America’s health care landscape is undergoing profound transformation. Cost pressures are mounting as pharmaceutical innovation accelerates, chronic conditions rise, and economic forces reshape how care is delivered and financed.

For employers, the challenge is no longer just managing year‑over‑year increases – it’s navigating a system that has become more complex, while meeting rising workforce expectations for flexibility, personalization, and a more seamless health care experience.

To stay ahead, employers are increasingly focused on strategies that bring greater clarity and control: Advanced analytics, integrated pharmacy–medical models, flexible and personalized benefits, and AI‑powered tools that simplify the health care experience. At the same time, breakthrough therapies and emerging fields like longevity medicine are redefining what effective care looks like, creating new considerations for how employers design benefits and plan for future costs.

"This year demands that we keep pushing to improve the customer experience and make health care more affordable and transparent."Bryan Holgerson, president, Cigna Healthcare U.S.

"Employers need clearer cost predictability, more flexible and personalized benefits and pharmacy strategies, and a better overall experience,” Holgerson said. “With clinical breakthroughs and the power of AI reshaping care, we have new opportunities to innovate – improving outcomes, reducing waste, and strengthening workforce health.”

Against this backdrop, five trends will define the employer-sponsored health care landscape in 2026 – trends that reflect not only what is changing, but why bold, integrated strategies are now essential.

With these forces reshaping the employer-sponsored health care landscape, let’s explore the top trends that will define 2026.

Trend 1: Measuring success amid escalating care costs

Inflation, rapid pharmaceutical innovation, an aging population, and the growing prevalence of chronic diseases are reshaping how employers plan, budget, and evaluate health care benefits. According to the Centers for Medicare & Medicaid Services, health care expenditures grew 8.2% in 2024 and are projected to rise another 7.1% in 2025. While these numbers are important, they shouldn’t be the only barometer employers use to measure success.

Instead of viewing cost growth as a single figure, leading employers are focusing on the reasons behind the increases to design more stable, employee‑friendly strategies in the year ahead.

"Employers now have the opportunity to reshape how we manage health care by using advanced analytics, novel technologies, and integrated clinical programs to take control of unpredictability."Shankar Madhavan, vice president of clinical strategy and enablement, Cigna Healthcare

“By pairing data‑driven insights with a more consumer‑centric approach, we can build benefits that are more stable, more transparent, and more aligned with what employees truly need,” Madhavan said. 

Why predictability and consumer-centricity matter

Predictability allows employers to:

• Plan with greater accuracy.
• Stabilize budgets.
• Reduce surprises in renewal cycles.
• Provide a more consistent experience for employees.

Predictability doesn’t necessarily mean lower costs – it means fewer unexpected swings and clearer visibility into what drives health care spending.

A consumer‑centric (or employee‑centric) experience is becoming a defining advantage as well. When employees can use their benefits confidently and access the right care at the right time, outcomes improve and unnecessary costs decline.

Trend 2: Pharmacy cost pressures will demand integrated, consumer-centered strategies for 2026

Today, 32% of total pharmacy and medical spend is related to pharmacy, prompting employers to look for strategies for containing overall trend.¹ In the pharmacy space, the number of new drugs entering the market continues to expand at unprecedented speed. These breakthrough therapies are transforming patients’ lives, but they’re also reshaping the economics of employer‑sponsored health care.

Consumer-focused solutions that provide cost information up front

Rising drug costs are a top consideration in treatment decisions, making cost transparency at the point of prescribing more important than ever. When a provider can see a patient’s specific out-of-pocket cost for medications directly in the prescriber’s electronic health record, it enables an informed discussion with the patient about affordability and clinically appropriate therapeutic alternatives before the prescription is written. At the same time, lower‑ and no‑cost options – both generics and select specialty medications – are becoming available to improve access. Benefit designs that incentivize the use of more affordable therapies via lower patient cost share help both employers and employees save.

Fertility and women’s health: A growing priority

Demand for fertility benefits and women’s health support is rising, driven by shifting workforce demographics and greater awareness of women’s health needs. Seventy percent of millennials experiencing fertility challenges would change jobs for fertility coverage. Because fertility care spans both pharmacy (medications) and medical (procedures, monitoring) benefits, integrated programs are essential to ensure affordability, access, and coordinated care.

Women’s health needs are expanding across their life span. Today, 20% of U.S. working women are in some stage of menopause. Expanded coverage for menopause‑related care – such as hormone therapy and cardiovascular and bone‑health evaluations – is critical to supporting this growing segment of the workforce.

Site-of-care optimization is essential to reducing waste

As specialty drug use and costs grow, the site of infusion administration has become a major cost driver. Infusion costs can double or triple in higher‑cost sites, making site‑of‑care selection one of the strongest levers for reducing spend. Shifting infusions from hospital outpatient departments to lower‑cost, clinically appropriate settings – and coordinating decisions across medical and pharmacy benefits – reduces waste and improves patient comfort. A recent study found that infusions outside of the hospital setting are associated with fewer reactions, reduced ER visits, fewer hospital admissions, and lower out-of-pocket costs.

