Get a Clearer View of Healthcare Costs — Before They Escalate

JULY 7, 2026

Employers are feeling the pressure from higher healthcare costs year over year, yet many continue to address this only at renewal with rate negotiations and plan design changes. While important, these strategies only focus on part of the problem. A large portion of healthcare spending is driven by several predictable — and often controllable — factors:

• Gaps in preventive screenings and routine care
• Undiagnosed or under-managed chronic conditions like Type 2 diabetes
• High prevalence of musculoskeletal (MSK) injuries and issues
• Delayed detection and treatment for high-cost conditions like cancer
• Rising pharmacy costs, driven in part by demand for GLP-1s

Left unmanaged, these issues increase the risk of catastrophic claims and drive up overall health plan spending. Employers must take a structured, multi-year approach to achieve sustained savings, rather than relying solely on annual renewal strategies.

Understanding the Cost of Claims Risk

To manage costs more proactively, employers need a clearer view of where future claims risk is likely to emerge. Cost avoidance modeling helps organizations identify areas of risk and estimate the long-term cost if not addressed.

USI Insurance Services supports this process through proprietary modeling grounded in real client data and benchmarking against top-performing populations, giving organizations a clearer view of what to target.

In practice, this type of analysis often highlights a consistent set of priority areas, including:

• Increased participation in preventive screenings
• Improved diabetes management and adoption of supportive technologies
• Expanded engagement in MSK programs
• Earlier detection of cancer through routine screening

Addressing these issues as part of a broader strategy can significantly influence future claims trends. Even partial improvements can yield substantial long-term savings. By taking a multi-year approach, organizations can move beyond reactive decision-making and toward a more deliberate strategy focused on measurable outcomes.

Practical Cost Management for Smaller Groups

Smaller employers may not have the claims volume needed for advanced cost avoidance modeling. However, they face many of the same challenges, particularly around preventive care and chronic condition management. USI helps these employers identify meaningful risk patterns and cost drivers within their claims and utilization data, and apply targeted solutions based on their specific needs:

Managing the Growth of GLP-1 Medications

GLP-1s can offer meaningful clinical benefits, including weight loss and improved management of diabetes and cardiovascular risk. These outcomes can help reduce the likelihood of high-cost claims over time.

However, rising demand and costs are making it more difficult for employers to balance access with oversight. Structured management programs can help establish guardrails — such as eligibility criteria, prior authorization, and integrated coaching — to support both clinical outcomes and cost control.

Expanding Access to Primary Care Through Direct Primary Care

Primary care engagement is the most efficient and effective way to promote general preventive care, including cancer screenings based on age and gender — but many employers continue to struggle with low primary care utilization. This often leads to increased urgent care and emergency room usage, and higher overall costs.

Employees frequently cite time away from work and concerns over out-of-pocket costs as the main reasons for avoiding primary care. Direct primary care (DPC) can help remove those barriers by offering more flexible care options and low- to no-cost visits. Under a typical DPC arrangement, employers pay a flat per-employee fee for primary care visits, instead of a per-visit expense. This usually includes preventive care and chronic condition management. When implemented effectively, this approach can greatly impact future claims costs.