Workplace Trends: WorkCare Delivers Solutions to Offset Rising Medical Costs

This WorkCare blog post is part of a periodic series on national trends that influence the way employers manage workplace occupational health, safety, and employee well-being programs. 

Medical costs are projected to increase in 2026, creating a domino effect for employers and employees who are enrolled in health insurance benefit plans or paying out-of-pocket for care. Cost drivers include cancer and emergency care, GLP-1 drug treatments for obesity, and high demand for mental health services. 

Who is Covered? 

The U.S. Bureau of Labor Statistics (BLS) and KFF (Kaiser Family Foundation) estimate that access to employer-supported health benefit plans ranges from 72% to 86%, with 54% to 60% of non-elderly workers enrolled in them. The BLS reports that medical care benefits were available to 72% of private industry workers and 89% of state and government workers in 2024: 

• The employer share of premiums was typically 80% and the employee share 20% for private industry workers in medical plans with single coverage; state and government workers paid 14% of premiums. 
• For family coverage, employers typically paid 68% of premiums for private industry workers and 71% for state and local government workers.  

In a related development, the Congressional Budget Office estimates that 15 million Americans, including many who are employed, will lose personal health insurance coverage between 2025 and 2034 under provisions of the 2025 federal budget reconciliation law (the One Big Beautiful Bill Act) that change Medicaid eligibility requirements and eliminate Affordable Care Act enhanced tax credits.  

Among potential consequences, studies show that Americans who lack healthcare coverage or pay higher than average insurance premiums are less likely to obtain urgent and preventive primary care, dental and vision check-ups, or to seek medical treatment for chronic conditions. Delayed care increases acuity, the need for life-saving care, and medical costs. In the workplace, it is associated with higher risk for injuries and illnesses, absence and productivity loss, and workers’ compensation and disability claims.   

Rising Cost Projections Vary 

The Business Group on Health’s (BGH) 2026 Employer Health Care Strategy Survey of large employers forecasts a median healthcare cost increase of 9% next year, or 7.6% with strategic benefit plan design changes, and an increase of 11-12% in pharmacy costs alone. Overall costs in 2026 are expected to be 62% higher than they were in 2017. 

Based on a survey of health plan actuaries, the global business consulting firm PwC has projected the U.S. medical cost trend will be 8.5% for the group market and 7.5% for the individual market in 2026, the same as 2025, with the pharmacy cost trend 2.5 points higher than it is for medical treatment. PwC defines medical cost trend as “the projected percentage increase in the cost to treat patients from one year to the next, assuming benefits remain the same.” Insurance companies use these projections to calculate health plan premiums for the coming year.  

In a summary of national health expenditure projections for 2024-2033, the Centers for Medicare and Medicaid Services reports that national health expenditure growth (5.8%) will outpace average gross domestic product (GDP) growth (4.3%), increasing the health spending share of GDP from 17.6% in 2023 to 20.3 percent by 2033. From 2026-2027, total health spending growth is expected to average 5.6%.  

What Can Employers Do to Better Manage Medical Costs? 

“Fixing healthcare” is a persistent challenge. In the U.S., healthcare delivery systems, related regulations, socio-political conditions, provider reimbursement models and benefits plans – to name just some of the confounding factors – are extremely complex. Meanwhile, the population is aging, public health policies are in flux, and more people are seeking mental health interventions to help relieve stress, anxiety, and depression. 

At the federal level, the U.S. Department of Health and Human Services and Centers for Medicare & Medicaid Services recently announced plans to establish an expert Healthcare Advisory Committee to develop recommendations to improve how care is financed and delivered across Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and in the health insurance marketplace, in general. Federal officials say the intention is to support patient-centered care, promote chronic disease prevention and management, simplify processes to reduce “red tape,” and digitize information systems. The proposed committee is just one example of efforts by political leaders, economists, healthcare and insurance professionals, and other experts to rein in rising costs. 

While keeping an eye on national developments, many employers opt to focus on what they can do at the local level to support workforce health and community well-being and facilitate access to affordable care.  

What We Do at WorkCare 

At WorkCare, we collaborate with employers to meet employees’ individual and collective occupational health needs. This includes providing required work-related medical exams and screenings, immediate injury care, and interventions to help prevent work-related injuries and illnesses. We also offer guidance on ways to reduce occupational exposure risks, manage fatigue and conditions such as diabetes and asthma that can impact productivity, and enhance overall physical and mental health companywide.  

WorkCare also leverages its expertise to help fill gaps in physician availability and streamline operations. Our company has invested in AI-driven platforms and technology to reduce administrative burdens and allow employers to redirect resources to support essential functions. (Refer to U.S. Physician Shortage Impacts Employee Health: WorkCare Helps Fill the Void.)  

Recommendations for Business Leaders

The Business Group on Health advises leaders at the large companies it represents to act with greater urgency as they head into 2026. “In this challenging environment, employers remain firmly committed to an ongoing investment in employee health and well-being,” said Ellen Kelsay, president and CEO. “Yet, they will need to make bold and strategic moves to contain costs, sometimes disrupting healthcare models along the way.”  

BGH recommends that employers:

• Rigorously evaluate benefit offerings, vendor performance, and patient outcomes 
• Explore non-traditional health plan and pharmacy benefit manager (PBM) models 
• Focus on utilization management and obesity interventions for optimal outcomes 
• Assess employee access to mental health services and appropriateness of care 
• Teach workers about health plan resources and navigation tools to simplify engagement 

PwC researchers encourage business leaders to “read the 2026 medical cost trend as a signal of the future, pointing to deeper, structural changes in how healthcare is used and what it costs.” According to PwC, longer term, bold reinvention will require reallocation of healthcare spending to create a patient-centric ecosystem anchored by care that’s preventive, personalized, and predictive, with flexible sites of care built around the patient.  

WorkCare has a proven history of making it possible for workplaces to function as trusted sources of medical care, prevention, and wellness education. Our experienced occupational health clinicians, including physicians, nurses, and athletic trainers, deliver on-site services, telehealth guidance, and referrals to qualified local providers throughout the U.S.  

Are you ready to look for new ways to help reduce medical care, pharmacy, and benefit plan costs at your company? Contact us to learn more.