By Morgan Kendrick, Brand Contributor. for Elevance Health, SOURCE Forbes
Apr 16, 2026
Healthcare costs are rising in part because of assumptions that go unchallenged and are quietly undermining the cost of care.
Employers have adapted to “healthcare trend” being a part of the cost of doing business. It is something to “absorb” and try to offset with higher contributions, higher deductibles or narrower choices. But the biggest driver of rising healthcare costs isn’t trend itself.
Healthcare costs are rising for many reasons, including higher hospital and prescription drug prices, as well as increased demand for care. But one often overlooked driver is how difficult it can be for people to navigate the system. When people are busy, stressed, or unsure of their options, they are more likely to delay care or choose higher-cost settings like the emergency room instead of lower-cost alternatives like urgent care. That is why helping people get the right care at the right time, and making it easier to understand their options, is something employers can help influence.
In other industries, simple, user-friendly experiences are expected. Healthcare should be no different. People want the freedom to engage on their own terms, in ways that are simple and convenient and more like how they shop, bank or order groceries. When healthcare becomes easier to access and understand, people take action earlier instead of waiting, leading to more preventive care, fewer avoidable health crises and better long-term health outcomes.
The real opportunity for employers is moving from reacting to healthcare costs to actively shaping them. Here are five common myths that employers can rethink to make this shift.
Myth 1: Higher price means higher quality.
In many markets, it’s easy to assume the most expensive option is the best one. Employers may even see higher prices for healthcare as a signal of safety: if it costs more, it’s better.
But in healthcare coverage, prices often reflect negotiating leverage and market dynamics more than measurable differences in outcomes. Price variation – sometimes for the same service – is a common feature of U.S. healthcare, and it is one reason lowering the cost of healthcare can feel out of reach.
What to do instead: Treat price as a variable, not a proxy, for clinical value.
For employers, that means partnering with providers and high-quality networks that make it easier for employees to get the right care through simplified access, personalized guidance, and coordinated care. Success should be measured by outcomes and total cost, not by volume of services.
Myth 2: Cost increases are out of employers’ control.
Employers can’t set hospital prices or rewrite federal policy or control what happens in local provider markets.
But it’s a mistake to conclude employers are powerless. The most effective health plan sponsors design their employees’ healthcare experience intentionally, reduce friction, and create clarity at the moments when decisions are made. In practice, that can include offering a single point of entry for care navigation, aligning incentives to steer employees toward high-value providers, and embedding decision support at the point of care selection.
That includes employee decisions like:
- Where should I go for care?
- Why is this care being performed and do I understand the next steps?
- Who can perform this service most efficiently?
- What will it cost?
When employers invest in guidance and navigation, they’re improving the odds that people get the right care at the right time, before a manageable issue becomes a high-cost event. At Elevance Health, this philosophy shows up in investments to make navigation easier through digital tools that help members find care and understand benefits more quickly and confidently. Lower friction supports better care decisions and better care decisions support lower healthcare costs.
Myth 3: Where care is delivered doesn’t matter
Many routine services can be delivered safely in multiple settings. Yet the price can change dramatically depending on where it is billed: a physician office, an ambulatory surgery center, or a hospital outpatient department.
A national analysis of employer health plan claims found that hospital outpatient department prices were consistently higher, in some cases up to five times more expensive than ambulatory surgery centers or physician offices for common outpatient services.
Employees should visit the hospital when they need acute care. But for routine care, employers can help ensure people aren’t directed to the highest-priced setting by default.
To support this:
- Encourage and enable employees to use lower-cost settings when clinically appropriate.
- Design incentives that don’t inadvertently push people toward higher-cost sites.
- Partner with health plans and networks that can actively guide site-of-care decisions.
What to do instead: Provide direction on where to seek care as part of your health benefits communications.
Myth 4: Virtual care cannot significantly lower healthcare costs.
Virtual care is often discussed as a convenience. But convenience can be a cost lever because it shapes behavior.
When people can access care in a way that fits their schedules – on-demand, after hours, from wherever they are – they may be less likely to postpone care until it becomes urgent. They also become more confident navigating the system, which supports more consistent engagement over time.
Virtual care is most effective when it is simple to use, available when people need it, and connected to a broader care pathway, including referrals into primary care, behavioral health, and medication management.
What to do instead: Integrate virtual care into your health benefits and make it easy for employees to access.
This can look like:
- Offering virtual-first for common healthcare needs.
- Using digital guidance to connect people to the right setting.
- Ensuring virtual care improves continuity rather than disrupting it.
Myth 5: More specialized solutions mean better healthcare.
Employers want to help employees across a wide range of needs – diabetes, orthopedic, fertility, mental health, caregiving, weight management, pharmacy and more. The market has responded with an explosion of point solutions.
But when the health benefit ecosystem becomes too fragmented, you can end up with the opposite of what you intended: employees don’t know what to use, when to use it, or how programs connect. Engagement drops and measurements become inconsistent. Vendors compete for attention. And your objective – providing personalized care – gets harder.
What to do instead: Simplify and connect healthcare benefits.
People don’t need fewer resources; they need better operating models:
- Fewer “front doors”
- Clearer guidance
- Securely shared data with trusted care teams
- Accountability for outcomes, not just participation
The leadership takeaway: shift from “managing budgets” to “lowering the cost of care”
Employers don’t lower healthcare costs by shifting them—they lower costs by shaping how decisions get made.
Healthcare costs will always be influenced by factors outside any single employer’s control. But employers have more influence than they think, especially when they treat health benefits like a product for their employees and apply the same discipline they do to other major spends.
The path forward is not just negotiating and cost shifting; it is challenging the assumptions that quietly drive overspending:
- Stop regarding price as quality
- Quit treating trend as destiny
- Start seeing site of care as part of the strategy
- Use convenience to drive engagement
- Simplify the ecosystem so employees can use it
When healthcare is easier to navigate, people engage earlier, get more preventive care and avoid more costly emergencies over time. That’s how employers move from reacting to healthcare costs to actively shaping them.
BRANDVOICE | Paid Program
Morgan Kendrick serves as Executive Vice President and President for Elevance Health’s commercial and specialty business. In this role, he leads the strategic direction, performance, and growth of the commercial business, which serves 33 million members nationwide. He is responsible for national accounts, individual and local group business, and specialty products. With more than 30 years of experience in the healthcare industry, Kendrick brings deep operational and market expertise to his role. He leads with a focus on making healthcare more affordable, improving the experience, and simplifying navigation for customers and consumers. His belief that “all healthcare is local” informs his approach to advancing solutions that reflect the needs of employers, members, and communities across the country. Prior to his current role, he served in numerous leadership positions at Elevance Health and its affiliated health plans, including president of the commercial business West markets (California, Colorado, Indiana, Kentucky, Missouri, Nevada, Ohio, and Wisconsin), president of national accounts, and president and general manager for Anthem Blue Cross and Blue Shield of Georgia. A native Georgian and a graduate of Auburn University, Kendrick is active in his community and serves on the executive board of the Metro Atlanta Chamber and regularly guest-lectures in business courses at his alma mater.
