Updated Health Care Trend Projections

Summarizes findings comparing 2024 health care and pharmacy trend projections from the summer of 2023 against projections at the end of 2023.


February 15, 2024

Health care costs for 2024 continue to be a concern for employers, as forecasts are generally worsening over the past 6 months. Driven by higher than expected medical and pharmacy costs, employers are taking a wide array of actions to mitigate increases.

2024 Trend Projections (After Plan Design Changes)

Employers projected: 6% increase for health care trend in summer 2023. 44% have since increased health care trend projections (46% reported projections have remained unchanged. Employers projected: 8.8% increase for pharmacy trend in summer 2023. 41% have since increased pharmacy trend projections. 50% reported projections remined unchanged.

Sources: 2024 Large Employer Health Care Strategy Survey and Updated Health Care Trend Projections Survey.

The increases in health care trend were about 1-percentage point higher than reported in the summer of 2023.

What factors do you attribute to your higher than original projections for health care trend before plan design changes?

71% Increased prescribing of GLP-1s. 67% Medical inflation/higher than expected cost per services rendered. 54% Higher than expected pharmacy cost inflation. 54% Higher utilization of medical services. 29% Higher than expected pharmacy utilization other than GLP-1s

Top Tactics Employers Are Using to Mitigate Cost Increases


Implement initiatives to improve health and well-being, including preventive care


Negotiate higher rebates/discounts


Improve navigation to quality care


Change (or add additional) health and well-being vendors or make changes to contracts


Implement more aggressive utilization management


Change PBM or make changes to existing contract


Hold vendors accountable for cost and health outcomes


Change TPAs or make changes to existing contracts

About the Updated Health Care Trend Projections Survey

Fifty-four employers responded to this survey, conducted between November 29, 2023 and December 13, 2023. This survey examines how health care trend projections have changed since the summer.

Updated Health Care Trend Projections

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