High-cost claimants require multidisciplinary, integrated support

People with high medical costs often have several health issues and need treatments that cover medical, pharmacy, and behavioral care. A fully integrated, high-touch clinical support model helps optimize health outcomes and lower costs. This approach also helps reduce ER visits and hospital admissions and re-admissions, as well as lengths of stay.

As the number of high-cost claimants increases with growing disease prevalence in the U.S., employers must invest in plans with the capability to provide personalized clinical support that combines medication management, care coordination, behavioral health resources, and proactive care transition programs. These integrated strategies help reduce total medical costs. According to Cigna Healthcare’s 2025 Value of Integration study, fully integrated pharmacy and medical benefits can save employers $241 per member per year and up to $28,000 per oncology patient per year.²

Trend 3: Benefits will continue to be a key strategic lever for talent attraction and retention

As the labor market enters another year of uncertainty, one truth is becoming increasingly clear: benefits are no longer a support function. They are a strategic lever for attracting and retaining top talent. In 2026, organizations will face a convergence of workforce expectations, demographic shifts, and economic pressures that make benefit innovation not just beneficial but essential.

For employers, the stakes are high. U.S. companies are projected to lose between $1.3 trillion and $5.1 trillion in 2026 if turnover trends continue and an estimated 34% of the workforce changes jobs. At the same time, 93% of organizations report concern about retention, underscoring how crucial workforce stability has become to business performance.

Benefits, once viewed as a cost center, are now emerging as one of the most influential drivers of workforce engagement and loyalty.

The new talent landscape: Flexibility, personalization and purpose

Today’s workforce expects far more from benefits than a standard package and a once‑a‑year enrollment meeting. Employees want benefits that feel relevant to their lives: flexible, personalized, and designed around their evolving needs.

The data underscores this shift:

• 8 in 10 employers say benefits play a critical role in attracting and retaining talent.
• 68% of employees want greater flexibility in selecting benefit options.
• 23% are unsatisfied with their existing benefits, which leaves companies vulnerable to preventable attrition.

Generational differences are also shaping expectations in powerful ways. Gen Z and millennials, now the largest segments of the workforce, prioritize benefits that support mental health, personal purpose, and overall life satisfaction. These groups favor flexibility, hybrid work support, mental health care, and values‑aligned benefits over traditional perks. Meanwhile, older employees continue to prioritize strong medical coverage, retirement support, and financial stability.

This diversity of needs means a single, uniform benefits model no longer works. Employers who ignore these shifts risk falling behind in a competitive talent marketplace where employees have more options and higher expectations than ever before.

“The ability to attract and retain talent by offering benefits is a top priority for employers,” Madhavan said. “The landscape is evolving, and benefits play a central role in workforce strategy.”

Trend 4: A growing demand for improvements across the entire health care experience

For today’s workforce, health care is now a defining part of the employee experience, not just a benefit. As expectations shift and technologies mature, employers are entering a new era where personalization, digital simplicity, and timely support are at the center of workforce well‑being.

In 2026, that evolution accelerates dramatically. Employees increasingly expect experiences that are easy, intuitive, and tailored to their needs. As organizations strive to attract and retain top talent while driving productivity, they increasingly view the health care experience as a crucial opportunity to make a meaningful impact on employees' lives – one that goes beyond simply providing a benefit and truly meeting people where they are.

"Health care touches people in the most real and personal moments of their lives."Katya Andresen, chief digital and analytics officer, The Cigna Group

“Our job is to make those moments simpler, clearer, more connected, and more human," Andresen said. "Whether it’s something routine or something life-changing, people deserve an experience that meets them with empathy and the right support at the right time. That’s the future we’re committed to building.”

AI ushers in a new level of personalization

Artificial intelligence is enabling a breakthrough in health care experience: personalization at scale.

“AI gives us the ability to move past broad categories and deliver care that feels personal,” Andresen said. “By connecting clinical data and preferences in real time, we can anticipate needs and guide each person to the right support, through the right channel, at the right moment. That’s how we make decisions simpler, reduce fragmentation, and improve outcomes for individuals and the employers who support them.”

For employers, this level of personalization delivers fewer gaps in care, greater employee confidence, and a more efficient health care ecosystem overall.

Digital tools reduce friction and boost employee satisfaction with their health plan

Employees want digital tools that help them help themselves, and employers are increasingly embracing self‑service. These tools streamline processes, reduce administrative burden, and make routine care simpler.

These platforms make it easier for employees to find in‑network providers, understand costs, and use their benefits more effectively. This reduces confusion and the productivity loss that occurs when people struggle to get the care they need.

The demand is clear: 65% of workers want better personalization, and 40% are actively seeking jobs with better benefits, underscoring how strongly experience influences retention.

