As we move deeper into 2026, the healthcare landscape continues to evolve rapidly, shaped by new therapies, shifting market dynamics and ongoing economic pressures. For employers tasked with designing and managing healthcare programs, the year ahead feels like a balancing act between optimism for innovation and skepticism about the realities behind the headlines. Here are five key areas on that benefits leaders and HR executives should watch closely with a critical eye.
#1: GLP-1 Drugs: Trump’s Promise to Lower Costs vs. Inevitable Rising Expenses
GLP-1 receptor agonists like semaglutide and tirzepatide have taken center stage in treating type 2 diabetes and obesity, delivering impressive clinical results. However, their skyrocketing costs are a growing concern for employer-sponsored health plans. While President Trump has made headlines promising to lower drug prices – highlighting deals aimed at Medicare and Medicaid populations – the reality for most employers is less rosy.
These moves may nudge prices down for select groups, but broad commercial price relief remains elusive. List prices for these drugs often exceed $1,000 per month, and generics for the newest GLP-1s are years away. Employers face a tough choice: cover these drugs to attract and retain talent or impose strict utilization management to control budget impact.
What this means for employers: Even modest uptake rates can translate into significant per-employee costs. For example, a 10% uptake at $1,000 per month equates to $1,200 per employee annually. Employers should model various uptake and price scenarios, require evidence-based clinical criteria, and integrate supportive services like nutrition coaching to maximize health outcomes while managing costs
#2: Mental Health Care Options for Employees: Progress Amid Market Fluctuations
The mental health benefits market has seen notable fluctuations recently, with rapid growth in teletherapy, digital cognitive behavioral therapy (CBT) and modernized Employee Assistance Programs (EAPs). Employers are rightly investing more in mental health, recognizing its impact on productivity and retention.
Yet, despite expanded offerings, challenges persist. Access to licensed clinicians remains uneven, wait times can be long and digital tools often struggle with engagement and clinical depth for more severe conditions. Utilization rates frequently fall short of expectations, suggesting that simply offering benefits is not enough.
What this means for employers: To truly support employee mental health, programs must go beyond availability. Employers should focus on integrated care pathways that include quick triage, digital-first options and expedited referrals for higher-intensity care. Training managers to recognize and address mental health issues and actively communicate benefits are critical to improving utilization and outcomes.
#3: Are Employers Getting Everything They Were Promised by Analytics?
Healthcare analytics vendors have made big promises: cost savings, utilization management, predictive insights and improved employee well-being. While some employers have seen benefits, many struggle to translate data into meaningful action.
Common pitfalls include poor data quality, fragmented sources, and lack of operational follow-through. Analytics dashboards can generate impressive reports, but without clear strategies and accountability for acting on insights, the value remains theoretical.
What this means for employers: I see two clear paths of action that should be taken simultaneously:
- Demand more than just data. Insist on vendor transparency with audited ROI examples and clear operational pathways from insight to intervention.
- Work with your consultant team to build a plan of action in response to data. Organizations that successfully utilize analytics do so by pairing data that you can act on coupled with useful strategies for utilizing it.
#4: Inflation vs. Healthcare: Rising Costs Demand Smarter Strategies
Healthcare costs continue to rise alongside general inflation, but the drivers are distinct. Medical price inflation is fueled by labor shortages, hospital service price hikes and expensive new therapies like GLP-1s. Wage pressures for clinical staff and provider consolidation add structural upward pressure.
Employers face the challenge of supporting their populations with quality care while managing these rising costs. Simply passing expenses onto employees will increase the risk of reduced access and higher downstream costs.
What this means for employers: Budget for healthcare cost increases well above headline inflation – expect 6-8% or more. Invest in value-based care arrangements and targeted programs addressing chronic conditions and musculoskeletal issues. Avoid short-sighted cost shifting that undermines access and long-term health outcomes.
#5: HSAs as a Viable Savings Vehicle: Healthy Skepticism Needed
Health Savings Accounts (HSAs) have been touted as a triple-tax-advantaged way for employees to save for healthcare and retirement. While participation and contribution limits have grown, HSAs have largely failed to deliver on their promise as a universal savings vehicle.
Many account holders use HSAs primarily for near-term medical expenses rather than long-term investment growth. Inflation erodes the real value of balances, and lower-income employees often find it difficult to contribute meaningfully.
What this means for employers: HSAs remain a valuable tax tool but are not a panacea. To maximize impact, employers should consider seed contributions, promote investment options and provide targeted education. Recognize that HSAs work best for financially stable employees and should be part of a broader benefits strategy.
Final Thoughts
2026 will be a year of navigating between hopeful innovation and economic realities. GLP-1 drugs and mental health benefits offer promise but come with cost and utilization challenges. Analytics can be powerful but require disciplined execution. Inflation pressures demand smarter budgeting and program design. And HSAs, while useful, need realistic expectations.
Employers who approach these issues with a skeptical but proactive mindset – modeling scenarios, demanding accountability and focusing on outcomes – will be best positioned to support their workforce and control costs in the year ahead.
Our employee benefits team can help you build tailored cost impact models or executive briefings on any of these topics to support your 2026 planning. Reach out to me and my team to take action now!
Brandon Thompson
Brandon Thompson is an Employee Benefits Advisor for Horton’s Employee Benefit Solutions. He is responsible for providing expert employee benefits consulting, bringing new clients on board, and servicing and retaining existing clients. He is an integral member of a specialized team dedicated to delivering cutting-edge healthcare solutions to employers.
Material posted on this website is for informational purposes only and does not constitute a legal opinion or medical advice. Contact your legal representative or medical professional for information specific to your legal or medical needs.
