Employer-sponsored healthcare is at an inflection point.
Higher utilization is driving substantial year-over-year increases in healthcare costs for plan payers to a projected tune of 6.7% per employee in 2026. The increasing prevalence of chronic disease, specialty drug options, and high-cost claims have created structural financial pressure for employers — pressure that is no longer sustainable through incremental renewal negotiations or traditional cost-shifting to employees.
As a result, healthcare benefits have become one of the top expenses for employers and a key driver of margin performance.
At the same time, benefit plan performance offers unique visibility into the financial ability and fiduciary scrutiny of an organization — and acts as a powerful factor for strategic workforce stability.
Despite today’s challenges, organizations have an opportunity to thrive in this high-cost environment by redefining how their health plans are designed and governed: by blending HR-led administration with CFO-aligned engagement and oversight, an area where Vālenz Health® is leading the way with transformative, integrated solutions that make it all possible.
Employers who are leading the way in healthcare cost containment are doing so by realigning their approach: moving from a reactive cost-management style to a more proactive cost-structure design.
Instead of increasing deductibles, raising employee contributions, and negotiating marginal renewal concessions, today’s employers are implementing tactics that rebuild their benefits plan strategy from the ground up.
Addressing rising healthcare prices starts with understanding the drivers behind those increases. Today’s employers demand enhanced visibility into actual unit costs (total costs of care by procedures), provider performance, and pharmacy pricing for a comprehensive picture of their plan’s finances.
According to Mercer’s 2026 Survey on Health and Benefits Strategy, 74% of employers plan to analyze participant costs and compare to benchmarks in the year to come, while 43% plan to work with their pharmacy benefit manager (PBM) to gain previously undisclosed prescription benefit financial data.
With this data in hand, employers not only give themselves more visibility into their healthcare costs but also the power to make smarter strategic adjustments to plan designs.
A study by United Healthcare reveals that nearly 90% of employers plan to invest in some type of value-based strategy in 2026 to support smarter, more cost-efficient healthcare choices by members.
Research shows that these value-based care models significantly increase member engagement with primary and preventive care, leading to fewer emergency department visits and inpatient hospitalizations.
By steering members toward providers proven to deliver consistent care outcomes, employers who invest in value-based care strategies help to minimize plan costs without compromising member access to high-quality care options.
In response to the increasing prevalence of high-cost claims driven by catastrophic diagnoses and chronic disease, employers are implementing new strategies to manage that risk before it becomes a snowballing financial burden.
Member engagement programs help to identify and manage chronic disease and specialty diagnosis exposure before claims escalate. Through a combination of preventive care and targeted care management services, today’s employers recognize and support high-risk members early on to minimize any resulting high-cost claims — a top priority for 89% of employers in 2026 according to Mercer’s research.
In the biggest shift from reactive to proactive plan design, employers are now evaluating multi-year cost trajectories during the renewal season, rather than taking a limited, one-year view at their anticipated healthcare costs.
This perspective shift requires substantial financial discipline, data intelligence, and structural redesign. Incremental adjustments are no longer enough to keep up with the rapidly rising costs of healthcare; forward-thinking employers who embrace a long-term plan strategy will be the ones best prepared to weather the uncertainties of the years ahead.
The benefits strategies of yesterday are no longer sufficient for the risks and demands of the modern healthcare ecosystem.
As a result, those employers who maintain their traditional health plan design models without structural reevaluation and redesign find themselves facing:
Current predictions of 7–9% inflation in healthcare costs are set to double the overall costs for employers in less than a decade. Without structural change to the industry, this trajectory becomes a permanent margin constraint for employers — significantly impacting the quality of benefits they can provide employees without facing financial disaster.
The future of employer healthcare belongs to those organizations that treat benefits strategy as enterprise risk management — in other words, as a challenge to be solved through strategic partnership between human resources and financial teams.
This approach requires all of the strategies discussed above, from transparent data access and engagement to value-based plan architecture to the addition of long-term financial discipline into short-term decisions.
Valenz stands at the forefront of supporting and leading this transformation.
With our eyes to the future, we are not simply supporting the administration of traditional health plans. We are redefining how employers control healthcare cost trajectory, while simultaneously protecting workforce health and organizational performance.
It’s how we work toward our mission every single day: creating smarter, better, faster healthcare for all.
While much of the market continues to operate using traditional health plan strategies, Valenz looks to the future with an integrated, transformative approach to benefits plan design — one that meets cost-containment demands while protecting employee access to high-value care options.
The success of the Valenz approach lies in the unparalleled level of data transparency provided to our clients at every stage in the care journey.
Our analytics break down data silos to illuminate cost drivers, high-risk populations, and care quality variation across the Claim Cost Arc℠, empowering CFO-level decision making aligned with HR-level engagement.
By incorporating that data across the entirety of our integrated platform, we provide a centralized view of transparency, including actionable insights to inform connected strategies supporting a continuous cycle of optimization.
Through transparent pricing and quality-driven provider networks, we align incentives around high-value care, not volume — improving cost containment while protecting member access to value-based care options.
With clear, actionable cost and quality data informed by industry-leading sources, the Valenz Bluebook navigation tool guides members to the highest-quality provider for their unique needs. The Valenz Variable Copay solution makes those choices even clearer by highlighting the lower copays associated with high-value, low-cost providers.
In rewarding high-value decision making, our value-based care solutions deliver significant savings for employers (7–12% for Variable Copay alone) while creating a culture of smarter, more informed healthcare shopping for members.
For sustainable, long-term risk management, we integrate early intervention, specialty care management, and cost-containment strategies designed not just to reduce frequency but also severity of occurrences.
With Valenz Clinical Engagement, we deliver a comprehensive suite of care management services for plan members, empowering them to make smarter decisions, reduce unnecessary utilization and expenses, and improve healthcare outcomes through personalized identification and outreach.
Valenz Precision Care goes even further, guiding members through the complexities of specialized and advanced surgical procedures to minimize potential out-of-pocket and plan expenses.
At the same time, our payment integrity solutions act as guardrails to reduce the financial risk of any anticipated high-cost claims. For example, through strategic pre-negotiation (part of the Valenz Clinical Bill Review solution), our team engages early and often to eliminate potential overpayments ahead of time, delivering results including more than $900,000 in savings for one complex member surgery.
One of the Valenz Core Values is collaboration, and we embody it every day through close, resourceful relationships with our clients.
At no point is that more important than during the benefits plan design process.
By partnering directly with both HR and finance teams for our clients, we help transform the financial preparedness and overall outlook for a plan. We bring our unmatched data transparency and early intervention strategies to the table to support:
As a result, we create sustainable affordability for both employer and employee, protecting each against the future cost increases of the modern healthcare system.
Healthcare strategy benefits strategy is no longer simply an HR expense line. It is a financial and governance priority for all executives of an organization and requires a collaborative effort from those teams to create a sustainable, value-based strategy moving forward.
Short-sighted, annual renewals are no longer the answer. To meet the challenges of today’s healthcare industry, we must reimagine the very design of health cost structures from the ground up.
Those who embrace this shift — and partner with innovators built for transparency, value alignment, and financial rigor — will lead the next decade of employer-sponsored healthcare.
Valenz is proud to be that partner.
As the platform to simplify healthcare, we’re innovating with transformative solutions that tackle the very root of today’s challenge to optimize the cost, quality, and utilization of healthcare for everyone.
Learn how we can help design a smarter, better, faster benefits plan for your needs by contacting us today.