Pulse of Purchaser Findings Released

Employers with Claims Data Access Take More Action on Healthcare Costs, National Alliance Survey Finds

Pulse of the Purchaser poll links claims visibility to more action on PBM transparency, hospital affordability and high-cost claims management

Employers with full access to medical and pharmacy claims data are more likely to act on hospital affordability, high-cost claims and pharmacy benefit management transparency, according to the Pulse of the Purchaser survey conducted by the nonprofit National Alliance of Healthcare Purchaser Coalitions (National Alliance) and its members. The survey of 408 employers also finds that rising healthcare costs remain a workforce challenge, with employers identifying the high-value purchasing strategies they are using in response.

Nearly all employers surveyed say attracting and retaining employees is a top priority (97%) and that health and wellbeing benefits are crucial to that effort (98%). At the same time, 92% say healthcare costs hurt competitiveness, 83% say cost increases trade off with wage and salary increases, and 93% expect costs to shift to employees.

“Healthcare affordability is no longer just a benefits issue; it is a business issue, a workforce issue and a wage issue,” said Shawn Gremminger, National Alliance president and CEO. “Employers have the concern and the will to act, but too often lack the usable data, contractual rights and staff capacity to do so. When those barriers are removed, employers are better able to move from concern to action. In a challenging economic environment, healthcare costs continue to be a driving factor in inflation, the concern most often cited by Americans going into the pivotal 2026 midterm elections.”

The findings come as employers face another year of projected healthcare cost increases outstripping inflation and pressure to protect wages, benefits and competitiveness. For employers, the results point to a broader shift in benefits strategy: rising costs are no longer being treated only as an annual renewal challenge, but as a business issue tied to vendor accountability and usable data.

Key Findings

  • Affordability pressures remain concentrated in drug prices, high-cost claims and hospital prices. Employers cite drug prices (77%), high-cost claims (75%) and hospital prices (68%) as the top significant threats.
  • Employers paying higher premiums expect sharper increases. Employers project an average 7.7% healthcare cost increase before plan design changes, and 33% of those providing an estimate expect increases of 9% or more. Fully insured employers were most likely to expect increases of 9% or more.
  • Hospital/facility costs and prescription drugs are the largest shares of spending. Employers estimate hospital/facility costs represent 30.5% of total healthcare spend, followed by prescription drugs at 21.1% and professional fees at 19.1%.
  • Data access helps employers move from intent to implementation. Employers with full claim-level access reported using nearly four more high-value purchasing strategies, on average, than employers with limited, no or uncertain access (11.9 versus 7.9). The two groups were considering similar strategies, suggesting that data access is a key factor separating concern from action.
  • PBM transparency remains a major focus. Employers identify PBM reform as the most helpful policy reform tested in the survey, with 87.6% rating it very or somewhat helpful. In addition, 43% of respondents are considering a PBM change within the next one to three years.
  • Hospital transparency and payment reforms are rising policy priorities. Employers rated hospital price transparency (84.6%), hospital rate regulation (82.6%) and hospital antitrust enforcement (72.2%) as very or somewhat helpful reforms.

Read the National Alliance Press Release

Learn More and Download the National Alliance Resource

 

About National Alliance of Healthcare Purchaser Coalitions

For more than 30 years, the National Alliance has brought together business coalitions and their employer and purchaser members to drive high-quality healthcare that enhances patient experience, promotes health equity, and improves outcomes while lowering costs. Its members represent public and private sectors, nonprofits, and labor unions that provide health benefits to over 90 million Americans — more than half of the employer-sponsored insurance market — spending over $850 billion annually. To learn more, visit nationalalliancehealth.org and connect on LinkedIn.

The National Alliance is hosting its 2026 Annual Forum, Beyond Transparency – Seeing Clearly, Acting Boldly: Employers’ Moment of Truth, Nov. 16-18 at the Crystal Gateway Marriott in Arlington, VA.