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Healthcare Costs Set to Rise 8.4%: What Employers Need to Know Now

Carol Warner
By: Carol Warner
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About the Author

For nearly two decades, Carol Warner has analyzed the legal and financial realities behind workplace decisions, covering employment law, benefits, payroll and HR technology. She translates complex legal updates, regulatory shifts and vendor claims into plain language that HR teams can act on. Her focus is simple: What does this mean for employers, and what should they do next? Connect with her on LinkedIn.

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Last Updated: September 8, 2025
5 minute engagement
managing healthcare costs
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As employers finalize their 2026 budgets, rising healthcare costs are forcing tougher decisions in financial planning and employee benefits.

Medical and prescription drug expenses are projected to increase by 8.4% next year, with pharmaceutical costs climbing even higher, according to HUB International’s 2026 Benefits Cost Trends Report. That’s up .26 percentage points from this year.

Let’s look at what this means in dollars and cents: Employers pay roughly $16,000 per year, per employee for healthcare. With an 8.4% rise coming next year, that’s about $1,300 more per person. For sizable companies, that adds up fast – over $260,000 more for 200 employees, and upwards of $630,000 for 500 employees.

Finance and HR leaders share overlapping challenges. Finance must anticipate volatile claims, reserves, and cash flow, while HR focuses on keeping employee benefits accessible and affordable. Joint planning helps employers protect budgets while supporting employee engagement and productivity. 

Regional Differences in Healthcare Costs and Their Impact

Healthcare inflation is not just a line-item issue. It has wide-reaching impacts.

Budgeting and Forecasting

Healthcare costs in 2026 will vary by state, making budgeting more complex for multistate employers:

  • Central region: 8.09%, up from 7.98% in 2025
  • East region: 9.8%, down slightly from 10.04% 
  • Pacific region: 9.5%, up from 9.29%
  • South region: 7.59%, down from 7.76%
  • West region: 9.03%, up from 8.96%

Most regions are seeing modest healthcare cost increases, while a few have slight decreases, creating a mixed picture. Finance teams need to build region-specific forecasts, and HR should tailor benefits and communications to local realities, balancing cost control with employee support.

Cash Flow Management

Healthcare expenses can be unpredictable, with fluctuating claims and stop-loss risks that can trigger sudden high costs. This volatility complicates cash flow management.

From a finance perspective, it’s important to use detailed claims data and predictive models to anticipate these swings so that enough funds are available when spikes occur. Stop-loss insurance can help cushion the impact of very large claims, but it requires active oversight to ensure coverage remains adequate and cost-effective. 

Overall, good cash flow management means staying agile and prepared, allowing the business to maintain financial stability even when claims are unpredictable.

Why are Healthcare Costs Rising?

Several forces are pushing 2026 healthcare costs higher, including:

  • Specialty drugs: Therapies such as GLP-1 medications for weight management and diabetes are driving costs rapidly upward.
  • Chronic conditions and mental health: Both categories continue to grow, increasing utilization and long-term claims.
  • Provider inflation and labor shortages: Rising wages for clinicians and staffing shortages are pushing costs higher across networks.

Employer strategies to address cost drivers include:

  • Encouraging cheaper biosimilars and generics
  • Directing employees toward more affordable care locations
  • Using prior authorizations for costly medications
  • Monitoring healthcare service use to prevent unnecessary costs
  • Managing vendor relationships to maintain quality and control spending

These measures rely on collaboration: Finance models cost changes, while HR ensures employees maintain appropriate access to care.

Workforce Impact of Rising Healthcare Costs

From the employee’s perspective, higher contributions feel like a pay cut – even when salaries increase. This can lead to:

  • Lower confidence in employee benefits programs
  • Increased absenteeism as employees postpone care
  • Reduced productivity as chronic conditions worsen
  • Higher employee turnover

The financial impact of turnover is significant. Recent analysis shows that the true cost – covering recruiting, onboarding, training, lost productivity, and morale decline – can range from 50% to 400% of an employee’s annual salary. Recognizing these costs highlights the substantial financial risks associated with employee turnover.

Clear communication about benefit changes is vital for HR. Highlighting support resources – such as telehealth, health coaching, and preventive care – also helps employees. For example, one employer paired healthcare cost transparency tools with a cash-back incentive, which encouraged employees to choose lower-cost, high-quality providers and increased engagement with value-based care decisions.

Meanwhile, Finance benefits from supporting a healthier workforce through reduced long-term costs.

How to Manage Rising Healthcare Costs

Employers are exploring multiple approaches to manage rising healthcare costs. Common tactics include adjusting employee contributions, deductibles, and out-of-pocket maximums. They are also exploring alternative funding models, such as self-funded or level-funded plans, pursuing more transparent pharmacy benefit manager (PBM) contracts, and consolidating vendors to improve integration and pricing leverage.

In addition to these traditional measures, some employers are considering structural alternatives. One option is partnering with a Professional Employer Organization (PEO). 

PEOs pool employees across multiple companies, giving smaller and mid-sized employers access to large-group pricing and more competitive benefits. This can provide cost stability for Finance while supporting HR’s recruiting and retention efforts. 

Many businesses turn to a PEO when they want to offer better benefits that would be unaffordable on their own, Justin Mincks of BestFit PEO Solutions previously told HRMorning.

The trade-off is less direct control over plan design, making close Finance–HR collaboration essential to ensure the model aligns with long-term workforce goals.

What Finance and HR Should Do

Finance Priorities

  • Model reserve and cash flow volatility beyond just annual premiums
  • Evaluate alternative funding (self-funded, level-funded, transparent PBMs)
  • Use utilization management strategies tied to high-cost medications or site-of-care

HR Priorities

  • Address employee perception that rising contributions reduce net pay
  • Communicate plan adjustments early and provide decision support tools
  • Expand support for chronic and mental health conditions to minimize productivity loss

Joint Strategy

  • Develop a multi-year cost-containment roadmap tied to workforce strategy
  • Use claims and utilization data to target the biggest cost drivers
  • Coordinate vendor, PBM, and broker partnerships to ensure Finance and HR objectives align

Quick Wins for 2026 Planning

Employers don’t have to wait to act. Early steps include:

  • Pinpoint top cost drivers (prescription drugs vs. medical claims) and target specific interventions
  • Reassess PBM and carrier contracts for immediate savings opportunities
  • Communicate early with employees to prepare for changes and help them maximize available resources

Final Takeaway

Rising healthcare costs require Finance and HR to coordinate closely. Without aligned strategies, employers risk unexpected budget spikes and gaps in benefits, but proactive collaboration can protect budgets while keeping employees supported and engaged.

The real challenge ahead is maintaining organizational trust and productivity while navigating one of the steepest cost environments in recent years. The companies that succeed will be those that align Finance and HR strategy early, continuously monitor costs, and actively support employee well-being.

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