Aligning Members, Plans, and Providers to Bend the Cost Curve

How can we get all healthcare marketplace stakeholders working together to address rising costs and slow the year-over-year premium increases in employer-sponsored health plans? A few key, actionable, and realistic steps stand out.

First, the member: link proactivity and better health maintenance to real financial value. Reduced downstream utilization, especially inpatient, should translate into lower premium contributions and increased compensation.

Second, the plan: make it easier for members to be proactive and maintain their health. Offer benefits that reduce rationing and increase access to high-value preventive care that lowers inpatient utilization and increases take-home pay.

Third, the provider: make it more valuable to deliver PROACTIVE CARE by minimizing revenue cycle pain points, including reimbursement delays, member collections, and administrative burden. Move market demand and dollars toward care that creates the most value for both the member and the plan.

The urgency is clear. Insurance premiums for employer-sponsored family coverage have increased at roughly three times the pace of workers’ earnings over the past 25 years (Kanimian et al., 2025). From 1999 to 2024, average worker contributions toward family premiums rose 308% and total family premiums increased 342%, compared to 119% growth in earnings and 64% overall inflation (Kanimian et al., 2025). Hospital prices remain a central driver of long-term cost growth (Kanimian et al., 2025). These findings were published in JAMA Network Open.

Kanimian, S., & Ho, V. (2025). US medical prices and health insurance premiums, 1999–2024. JAMA Network Open, 8(12), e2547462. https://doi.org/10.1001/jamanetworkopen.2025.47462