Top 5 Healthcare Trends Employers Should Watch in 2026
By Curt Kubiak, President & CEO, The Alliance
Healthcare is evolving at an increasingly rapid rate. For employers, this change comes with both opportunities and challenges. Rising costs, shifting employee expectations, and a changing regulatory landscape makes healthcare a top concern for businesses of all sizes and in all industries. At The Alliance, we see these influences shape responses every day across our cooperative of self-funded employers.
However, this upcoming year, the most successful employers won’t simply react to change; they’ll use it as an opportunity to rethink how they purchase healthcare, engage their employees, and use data to make decisions. Below is our view of the top five healthcare trends to watch in 2026, what they mean for employers, and how we can navigate them together.
1. Sustained Medical Cost Inflation
Healthcare costs continue to increase with the global medical cost trend projected to rise 10.3% in 2026. In the U.S., projections for employer medical spending predict an 8.5 % increase for the group market and 7.5% for the individual market. This pressure is driven by advanced specialty treatments, ongoing workforce shortages, higher utilization, especially for behavioral and musculoskeletal care, and inflation throughout the care delivery system.
The pressure for employers to manage costs while maintaining access for employees will be significant in 2026. Our proactive approach at The Alliance is to identify employer health spend cost drivers, and create opportunities through benefit plan design, employee education, and employee engagement to lower them.
Employers Can:
- Encourage employees to take earlier action on high-cost conditions to avoid preventable complications later.
- Prioritize provider network design and steering to high-value healthcare options.
- Prepare for shifts to increased outpatient care, management of chronic conditions, and growing demand for behavioral health.
- Strengthen formulary and drug-spend oversight through transparent, value-aligned PBM partnerships.
The Alliance helps employers design custom networks that prioritize value and total cost management. Rising costs don’t have to result in increased overall spending; we can bend the medical cost trend when we identify these issues earlier and act together to create a plan to curb medical spend.
2. Digital Health and Telemedicine Expansion
We believe that digital health solutions, including telemedicine, remote monitoring, and virtual care, are not a passing trend, but rather a strategic tool for expanding access to care.
Telehealth strategies from recent years are evolving into virtual hospital models and more robust remote/home-based care networks. Today’s digital ecosystem includes virtual primary care, asynchronous care models, AI-enabled triage, and hybrid clinics that integrate digital and in-person care.
As demand for care continues to outpace provider supply, virtual care fills critical gaps. Employers are increasingly using digital tools to:
- Expand access for employees in rural or underserved areas
- Reduce wait times and unnecessary ER or urgent care visits
- Streamline chronic condition management
- Offer more convenient, lower-cost alternatives to in-person care
The Alliance encourages employers to treat digital health as an integrated strategy, not an add-on to existing benefits. When virtual and hybrid care is built directly into plan design, with clear incentives, it can improve outcomes, increase access, and lower costs.
3. AI and Data-Driven Healthcare
In 2026, employers should expect more use of AI agents to perform tasks like triage, scheduling, analyzing results, and patient follow-up. AI will increasingly assist in research (like drug discovery), operations (including workflow automation), and patient-facing care (like monitoring and alerting). AI is not replacing human care, but it will streamline operations and enhance patient experience.
AI also allows employers to act sooner by reshaping how quickly they can spot risk. Predictive analytics and claims data analysis will allow employers to identify trends, anticipate high-cost claims, and intervene before small issues become expensive.
This is where The Alliance’s experience with data and transparency gives our self-funded employer-members a unique advantage. We know that employers need accurate data to make better decisions, and in 2026, this will become even more essential.
Employers can leverage data and analytics to:
- Identify the highest-impact opportunities for cost savings
- Understand provider performance
- Predict trends and prevent high-cost events
- Make more informed decisions on network design and benefit strategy
Our Smarter HealthSM analysis does not just present employers with medical spend insights; we help employers act on them. With the right data, employers can take control of spend and build benefit plans that work better for employees and their families.
4. Increased Focus on Benefit Optimization and High-Value Healthcare
One of the key focus areas for employers in 2026 is benefit optimization, moving beyond cost-shifting to more strategic cost management and design. Employer plans will increasingly look at network design, alternative sites of care, and digital tools as levers to manage costs.
High-value healthcare is at the center of this shift. Employers can focus on steering shoppable services to Preferred-Value Providers and lower-cost sites of care and expanding access through digital tools and virtual/hybrid care.
By partnering with providers who consistently demonstrate favorable outcomes, employers can:
- Reduce unnecessary or non-value-added services
- Improve employee outcomes and satisfaction
- Lower total healthcare spend
The Alliance helps employers build benefit plans designed around value. When employers prioritize high-value care, employees get better outcomes, and organizations save significantly. The goal is to spend smarter when it comes to healthcare. And The Alliance is here to help employers take the guesswork out of that process. Further, we work with providers to improve access, obtain faster diagnosis, and assist our employer-members to keep employees on the job.
5. Mental Health and Wellness Programs Gain Traction
Employee wellness and mental health have become central to workplace benefits. Burnout, stress, and mental health challenges not only affect employee well-being but also impact productivity, absenteeism, and overall healthcare costs.
In 2026, we expect employers to invest more in holistic approaches that combine:
- Traditional mental healthcare
- Tele-mental health services
- Employee assistance programs (EAPs)
- Wellness coaching
- Fitness and lifestyle initiatives
For employers facing provider shortages, digital mental health solutions offer a scalable, accessible option. Digital data can also help flag rising mental health needs earlier, allowing employers to intervene before employees reach crisis points.
We’ve seen improvements first-hand when employers support both physical and mental health, as employees are healthier, workplaces are more productive, and costs are lower.
The Self-Funding Advantage
These trends highlight the importance of flexibility and control enabled by analyzing healthcare utilization and spend data to shape benefit design. With self-funding, employers gain:
- Flexibility to design high-value provider networks
- Control of pharmacy spend
- Visibility through rich claims data
- Agility to respond quickly to new trends
- Customization of digital health and wellness strategies
- Alignment with providers who deliver real value
Self-funding gives employers the control to design better benefits, improve employee health, and manage costs effectively, with the flexibility to adapt to emerging trends.
Looking Ahead
Healthcare will continue to evolve rapidly, and employers who stay informed and work to create benefit plans that remain ahead of these trends will be better positioned to support their employees and their bottom lines.
The most encouraging point here is that you don’t have to navigate it alone. At The Alliance, we’re in your corner. We advocate for employers, partner with providers, deliver transparency and data, and help design benefits that work. By working together, we can bend the medical cost trend and make healthcare work better for everyone.
Reach out to us to learn how to optimize your benefit plan and stay ahead of the curve in 2026.
This post is locked to comments.
