What Will Shape the Healthcare Market in 2026

A Clear Look at the Forces Redefining Employer Risk

Volatility is rising across the healthcare landscape, and early healthcare cost trends for 2026 point to another high-spend year. As employers plan ahead, understanding the forces driving these increases is essential to shaping a more predictable benefits strategy.

GLP-1s Continue to Reshape Pharmacy Spend

GLP-1 medications are driving a disproportionate share of pharmacy trends, and that pressure will continue into 2026. Employers remain concerned about cost, long-term adherence, and the increasing number of obesity-focused formulations coming to market.

PwC notes that GLP-1s remain one of the most significant contributors to recent spikes in pharmacy spending, with costs rising faster than most employers can budget for.1

All indicators point to a high-cost environment in 2026. Multiple sources paint a consistent picture:

  • Mercer projects a 6.5% increase in employer health benefit costs. The highest in 15 years, potentially rising to 9% for employers without strong cost-management strategies.2
  • PwC forecasts medical cost trends set to grow at 8.5% across the group market, driven by pharmacy inflation, increased utilization, and provider pricing.1

Together, these indicators point to a year where employers must take a forward-looking approach to risk, not just renew and react.

How RMTS Helps Navigate a High-Risk 2026

In an evolving marketplace, RMTS delivers stability and insight, supporting brokers and TPAs nationwide with:

  • Custom stop-loss solutions designed to fit the exact needs of each employer population.
  • Data-driven underwriting and modeling that helps employers anticipate cost pressures before they hit
  • A holistic approach that considers GLP-1 exposure, utilization patterns, and emerging technology on risk.
  • Proactive guidance for brokers and TPAs adapting benefit structures to shifting cost trends.

As 2026 approaches, RMTS remains committed to helping organizations build more resilient, predictable, and financially secure health plans.

1. https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html
2. https://www.fiercehealthcare.com/payers/mercer-survey-employers-anticipate-highest-health-benefit-cost-increase-15-years-2026