Employers prepare for disruptive and transformative health plan changes, WTW survey finds

Core Insights - Companies are planning to evaluate disruptive changes to their healthcare plans as U.S. healthcare costs rise to the highest level in over two decades, with projected increases of 9.1% in 2026 compared to 8.1% in 2025 and 7.0% in 2024 [1] Cost Drivers and Employer Actions - One in three employers are considering significant changes to their healthcare programs within the next three years, with top cost drivers identified as pharmacy costs, high-cost claimants, and chronic conditions [2] - Employers' top priorities over the next three years include managing medical costs, pharmacy costs, and ensuring affordability for employees, followed by employee wellbeing and healthcare delivery [3] Cost Management Strategies - Nearly 59% of employers plan to implement broader cost-saving actions in the next three years, up from 46% in the past three years, focusing on program subsidies, alternative plan designs, and improving operational efficiency [4] - Employers are reducing unnecessary medical expenses through vendor contract management, audits, and preventing overutilization, with 46% evaluating vendor performance and 36% taking medical plans out to bid [6] Alternative Plan Designs and Innovations - Alternative plan designs are currently used by 41% of companies, with nearly half planning to implement attributes such as cost transparency and enhanced navigation in the next two years [7] - Employers are frustrated with their pharmacy benefits managers (PBMs), with 75% planning to take their PBM out to bid and 58% having recently audited their pharmacy benefits [8] GLP-1 Medications and AI in Healthcare - While 57% of employers cover GLP-1 medications for obesity, 15% are considering removing coverage, with various management tactics being evaluated [9] - Only 21% of employers currently use AI in their healthcare programs, but 80% believe it will fundamentally change healthcare benefits management in the next three years [10] Long-term Strategies - Employers are encouraged to adopt a revolutionary approach to address immediate cost pressures and long-term trends, focusing on innovations in clinical programs and effective uses of AI to manage chronic diseases [11] Survey Details - The survey involved 417 employers and was conducted in June and July 2025, representing a workforce of five million employees [12]