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Employers worry less about healthcare costs while backing more reforms
A 2026 Pulse of the Purchaser survey found employer threat ratings for drug prices and hospital prices fell, even as support for PBM reform and price transparency rose.
Employers appear to be dialing back their concern about specific healthcare cost threats, while increasing support for policy changes, according to Insurance Business. The findings come from the 2026 Pulse of the Purchaser survey published by the National Alliance of Healthcare Purchaser Coalitions, based on 408 employer and purchaser responses collected through member coalitions in May and June.
The survey tracks drug prices, high-cost claims, and hospital prices as top affordability threats each year. In 2026, drug price concerns fell to 76.7 percent from 93.1 percent in 2024, and hospital price concerns dropped to 68.1 percent from a 2023 peak of 82.4 percent. Over the same period, health system consolidation concerns fell from 64.7 percent to 49.7 percent.
The report points to multiple possible explanations for the lower threat ratings, including genuine improvement, normalization as high costs become routine, or attention shifting to other pressures. It notes the survey cannot determine which explanation is driving the trend, but it says employer views on workforce concerns have stayed essentially flat since 2023.
Even as the threat ratings eased, support for reform climbed across the categories tested. PBM reform support increased from 68 percent in 2023 to 87.6 percent in 2026, hospital price transparency rose from 75 percent to 84.6 percent, and drug price regulation increased from 72.9 percent to 83.8 percent, alongside gains for hospital rate regulation.