2026 Benefits Survey of Hospitals

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2026 Benefits Survey of Hospitals

2026 Benefits Survey of Hospitals

Our Survey

Now in its 21st year, Aon’s Benefits Survey of Hospitals provides crucial benchmarking and insights that hospital HR and Finance executives need to offer a more attractive benefits package and better manage their employer-sponsored health plans.

This survey highlights strategic benefits and wellbeing priorities and tactics deployed in response to increasing healthcare costs as health systems deal with financial headwinds impacting operating margins, funding and budgets. While health systems recognize the need to manage costs more effectively, it is increasingly important to ensure that benefits are not only perceived as valuable by employees but optimized for their return on investment. 

The 2026 survey covers the entire United States and provides key findings for:

  • 170

    health systems

  • 1,800

    hospitals

  • 4.2M+

    employees

hospital chart 2026

Key Areas of Concern

Health system leaders face a clear mandate: manage rising healthcare costs while demonstrating the value of benefits investments, supporting workforce health and maintaining competitive total rewards. Health system employers continue to find ways to adapt and be nimble in this challenging environment.

  • Cost containment remains the leading priority. Increasing healthcare costs remain the top concern, followed by managing high-cost claimants—a new addition to this year’s list. These priorities underscore the challenge of maintaining plan affordability while managing the financial impact of high-cost care, driven by new and advanced technology and medicine, the rise in chronic condition prevalence, inflation, along with payer/provider contract negotiations.
  • Demonstrating benefits value is essential. Employee understanding of benefits’ value ranks third, while measuring return on investment enters the top 10. Together, these findings highlight the importance of demonstrating value to employees and evaluating the impact of benefits spending. Cost and value go hand in hand – as health systems invest in some benefits and reduce others, if the value is not clearly articulated to employees and understood by employees, the return on that investment or decision to cut cannot be adequately assessed.
  • Improving health outcomes and preserving affordability remain central. Improving health outcomes ranks fourth, with employee affordability sixth. Health systems face the ongoing challenge of managing plan costs while maintaining benefits that support employees’ health and financial wellbeing. Health systems may look for cost savings before cost shifting, but inevitably, both levers are being utilized, with attunement to supporting low-wage earners around any changes.
  • Domestic network strategy remains a strategic focus. Retaining services within the domestic network ranks fifth, with network adequacy and access also in the top 10 (domestic reimbursement methodology is also in overall top concerns). These priorities reinforce the need to consider domestic utilization alongside employee access to care, while providing prudent fiduciary oversight.
  • Governance and fiduciary oversight remain priorities. Managing fiduciary obligations and plan sponsor risks ranks seventh and moved up in ranking, underscoring the importance of effective plan oversight as health systems navigate business demands on plan design and having a process in place to ensure that all plan sponsor fiduciary obligations are being met.
  • Competitive total rewards support talent attraction and retention. Offering competitive total rewards ranks eighth, highlighting the importance of a benefits offering that supports health systems’ ability to attract and retain talent while meeting workforce expectations. This category was slowly moving down in ranking as cost containment objectives rose, but health systems have put in more strategies to evaluate and optimize total rewards over the last few years.
  • GLP-1 cost management has shifted in priority. Managing GLP-1 spend for weight loss moved down nine places in ranking—not because the costs are immaterial, but because many health systems have landed on a philosophy in this space. They either cover the medications and implement programs and access rules to manage cost and utilization, or they do not cover them and let employees access medications through other outlets, such as point solutions or direct-to-consumer options.
  • Workforce wellbeing remains a key consideration. Mental health access, health plan satisfaction, and burnout and workforce resiliency complete the top 15—illustrating the breadth of priorities competing for attention alongside cost management and benefits optimization. While it may seem that access to mental health providers is less of a concern to health systems, the reality is that health systems have implemented more emotional wellbeing resources than ever before, and there has been a marked shift in organizational culture to support and de-stigmatize the need for mental health.   

Topics Covered in the Report

The report further illuminates how health systems are addressing these areas:

  • Health plan concerns, strategy, and fiduciary oversight
  • Strategies to manage rising medical and pharmacy benefits costs
  • Strategies to attract and retain talent
  • Benefits implemented to address workforce challenges and needs for a diverse workforce
  • Health plan cost sharing and affordability tactics
  • Strategies to drive domestic utilization
  • Wellbeing strategy and programs
  • Employee experience and engagement strategies
  • Plan costs (national and regional breakout available)
  • Medical and pharmacy plan design and employee contributions (national and regional breakout available)
  • Employee cost share differentials between domestic, in-network (non-domestic) and out-of-network tiers; and in-house and external pharmacy

You may request a complimentary and tailored session with an Aon healthcare industry leader to explore key findings, benchmarking to other health systems in your region, and recommendations specific to your organization.

2026 Benefits Survey of Hospitals

Report

2026 Benefits Survey of Hospitals

If you are interested in receiving the full 2026 report and would like to participate in the 2027 Benefits Survey of Hospitals, please connect with us.

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