U.S. Health Systems Increase Focus on High-Cost Claims and Benefits Value Amid Rising Healthcare Costs, Aon Report Finds

Aon plc (NYSE: AON), a leading global professional services firm, released findings from its annual Benefits Survey of Hospitals surveying over 1,800 hospitals across 170 U.S. healthcare systems, representing over 4.2 million covered employees.

The results show that healthcare costs remain the most commonly cited benefits challenge among participating health systems, with 92% identifying cost as a top concern and per employee per year spend increasing 8.8% among systems participating year-over-year.

“For health systems, rising employee healthcare costs are part of a much broader financial equation,” said Sheena Singh, U.S. Healthcare Industry Practice Lead, Aon. “As both employers and providers, health systems have unique opportunities to address those pressures through better management of complex cases, pharmacy spend and their own delivery networks. The challenge is determining which approaches are having the greatest impact on cost, care and the employee experience.”

The 2026 findings also demonstrate how health systems are evolving their response to those pressures. Managing high-cost claimants and measuring the return on benefits investments emerged as new areas of concern this year, reflecting greater scrutiny of both what is driving healthcare spend and how benefits programs are performing. Across participating health systems, the median share of members with annual medical claims over $100,000 was just 1.2%, yet those members account for 39.2% of medical plan costs. The concentration of spending among a relatively small number of members underscores the growing importance of identifying and managing complex cases.

Against broader financial pressure across the hospital sector, the findings point to a shift beyond managing the overall rate of healthcare cost growth toward more targeted strategies that address the underlying drivers of spend and where intervention can have the greatest impact.

Additional key findings include:

• Managing Complex Cases: Health systems are looking for opportunities to identify emerging risks earlier and better manage their clinical and financial impact. Sixty-four percent use carrier clinical and case management programs, while 21% use healthcare navigation or advocacy vendors. Additionally, thirty-eight percent are using predictive analytics to proactively identify and engage potential high-cost claimants.
  
  
• Delivering Measurable Value: Eighty-five percent of health systems evaluate financial return when assessing point solutions and carrier programs, while 75% measure engagement and 64% consider clinical outcomes, pointing to greater focus on whether benefits investments are delivering intended results.
  
  
• Strategic Plan Design: Health systems continue to use plan design to balance cost, employee affordability and access to care. Eighty-three percent offer their employees lower costs for receiving care through their own facilities or providers, while health systems are also assessing contribution and cost share strategies, evaluating network design and provider specialty access and other approaches to influence where and how employees receive care.
  
  
• Pharmacy Management: Pharmacy remains a significant area of cost-management focus, with 79% of health systems identifying pharmacy strategies as a primary area of focus to managing health-plan costs. GLP-1 medication management illustrates that evolution: Among the 47% that cover GLP-1s for weight loss, 92% now have at least one management strategy in place, up from 72% in 2025.
  
  
• Employee Value Perception: While 77% of health systems believe their total rewards package meets employee needs, only 25% believe employees fully understand its value. Despite 67% having a year-round benefits communications strategy, the findings highlight an opportunity to improve how employees navigate, understand and ultimately use the benefits available to them.
  
  

As both employers and healthcare providers, health systems have a unique set of levers to manage healthcare costs. The findings highlight an opportunity for health systems to more closely connect benefits strategy with clinical capabilities, pharmacy, provider networks and employee experience as they seek to improve affordability and outcomes while managing overall plan performance.

“For health systems, these decisions have implications beyond the benefits budget,” said Singh. “The same organization is often financing employees’ care, delivering that care and competing for the talent needed to provide it. That makes affordability, access and employee experience interconnected with the health system’s broader workforce and financial strategy.”

About Aon’s Benefits Survey of Hospitals

Aon’s Benefits Survey of Hospitals has provided actionable data and benchmarking for hospital employers for 21 years. The survey is offered at no cost to participating health systems, with regional benchmarking and a complimentary tailored follow-up session available. The 2026 survey reflects data from 170 health systems, representing over 1,800 hospitals and 4.2 million covered employees.

The information contained in this release is for general informational purposes only and is based on Aon’s 2026 Benefits Survey of Hospitals and information available as of the date of publication. Survey results reflect participating health systems and may not be representative of all health systems or employers. The information is not intended as medical, legal, regulatory, financial or other professional advice and should be considered in the context of each organization’s particular circumstances.

Learn more about Aon’s national healthcare practice.

About Aon

Aon plc (NYSE: AON) exists to shape decisions for the better — to protect and enrich the lives of people around the world. Through actionable analytic insight, globally integrated Risk Capital and Human Capital expertise, and locally relevant solutions, our colleagues provide clients in over 120 countries with the clarity and confidence to make better risk and people decisions that protect and grow their businesses.