10 Forces Shaping Healthcare in 2026: Addressing Rising Costs and Creating a Better Future for All

Snezana Mahon, Pharm.D, President, Transcarent

Conversations about healthcare costs are happening everywhere, including kids’ birthday parties, boardrooms, the halls of Congress, and they even dominated discussions this year at Voyages, Transcarent’s annual client innovation summit.

Industry leaders like Ellen Kelsay from Business Group on Health shared a sobering outlook: employer costs are expected to rise another 9% in 2026¹, underscoring the urgent need for bold action that creates sustainable changes in the health and care experience.

Current forces, such as rising costs, system confusion, and demand for agentic AI action are shaping the future of health and care and the trends we’re seeing today. Knowing these emerging trends can give leaders the confidence they need to be bold and act fast as they create the change needed to get ahead of what’s to come.

Here are 10 trends leaders should know and watch as they plan for the rest of the year

1. Employees want One Place™ to go: People are done with multiple portals and long wait times. AI-powered, personalized navigation is the new expectation, and a key lever to reduce waste and confusion.

2. Provider consolidation is driving prices higher: More mergers mean less competition and higher costs. High-value networks and Centers of Excellence, backed by quality and price transparency, support more choice in quality care.

3. Mental health is a core business priority: It’s the top driver of disability claims and a major productivity drain. Early detection, quick access, and integrated behavioral care are now essential.

4. Compliance expectations are rising: New laws and regulations around transparency, PBMs, and data privacy raise the stakes. Partners that operationalize compliance and provide real-time visibility can help reduce fiduciary risk.

5. Everyone wants to be closer to health consumers: Pharma and device makers are going straight to employees with direct-to-consumer engagements. More often, employers will seek to structure new contracts to pay for results.

6. Inclusion and personalized well-being are table stakes: Employees and their families expect benefits tailored by gender, culture, life stage, and language. Personalized, culturally competent support drives better outcomes and reduces waste.

7. Virtual care plus in-person care is the new standard: The most effective model is hybrid: start with virtual care, use in-person when needed, and ensure the handoffs are seamless. Soon, people won’t see this care as virtual healthcare; it will just be healthcare.

8. Specialty therapies are exploding costs: GLP-1s and other innovative and life-saving therapies are driving major cost spikes. Proactive pharmacy care will be at the center of more benefits strategies to support high-value steerage.

9. Responsible AI is reshaping care: When it’s transparent, responsibly governed, and embedded into workflows, AI can make care feel more personal by closing gaps, enabling outreach, and connecting people to trusted guidance.

10. A multi-generational workforce requires targeted engagement: With four distinct generations at work, communications and benefits experiences must be tailored to how different people learn, connect, and seek care.

What the future looks like today

The future relies on delivering a connected, accountable experience that people love. This includes: a trusted platform for all needs; integrated care teams sharing data; transparent economics with outcome-based fees; AI agents that act instead of just answering; and personalized navigation that guides Members to high-value care.

This is why we built Transcarent: to align incentives with employers and families, making access to high-quality care easy and paying for what works. We’re changing the system alongside bold, forward-thinking employers who are impatient with the status quo. With the right strategy and partners, employers can turn these trends into tailwinds for their people and business. Let’s embrace the innovation ahead and create the health and care experience people deserve.

Sources

Transcarent is committed to providing accurate, evidence-based information to help you make informed health decisions.

1. 2026 Employer Health Care Strategy Survey: Executive Summary, August 19, 2025.