Shift from Reactive to PROACTIVE CARE to Bend the Cost Curve

Want to start shifting rising medical and pharmacy benefit cost trends? Employers must move benefits strategy from reactive, high-cost care to PROACTIVE CARE that reduces downstream utilization, including inpatient services. There is an easily identifiable cohort most likely to become future high-cost claimants: individuals with cardiometabolic disease, including obesity, type 2 diabetes, hypertension, and high cholesterol. Removing barriers to care for these common chronic conditions is a critical first step. The urgency is clear. Nearly half of U.S. adults are projected to have obesity by 2035, up from 42.5% in 2022 (DeCleene et al., 2026). At the same time, about 80% of U.S. adults with hypertension do not have their blood pressure controlled below recommended levels, and most are not taking medication (Hardy, 2026). We cannot allow the slowly increasing rates of these conditions to boil our benefits budgets to death. We can act in positive ways. There is hope. Employers can use benefits strategy and PROACTIVE CARE purchasing decisions to better align individuals with cardiometabolic disease and their providers. This includes removing financial barriers, such as patient deductibles and provider revenue cycle delays, and reducing administrative friction. These steps optimize the ability to do today’s work today and help prevent tomorrow’s high-cost claims.

DeCleene, N. K., Kahn, E., Yuan, C., et al. (2026). US state-level prevalence of adult obesity by race and ethnicity from 1990 to 2022 and forecasted to 2035. JAMA. https://doi.org/10.1001/jama.2025.26817

Hardy, S. T., Jaeger, B. C., Emanuel, E., & Muntner, P. (2026). Blood pressure above goal among US adults with hypertension. JAMA. https://doi.org/10.1001/jama.2025.25657