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Thursday, 11 June 2026 |
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| We’re getting our first signs of where healthcare costs are heading next year. |
| According to a survey of actuaries at 27 health plans covering employers and individuals on the exchanges released today, PwC estimates that healthcare costs will rise 9% in 2027. |
| PwC says that’s a higher expected rate of growth than we’ve seen in the last 17 years —and the consulting firm doesn’t expect that to be a “temporary spike.” |
| The forces driving up healthcare spending are likely familiar if you’ve been reading our newsletter over the last year: AI tools are helping providers get more revenue, consolidation is driving up payment rates, pharmacy and behavioral health costs are rising, and arbitration via the No Surprises Act is leading to more out-of-network reimbursements than plans anticipated. |
| At this rate, PwC estimates annual healthcare spending will hit $9 trillion in 2035, up from $5.3 trillion in 2024. |
| In terms of what might bring down costs, the report mentions improving the accuracy of payments (but not denying claims!) and better managing pharmacy expenses, particularly related to GLP-1s and specialty drugs. |
| I’m told all the time that there’s urgency to curbing rising healthcare costs. But even as reports detail just how much spending is growing year to year, it’s been harder for me to discern what it’ll take to really see that change — and which
organizations (employers or otherwise) will take the drastic steps that might be needed. In the meantime, as a healthcare consumer, I worry about how exposed I’ll be to these costs. |
| - Lydia |
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Never gonna happen |
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49 |
The percentage of health plans that don't cover GLP-1 weight loss drugs for obesity and say they would not at any price, according to pharmacy benefits consultancy Pharmaceutical Strategies Group’s annual report on drug benefit design. PSG surveyed more than 200 leaders representing employers, health plans, and unions with a median of 14,000 covered members. |
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Worldwide made. Thanks for reading.
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