2027 Renewals: The Biggest Healthcare Cost Spike in Nearly 20 Years
Background:
Coming into 2026, consultants were preparing employers for a 6%–8.5% trend increase in medical and pharmacy costs. Looking ahead to 2027 renewals, many are bracing for a 9%–9.5% increase — a level not seen in nearly 20 years.
Key cost drivers: an aging workforce with increased healthcare needs, GLP-1 obesity drugs, costly gene therapies, rising behavioral health cost and utilization, and payer reimbursement disputes under the No Surprises Act.
Strategies to deploy ahead of your renewal:
- Provider Network: Evaluate your carrier’s provider network to identify coverage gaps that may be pushing employees to out-of-network providers and look for opportunities to expand the network or negotiate costs.
- Hospital Pricing: Identify hospital networks that offer negotiated pricing for your most frequent procedures (e.g., joint replacement surgeries).
- Clinical Data: Review your health and pharmacy data to uncover cost-reduction opportunities — for example, replacing physician-administered drug therapies with self-administered alternatives.
- GLP-1s: Prepare cost and risk management for GLP-1 drugs expansion beyond Type 2 diabetes and obesity into other treatment areas. Getting ahead of this growth now will soften the impact later.
- Behavioral Health: In some markets, behavioral health treatment is outpacing medical spend — make sure your carriers deliver the highest quality, lowest cost, and greatest access in-network for your employees.
How Optimatum Can Help:
Optimatum Solutions’ clinical management team specializes in optimizing HR and employer sponsored benefit operations with proactive analysis of healthcare spend, assessment of point solution ROI and targeted program management to ensure you are receiving the optimal solutions from your vendor partners.