Article
A jump in shopping activity
The Purchaser Business Group on Health, a coalition of 40 of the largest US health care purchasers, reports that 37% of its members issued a request for proposals for medical benefits this year, up from 12% in 2024. Its members spend more than $350 billion a year covering 21 million workers and family members. Pharmacy benefit bids rose more modestly, to 23% from 20%, while use of nontraditional pharmacy benefit managers climbed to 27% from 16%.
The pressure behind the shift is cost. Healthcare Dive reported on April 16 that health benefit costs are expected to rise roughly 6% to 8% this year, citing drug spending, chronic disease and provider consolidation as drivers. Last August, the Business Group on Health found its large employer members projecting a 9% increase for 2026 before plan design changes, the largest in more than a decade.
Why hospitals should pay attention
Employers rarely negotiate with hospitals directly, but they shape the terms their carriers bring to the table. When a large employer moves its business, the winning carrier often promises lower unit costs or tighter networks to win the account. That promise usually flows back to providers in the next contract cycle.
After affordability, PBGH members ranked data and transparency as their top concerns, including clearer pricing for procedures. Price transparency is also a stated priority of the administration. Taken together, this means employer benefit managers will increasingly compare hospital prices using public files, and will expect carriers to justify why a given system belongs in a network.
How to get ahead of it
- Know your exposure: Identify your largest self-funded employers by region and which carriers administer their plans.
- Check your public price data: Make sure your posted rates are accurate and that your team can explain outliers before a buyer asks.
- Build a value story: Gather quality, total cost of care and access data for common procedures that employers track.
- Talk to employers directly: Consider direct conversations with major local employers about service lines, worksite care or centers of excellence.
- Plan for narrower networks: Model the volume effect if a carrier offers a tiered or narrow product that excludes your system.
Archive entry for Apr 21, 2026, added Nov. 11, 2026.