A new national survey highlights the growing pressures employers face in managing healthcare spending — pressures Rhode Island businesses know all too well. Conducted by the National Alliance of Healthcare Purchaser Coalitions, the survey of 324 employers across all 50 states finds that rising drug prices, hospital costs, and high-cost claims remain the top threats to affordability.

Employers with full access to claims data are nearly twice as likely to engage in health policy initiatives and implement value-based strategies. The findings reinforce the Rhode Island Business Group on Health’s (RIBGH) call for greater transparency in health spending.

Healthcare costs are increasingly affecting competitiveness. More than half of employers nationwide (53%) report that rising costs limit their ability to compete, up from 35% in 2022. Employers are also shifting away from traditional pharmacy benefit managers toward more transparent models. Larger firms are embracing strategies like centers of excellence, site-of-care redirection, and direct hospital contracting to secure better value — approaches that align with Rhode Island efforts to control hospital overhead and curb rising commercial insurance premiums.

“These findings reinforce what we are experiencing here in Rhode Island,” said RIBGH Executive Director Al Charbonneau. “Employer purchasers cannot remain on the sidelines. With costs rising faster than wages or economic growth, access to claims data and value-based strategies are essential if we are to achieve affordable, high-quality care for our workforce and families.”

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20%+ Premium Hikes? Do Something Different

Rhode Island Business Group on Health is hosting a new session focusing on designs, incentives, and care models that actually lower total spend.

Sponsored by

When: October 21, 2025 | 7:30 - 11:00 a.m.

Where: Crowne Plaza, 801 Greenwich Ave, Warwick, RI, 02886

Program

• Mercer Survey: Learn how employers are preparing for the highest health benefit cost increase in 15 years. Featured speakers: Christine Gomes, Senior Principal at Mercer, and Megan McNiff, Principal at Mercer.
• New Products That Drive Better Choices: Discover new options from ICHRA (Neighborhood Health Plan of RI), ParetoHealth, SimplePay (Aetna), and Surest (United Healthcare.)
• What Primary Care Can Do for Employers: Panel discussion featuring Martin Kerzer, MD, Medical Director RI at Astrana Health, Edward McGookin, MD, MHCDS, FAAP, Chief of Primary Care at Brown University Health - Brown Health Medical Group Primary Care, and Thomas Warcup, DO, MHA, Chief Medical Officer at RI Primary Care Physicians Corp.

Cost

This summit is tailored for benefits leaders, HR executives, employers, purchaser coalitions, brokers, consultants, and policy stakeholders who want to gain a 3-step action plan for 2026 renewals, take home a purchaser checklist to pressure-test proposals, and learn key questions to ask their broker and vendors immediately.

The event is free for members and $40 for non-members.

Sponsorship opportunities are available! Reach out to RIBGH for more information.

New data from the MEPS-IC survey highlights a troubling pattern in family health insurance premiums. Over the past 15 years, premiums have not only risen steadily but have also spiked at increasingly higher levels — with jumps of 9% in 2010, 10% in 2019, and 11% in 2024. Employers are now bracing for another 20% increase in 2026, signaling an unsustainable trend that outpaces both inflation and wage growth.

The impact is felt across the board: employers face shrinking budgets for wages and benefits, while families are burdened with higher payroll deductions and out-of-pocket costs. The data underscores that traditional strategies are no longer enough — reforms in payment models, transparency, and cost alignment are essential to reversing this trajectory.

Rhode Island’s Office of the Health Insurance Commissioner (OHIC) has approved substantial increases in health insurance premiums for 2026, reflecting rising healthcare costs nationwide and state-specific policy changes.

The weighted average rate changes are 21.0% for the individual market, 17.6% for small groups, and 19.3% for large groups, marking some of the steepest hikes in recent history.

Key factors driving the increases include rising unit prices for healthcare services and drugs, higher utilization, and the upcoming expiration of federal Enhanced Premium Tax Credits (EPTCs). The new state-mandated health insurance fee, aimed at funding Medicaid rate increases for primary care and other critical programs, will also add roughly $50 per person annually to premiums.

OHIC’s Measures to Mitigate Increases:

⮞ Rejected all insurer-proposed administrative cost increases beyond inflation

⮞ Encouraged accountability among providers and insurers to manage costs

⮞ Highlighted the impact of EPTC expiration on premiums, particularly for lower-income and older Rhode Islanders

“Premiums in Rhode Island and in many states across the country will rise more significantly next year than they have in recent memory,” said Health Insurance Commissioner Cory King. “To guard against double-digit rate increases becoming the new normal, large health care provider organizations and health insurers need to bear more accountability for managing costs and providing access to affordable health care.”

With these changes, Rhode Islanders should prepare for significant premium increases in 2026, while state officials continue exploring strategies to stabilize costs and improve affordability.

Original reporting by GoLocalProv News Team.

Fueling Biosimilar Adoption: What’s in Your Toolkit?

October 2, 2025 | 2:00-3:00 p.m. (ET)

This complimentary webinar, offered by National Alliance of Healthcare Purchaser Coalitions, explores how to unlock that potential using the new National Alliance Biosimilars Toolkit—which will be revealed prior to the webinar—along with real-world examples of organizations successfully leveraging biosimilars to significantly reduce medical and pharmacy spend—without compromising patient care.

Webinar Speakers:

• Denise Giambalvo, Executive Director, Washington HealthAlliance, Moderator
• Rosa Novo, Administrative Benefits Director, Miami-Dade County Public Schools
• Jonathan Kimball, VP Global Public Affairs, North American Corporate Affairs, Sandoz
• Michael H. Shannon, MD, Medical Director, Ventegra

National Health Observances in October

⭐ Breast Cancer Awareness Month

⭐ National Depression and Mental Health Screening Month

⭐ National Physical Therapy Month

⭐ World Mental Health Day - October 10

⭐ National Mammography Day - October 17

Upcoming Events in Rhode Island

📅 Oct 14: The Providence Center's Circle of Stars Celebration

📅 Oct 15: Rhode Island Cancer Summit in Warwick

📅 Oct 22-24: Pri-Med East Conference at RI Convention Center

📅 Nov 7: Brown University Health Research Day 2025

📅 Nov 13: Rhode Island Word Diabetes Conference 2025 in Warwick

Driving Change in Rhode Island Health Care

Since the 1980s, RIBGH has championed a more affordable and sustainable health care system for Rhode Island employers and their employees.

By advocating for accessible care, influencing policy, fostering collaboration, promoting long-term solutions, and providing leadership statewide, we drive meaningful change in health outcomes and costs.

Your contribution helps us continue shaping a healthier, more sustainable future for Rhode Island.

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