$37,824.

Is the cost for employer-based healthcare for a family in 2026.

Over the last year, healthcare costs for the average person in an employer-sponsored plan jumped almost 8% to $8,460.

Almost half of that cost is for facility-based care.

And almost a quarter is for drugs…

For now, let’s focus on facility spend. There are four reasons facility costs have exploded.

1. Consolidation. Health systems are growing larger, acquiring physician practices, clinics, and ancillary services in an effort to control as much spend as possible. This also greatly reduces competition while doing nothing to improve outcomes.

2. Billing sophistication. As we’ve discussed here at great length, facilities are winning the billing arms race, becoming increasingly adept at coding, documentation, and patient acquisition (marketing to employers’ workers) while payers stumble in their efforts to keep up.

3. Healthplans are getting their collective butts kicked. In a desperate effort to hold onto employee lives, they are forced to acquiesce to health systems’ demands in contract negotiations.
   Oh, and the higher the medical costs are, the more health insurers’ revenues increase which helps their stock prices and executive bonuses.

4. Health systems fully grasp the reality that Republicans’ massive cuts to Medicare Medicaid and ACA healthplans are an existential threat. They know their survival depends on employee healthcare.

For a detailed look into cost drivers read Milliman’s report.

What does this mean for you?

If it doesn’t scare the bejesus out of you, you aren’t paying attention.