward more personalized and accessible care, benefit managers are being asked to do more with less. Leaders are exploring new plan designs, high-touch clinical navigation, and digital health solutions that promise better outcomes and cost control. At the same time, they're scrutinizing vendor contracts, evaluating point-solution overlap, and digging deeper into claims data to understand the true drivers of spend. 

Despite growing interest in innovation, leaders must also ensure any changes are communicated clearly and empathetically so employees understand not just what's changing, but why. Ultimately, the organizations navigating this moment most effectively are those treating cost management as a strategic, long-term initiative rather than a once-a-year renewal conversation. 

Top leaders in the healthcare and benefit industry shared their strategies this year, giving benefit managers a plan of attack for a more cost-effective 2026. Here's what they had to say: 

Business Group on Health's 2026 Employer Health Care Strategy Survey projects a median 9% rise in medical cost trends — or 7.6% after plan design changes. This comes on the heels of the highest back-to-back jumps in a decade.  

"In this challenging environment, employers remain firmly committed to an ongoing investment in employee health and well-being," said Ellen Kelsay, president and CEO of Business Group on Health. "Yet they will need to make bold and strategic moves to contain costs, sometimes disrupting health care models along the way." 

Read more: Healthcare costs projected to rise 9% in 2026

When care is inaccessible, employees either delay it or are forced to turn to expensive emergency departments for issues that could have been addressed earlier and more affordably. The result is a negative cycle: Worsening employee health and productivity alongside rising costs for employers.

Benefit brokers and advisers should encourage their employer clients to offer smarter benefits, not necessarily more, to break this cycle. One of the most promising approaches is giving employees access to responsible, AI-enabled, physician-led care that is always available, asynchronous and built to deliver personalized guidance in minutes. 

Read more: How offering seamless healthcare can lower costs

Behavioral health benefits like addiction and recovery services have received far less attention and investment than other wellness programs. However, employers risk further increasing their healthcare spending in the long-run if they don't invest in preventive services and other more acute needs, as untreated substance use disorders often lead to repeated emergency visits, costly complications and more intensive medical care down the line.

"Benefit leaders are facing some really difficult choices," Zelnick says. "How do they build more robust wellness benefits that are competitive and that meet the needs of their employees, without sacrificing their own financial stability or passing those costs on to their employees?"

Read more: 2026 healthcare trends: The growing role of addiction and recovery support

With healthcare premiums expected to rise in 2026, many companies are looking for ways to save money without sacrificing quality of care. Brokers in this space are evolving from vendors to strategic partners, helping benefit leaders use data to make smarter choices and design plans that cut costs while improving care access, according to Al Marino, Trucordia's health and benefits practice leader.

"Clients have some serious fiduciary pressures now that they didn't have before," Marino says. "Employees are demanding more … so it's really on brokers to act as a strategic partner." 

Read more: Data-driven benefits gain ground as employers face steep premium hikes

Trump's law plans to cut $500 billion from Medicare starting in 2026, and nearly $1 trillion in cuts to Medicaid. It's expected that nearly 12 million people will lose healthcare coverage as a result of these cuts. Additionally, a rise in uninsured individuals and a drop in reimbursement will present budget challenges for healthcare providers and hospitals, says Christoph Dankert, chief network officer at value-based Centers of Excellence (CEO) specialty care platform Carrum Health. While the timing is up for debate, private insurers, and thus employers who use them, can expect to see costs increase to close the gap, he says. 

"If you're taking money out of Medicaid and out of the marketplaces, providers will see a reduction in reimbursement from that," Dankert explains. "Yet, they can't just turn people away, so they'll provide care they're not going to get reimbursed for. What do providers do in this instance? They turn to the commercial market, because that's where they have some way of recouping some of that money. That will then drive up the reimbursement of insurance-based providers, and then, in turn, drive trends on the employer side."

Read more: How Trump's One Big Beautiful Bill Act will increase employer healthcare costs