Single-digit cost increases are a thing of the past. Costs are teetering on double-digit hikes—the highest in 15 years—prompting swift, immediate change. Incremental tweaks aren’t enough. Intense financial pressure is forcing employers, payers, and partners to question traditional condition management models and welcome innovative solutions that can clearly reduce costs, ideally in the first year, while improving outcomes.
Here are four key trends reshaping how our industry is pioneering better health outcomes and reducing costs in 2026 and beyond.
GLP-1s and other specialty drugs continue to escalate costs as their use broadens, becoming more mainstream, and demand remains high—even after the FDA removed them from its drug shortage list. Many people taking GLP-1s also manage multiple prescriptions, supplements, or herbal remedies from different providers, often without coordination or a long-term plan.
This fragmented care increases the risk of complications, as no single provider has a full view of each patient’s health. To address these risks, and effectively manage obesity and related conditions, individuals need strong support to help with medication management and sustainable lifestyle changes. Care resulting in comprehensive impact will relieve cost pressures.
Specialty drug costs, especially for GLP-1s and other high-cost biologics, are surging and remain a huge driver of system utilization and rising health care costs.
Employers and plans once relied on point solutions for individual conditions to offset cost increases, but with more than half of Americans now living with two or more chronic conditions, this approach is no longer viable. Beyond the conditions themselves, the complex interplay of symptoms, treatments, and care needs creates a fragmented experience, leaving employees and members juggling multiple programs and providers, leading to gaps, duplication, and wasted resources.
This new reality is pushing employers and health plans toward consolidating their vendors, seeking cross-condition, integrated partners. The focus now is on solutions that fit with existing vendors without duplication and meet the rising needs of increasingly complex populations—easing the burden of multiple chronic conditions and delivering more connected, measurable outcomes.
The old strategy of single-point solutions has led to a fragmented experience for employees juggling multiple chronic conditions, wasting resources and widening care gaps.
Physician shortages, health care deserts, and provider burnout are highlighting the importance of personalization and trust in the provider-patient relationship. In today’s fee-for-service model, quick, transactional visits result in drug therapy over 70% of the time, leaving little room to address lifestyle changes like getting quality sleep, exercise, and eating well—commonly the first line of treatment for many conditions.
Providers are exploring models that prioritize human-to-human engagement and condition management support between visits. This approach is vital for individuals managing multiple conditions seeing multiple providers with uncoordinated care and those in underserved areas, where ongoing relationship-driven programming can bridge key care gaps, foster trust, and support specific needs.
Quick, transactional visits leave little time for meaningful support or first-line interventions, highlighting the need for relationship-driven, human-to-human care.
High-cost claims are spiking—claims over a $1 million have risen 50% in just four years. However, proactive lifestyle measures can prevent most diseases before becoming catastrophic.
To reduce costs with speed and promote better long-term health, organizations should identify and support rising-risk individuals before their conditions escalate into expensive episodes. This means combining data-driven insights with whole-person engagement to drive year-one savings within the population of people with multiple chronic conditions and long-term savings by building healthier populations over time.
High-cost claims over $1 million have spiked 50% in four years, emphasizing the need for more proactive interventions to prevent chronic diseases from escalating.
The trends shaping 2026 create a clear call to action: As health care costs reach double-digit increases, creative and collaborative solutions are a must. A critical first step is partnering with vendors who can demonstrate swift, measurable cost savings to achieve fast, yet sustainable, results.
Recent shifts in public-sector program policies will likely drive more people to emergency departments when health concerns arise, putting added pressure on hospitals and providers. Ultimately, these rising costs get shifted to employers, employees, and commercial plans through higher premiums and greater out-of-pocket expenses. The time for action and rapid cost-saving measures is now.
Organizations that invest in integrated, whole-person support and prioritize relationship-based care—delivered by partners who prove real, near-term savings—will be best equipped to manage these rising costs while improving member and employee health. Condition management programs that blend innovation, evidence-based strategies, and the power of human connection will spark measurable, lasting change and help tame today’s steep health costs.
Kurt Cegielski | Chief Commercial Officer | MOBE
He has more than 20 years of experience in health care technology. A co-founder of RedBrick Health (now Virgin Pulse), he has held senior leadership roles focused on transforming health care and empowering individuals. Kurt is committed to MOBE’s mission of providing innovative solutions that engage members, improve health outcomes, and reduce costs for health plans and employers.
