2026 Health Trends

Heading into 2027 renewals, brokers face a familiar but intensifying challenge: help clients make sense of rising costs.

Healthcare spending continues to outpace inflation, and clients want to understand how their costs fare against other employers and, more importantly, how to manage their spend and protect employees’ dollars.

UnitedHealthcare’s 2026 Health Trends Report examines claims data and utilization patterns from across its book of business from November 2024 to October 2025. The goal is to give brokers and benefits leaders the intelligence they need to make more confident and informed benefits decisions. Three trends may provide essential context to bring to client conversations.

1. Catastrophic and Complex Claims are Climbing

Medical costs related to catastrophic claims of $100,000 or more increased 12.9% year-over-year, according to the Health Trends Report; UnitedHealthcare claims data from the first half of 2026 indicates these costs are not slowing. In fact, paid per member per month (PMPM) costs are up 7.1% over the same period in 2025. That growth signals employees are experiencing more complex and less predictable care needs, compounded by innovative and expensive new treatments.

What this means for brokers: Help your clients understand the value of robust care management programs, especially for cancer as the No. 1 driver of high-cost claims, and the importance of working with a carrier that can help identify high-risk members early and intervene before they become a high-cost claimant.

2. Specialty Pharmacy Remains a Dominant Cost Driver

Pharmacy costs rose by 11% in 2025, with similar growth projected for 2026 and 2027, according to the 2026 Employer Health Care Strategy Survey by the Business Group on Health and projections by HR firm Segal, respectively. Specialty medications are the primary reason. For UnitedHealthcare clients, specialty drugs represented approximately 55% of total pharmacy benefit spend during the study period despite accounting for less than 2% of usage, the UnitedHealthcare 2026 Health Trends Report shows.

Analysis of UnitedHealthcare 2026 claims data shows that cancer remains the largest cost category overall, reaching $60.28 per member per month in the first half of 2026—up $4.51 from the same period in 2025. Conditions such as inflammatory diseases accounted for roughly one-third of specialty spend during that period. Use of GLP-1 medications; new oncology therapies; cell, gene, and molecular therapies; and U.S. Food and Drug Administration-driven expanded indications for existing drugs also contributed significantly. Musculoskeletal conditions showed the largest percentage cost increase among clinical categories, rising 5.7% over the first six months of the year compared to the same period in 2025.

What this means for brokers: These figures may help you frame pharmacy strategy at the bargaining table. Tools such as formulary management, site-of-care optimization, targeted clinical programs, and benefit integration may help clients manage specialty spend more effectively without limiting access to necessary therapies.

3. ER Usage Growth Points to Gaps in Health Literacy

Usage patterns reveal a continued reliance on expensive and often avoidable emergency room (ER) visits. The 2026 Health Trends Report cites a 5.2% year-over-year increase in ER visits. This trend has continued into the first half of 2026, where total ER costs increased 6.5% from the first half of 2025, while the cost per ER visit rose 4.9%, according to UnitedHealthcare claims data. Urgent care use, though, declined by 7.6%.

Generational usage differences also stand out. Generation Z ER visits per 1,000 increased by 9.8% between the first half of 2025 and the first half of 2026—the largest increase of any generation—while older generations held steady or declined. The 2026 Health Trends Report showed similar patterns regarding Gen Z ER visits, with a 5.2% year-over-year increase in ER visits from 2024 and 2025.

What this means for brokers: These patterns reveal opportunities to help clients direct employees and members toward appropriate sites of care and encourage preventive care, especially among younger generations. Notably, virtual and telemedicine visits are rebounding, as shown by UnitedHealthcare’s first-half 2026 claims data: virtual visits per 1,000 rose 3.5%, and telemedicine visits per 1,000 jumped 19%—options worth promoting in enrollment materials.

The cost trends outlined here are driven by deep, persistent forces, not by temporary fluctuations. No single change will reverse them overnight. But clients that choose a carrier that is working to drive greater healthcare affordability and pair that selection with thoughtful plan design, active member education, and targeted clinical support may be better positioned to manage trends while still delivering a strong benefits experience.