Trend 5: Clinical breakthroughs and AI will transform how care is delivered

Health care is entering a new era, defined not just by operational improvements, but by scientific and technological advances that are reshaping how care is delivered.

Emerging therapies, next‑generation metabolic treatments, longevity and health span medicine, and the rise of agentic AI in clinical decision‑making are accelerating faster than employers – and in many cases, health systems – have ever seen. These developments represent more than medical breakthroughs, but strategic inflection points that will have far-reaching implications for workforce health, affordability, and predictability.

The era of GLP‑1s and the rise of longevity and healthspan medicine

GLP‑1 medications have moved beyond diabetes management to influence obesity, metabolic health, cardiovascular risk, and even sleep apnea outcomes. Adoption is accelerating rapidly, with 1 in 8 adults in the U.S. taking GLP-1 drugs for weight loss, diabetes or another condition as of November 2025. Their impact is creating a new clinical category where medications treat root‑cause metabolic dysfunction rather than symptoms alone.

At the same time, longevity and healthspan medicine are emerging as essential counter measures to decades of a reactive “sick‑care” system. This rapidly evolving field focuses on extending not just how long people live, but the number of years a person lives in good health. Examples include metabolic optimization programs, early detection technologies, microbiome‑informed interventions, and precision prevention built around genetics and biomarkers. Research shows that each additional year of healthy life is estimated to add $38 trillion to the global economy.

For employers, these advances bring both opportunities and planning considerations:

• Increased pharmacy spend and GLP‑1 adoption curves that require forward‑looking benefit design.
• New demand for coverage clarity around metabolic, obesity, and longevity‑related treatments.
• Opportunities for earlier, more proactive interventions that meaningfully reduce downstream medical costs.

AI moves from navigation to clinical decision‑making

Not only is AI an enabler of improved care experience and personalization, it is also stepping into the clinical arena itself.

New forms of agentic AI are emerging with the ability to complete clinical tasks, synthesize patient data, and even assist with prescribing decisions.

Early use cases include:

• AI‑powered triage and clinical risk assessment.
• AI agents that help providers prepare care plans, order tests, or flag contraindications.
• AI tools like ChatGPT moving from consumer health research into care coordination and clinical decision support.

These capabilities promise better access, reduced administrative burden, and improved consistency in clinical outcomes, but they also raise important questions around governance, compliance, model transparency, and data quality.

Adoption metrics show an industry already in motion. AI use among physicians surged 78% year over year, with 66% of U.S. physicians now using AI tools as part of their clinical practice. Eighty-eight percent of health systems are using AI internally, but only 18% have mature governance frameworks in place, creating a gap between adoption and oversight. In addition, health care as a whole is adopting AI at more than twice the rate of the broader economy, making it the fastest‑moving vertical in enterprise AI today.

"We’re entering a new era where science and technology converge to change the very nature of care delivery."Dr. Amy Flaster, chief medical officer, The Cigna Group.

“Breakthroughs like GLP‑1 therapies and longevity medicine are redefining what it means to stay healthy, while AI is moving from convenience to clinical decision‑making," Dr. Flaster said. "For employers, this isn’t just about innovation – it’s about anticipating these shifts to deliver better outcomes, greater predictability, and a simpler, more human experience for their workforce.”

A turning point for employers in 2026

As employers look ahead to 2026, it’s clear that the forces shaping the health care landscape are not new, but their convergence is unprecedented. Cost pressures, technological advancement, shifting workforce needs, and rising expectations for personalization are colliding in ways that mark a pivotal moment in benefit design. Employers are no longer tasked solely with managing plan expenses. They must also navigate a rapidly evolving environment where experience, integration, and innovation define success.

Understanding why these trends matter is essential. Each reflects a broader transformation in how health care is delivered and how employees engage with it. The emphasis on pharmacy personalization, flexible benefits, digital navigation, and clinical integration signals a fundamental shift toward whole‑person support. Employers who recognize how these elements work together, and why they are accelerating now, will be best positioned to adapt. This requires not only awareness but a commitment to evolve benefits, invest in data‑driven tools, and lean into approaches that simplify, personalize, and improve care.

Ultimately, the employers who proactively engage with these trends will gain a meaningful competitive advantage. By embracing innovation, deepening their focus on employee well‑being, and preparing for continued change, organizations can strengthen their ability to attract and retain talent, manage costs more effectively, and build a healthier, more resilient workforce. 2026 is not just another year in health care, it is a pivotal opportunity to lead with clarity, confidence, and purpose.

¹ 2025 Cigna Healthcare Book of Business data

² Cigna Healthcare 2025 National Book of Business study of 2024 claims of medical customers who have Cigna Healthcare integrated medical, pharmacy and Cigna Total Behavioral Health benefits. Individual client/customer results will vary and are not guaranteed. Savings are for those with a condition diagnosis and engaged in Case Management or a Health Maintenance Activity. Individual client/customer results will vary and are not guaranteed.