CHECKLIST: 5 KEY STEPS FOR MANAGING COST INCREASES
What should employers do next?
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UNDERSTAND WHAT’S DRIVING YOUR UNIQUE COSTS
- Identify the primary factors behind your healthcare spend.
- Use claims data and analytics to pinpoint the combination of conditions, claimants, and prescriptions driving costs.
- Determine which cost drivers you can influence, and which are less within your control.
Understanding what is driving your plan costs helps focus resources and strategies where they can have the greatest impact.
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REVIEW PURCHASING EFFICIENCY & CONTRACTUAL TERMS
- Assess whether you are purchasing the right services at the most cost-effective price.
- Review carrier, administrator, and vendor contracts to understand how each partner generates revenue.
- Identify opportunities to negotiate costs, improve terms, or strengthen transparency.
Reviewing these areas can uncover opportunities to get greater value from your healthcare spend.
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EVALUATE RISK TOLERANCE & READINESS FOR INNOVATION
- Define your organization’s appetite for financial risk and evaluate whether your current approach aligns with it.
- Explore available solutions across medical, pharmacy, specialty drug management, and stop loss.
- Determine which new approaches align with your cost drivers, organizational goals, and ability to implement change.
Understanding both your risk tolerance and the options available in the market can help you pursue innovation that makes sense for your organization.
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BALANCE COST, RISK, POPULATION NEEDS & DISRUPTION
- Consider your workforce demographics, health needs, and preferences.
- Weigh potential cost savings against financial risk and the impact on employees.
- Assess how much disruption your organization and employees can absorb and when change should occur.
Considering these tradeoffs together can help ensure cost-management decisions support both financial objectives and the needs of your workforce.
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BUILD A MULTI-YEAR STRATEGY
- Establish guiding principles around competitiveness, cost sharing, and plan design.
- Prioritize opportunities based on their potential impact and organizational readiness.
- Build a multi-year roadmap that sequences changes over time and can evolve as needs and market conditions change.
A multi-year strategy provides a clear direction while allowing you to introduce change thoughtfully and pursue opportunities when the timing is right.
Bringing the right expertise to the table
Most partner with the right specialists across clinical, pharmacy, financial, risk, population health, employee experience, and more to connect insights, rather than making decisions in isolation.
A thoughtful benefits strategy considers how individual plan decisions work together to support broader organizational goals.
