Access to Healthcare Data Key to Employers Managing Costs

The recent 2026 Pulse of the Purchaser survey emphasizes a critical divide between employers who express a desire to control healthcare costs and those who take tangible steps toward that goal. The key differentiator? Their ability to access and utilize comprehensive medical and pharmacy claims data.

Data from the National Alliance of Healthcare Purchaser Coalitions, which advocates for employers providing health benefits to over 90 million Americans, reveals that organizations with full access to their claims data employ an average of 11.9 high-value purchasing strategies. In stark contrast, those with limited or no access average just 7.9 strategies. This disparity indicates that it's not a lack of ambition driving the difference, but rather the essential barrier of data access.

Shawn Gremminger, president and CEO of the National Alliance, pointed out that employers often possess the concern and determination to act on costs but are hindered by limited data capabilities. He noted, "When those barriers are removed, employers are better able to move from concern to action."

Impact of Data Access Strategies

Accessing comprehensive data unlocks a range of effective strategies for cost management, including network evaluation, hospital price reviews, vendor audits, reference-based pricing, direct contracting, and centers of excellence. These approaches tend to generate sustainable savings, in contrast to the temporary shifts in costs often experienced by employers.

Current Cost Projections and Employers' Concerns

The survey also highlights concerning trends in healthcare costs. Employers foresee an average healthcare cost increase of 7.7%, with one-third expecting rises of 9% or more. Predictably, fully insured employers anticipate the most significant hikes.

Employers view healthcare costs not just as an expense, but as a factor impacting their competitiveness. A staggering 92% believe rising costs are detrimental to their competitive stance in the market, and 83% recognize that these increases directly conflict with wage growth. Furthermore, 93% anticipate that costs will shift to employees, potentially affecting retention, engagement, and overall workforce stability.

Identifying Key Drivers of Costs

Drug prices (77%), high-cost claims (75%), and hospital prices (68%) rank as the primary threats. Hospital and facility expenses account for the largest segment of overall healthcare spending at 30.5%, followed by prescription drugs at 21.1%, and professional fees at 19.1%. Notably, data indicated that a mere 1% of members accounted for a third of all medical and pharmacy spending in 2025.

Shifts in Pharmacy Benefit Management

Moreover, the survey suggests a significant shift in the pharmacy benefit management (PBM) landscape. The percentage of employers relying on the three largest PBMs decreased from 63.4% in 2025 to 54.3% in 2026, particularly among mid-sized employers, who appear to spearhead this reassessment of partnerships.

Of those remaining with the larger PBMs, 55.7% are contemplating a switch in the next one to three years, contrasted with 31.1% of employers using alternative PBMs. This restlessness appears to stem from confusion over contract details, with nearly 24% of large PBM clients unsure of their contract specifications, nearly double the uncertainty experienced by those with alternative PBMs.

Policy Engagement and the Road Ahead

A substantial 87.6% of survey respondents identified PBM reform as the most beneficial policy change, with significant support also for hospital price transparency (84.6%) and hospital antitrust enforcement (72.2%). Encouragingly, engagement in healthcare legislative activities has seen an uptick, with 51.3% of employers now involved, compared to 42.5% the prior year—higher engagement was linked to those with full pharmacy claims data.

This survey uncovers a tangible opportunity for brokers. The difference in strategic approaches between those with limited data and those with complete access does not reflect varied intent but illustrates a significant accessibility gap. Brokers who can negotiate for comprehensive claims data rights and assist clients in interpreting and utilizing this data stand to provide unparalleled value in a competitive market.

As drug expenditure rises to encompass nearly a third of employer claims, those employers equipped with insights from complete data access will undoubtedly be better positioned to manage costs effectively. This sets a compelling case for why data rights are pivotal in contract negotiations during this renewal cycle.