Message From the CEO

As 2026 begins, Tennessee’s healthcare landscape is evolving rapidly. Major investments—such as the $208 million CMS award to strengthen rural health—are driving innovation in healthcare delivery, all while employers continue to face rising healthcare costs and the burden of chronic disease. Amid this evolution, HCTN’s commitment remains the same: delivering the clarity and guidance employers need to inform confident, strategic health benefit decisions.

2025 was extremely successful, and we’re excited to build on that momentum in 2026! Employers can expect timely and impactful engagement opportunities, including working groups on effective primary care, targeted webinars and roundtables focusing on the top healthcare issues, and more opportunities to have their voice heard in the policy arena. As always, HCTN welcomes your input to programming on the issues and challenges that matter most to you!

We’re kicking off the year with two educational offerings: the Value-Based Purchasing of Healthcare course starting today (you can still register HERE), and a session on evidence-based diabetes management on February 5. According to CDC National Diabetes Statistics Reports, about half of US adults (aged 18+) have diabetes or pre-diabetes. Employers don’t want to miss this impactful webinar!

If you haven’t already, please follow us on LinkedIn. We look forward to continuing the conversation and accelerating employer impact in Tennessee—together.

Phil Belcher

Chronic Conditions in the Workplace: Why Effective Primary Care Matters

Effective primary care is central to addressing chronic conditions. Most diabetes, hypertension, and obesity care occur in primary care settings, making it the frontline for prevention, early detection, and ongoing management. Employers know that preventing and managing chronic conditions requires more than simply offering primary care coverage—it requires access to effective primary care.

When primary care is coordinated, accessible and focused on the whole person, it can reduce complications, avoid unnecessary hospital care, and improve health outcomes for employees and dependents. For employers, effective primary care can lower downstream medical costs, improve productivity, and decrease absenteeism.

Recognizing the challenge for employers, HealthCareTN made effective primary care a strategic priority in 2025 and worked with employers and other stakeholders to better understand how this impacts the workforce. In 2026, HCTN will continue to advance this work through more employer-focused webinars, stakeholder collaborations, workgroups and practical solutions designed to help employers strengthen their primary care strategies and better address chronic conditions.

To kick off 2026, we want to hear from you! Be on the lookout for our upcoming survey on primary care. This brief survey will be released on January 26, 2026, and participants will receive a $25 gift card.  

Changing PBM Trends May Require Evaluating Niche Consultants

As the saying goes, “Insanity is doing the same thing over and over and expecting different results.” The PBM industry—marked by double-dealing, lack of transparency, and an anticipated 6.5–8.5% trend in 2026—has prompted employers of all sizes to rethink their PBM relationships.

Over the past few years, HCTN has seen growing interest in niche PBM consultants who often present with less conflicts of interest, focus on target rich formulary management, and bring independent, data-driven insight rather than traditional repricing spreadsheets. Through HCTN Speed Dating and Pharma U programs, HCTN has worked to broaden employer member resources by introducing them to nationally recognized, niche PBM consultants with well-earned reputations. These independent consultants are designed to better align their practice with employer interests.



HCTN has successfully connected several member employers to these PBM consultants, much to the employer’s satisfaction. If you are in a renewal or selection cycle, you may want to consider a different approach. Contact Jeffrey Townsend (jtownsend@hctnonevoice.org) for more information on our niche consultant contacts.

2026: A Pivotal Year for Healthcare

Rising healthcare costs have left employers reeling. High-cost claims—notably specialty drugs billed through medical and escalating hospital prices—are straining budgets. Cost pressures are compounded by persistent quality issues, and utilization of low-value care like wasteful drugs and inappropriate testing remains widespread, raising the question: Will 2026 bring more aggressive employer action?

Paul Keckley, in the Keckley Report, predicts the healthcare system will be forced to “do more with less” in 2026. Policy changes and growing consumer frustration are pushing patients to demand better value. This dynamic is likely to accelerate AI adoption while intensifying conflict among hospitals, insurers, PBMs, and drug manufacturers.

According to Mercer, healthcare inflation may reach a 15-year high in 2026. Costs are projected to rise 6.2% for plans that shift costs or reduce benefits, and 9.2% for plans that maintain the status quo. GLP-1 drugs will drive pharmacy spending, but broader price inflation, consolidation, and lack of transparency will continue to push costs higher.

These challenges are not new, but employer fiduciary pressure is mounting. Join your HCTN employer member peers for our six employer roundtables in 2026 to share lessons learned and learn from peers who are experiencing the same pressures!

The close of 2025 brought an unresolved debate over extending ACA subsidies. While the ACA was originally passed to help control healthcare costs, its legacy has proven complicated. Commercial healthcare costs continue to rise, placing increasing pressure on employers to pull every available lever to manage spend. One lever gaining renewed attention is public policy.

HCTN is committed to educating members on key state and federal healthcare policy issues, while also building meaningful relationships with legislators to ensure employer perspectives are understood and represented in any proposed healthcare legislation. By the end of 2025, HCTN had traveled twice to Washington, DC—alongside longtime employer member Helen Ross McNabb—to engage lawmakers on critical topics including PBM reform, 340B, and hospital price transparency.



As we move into 2026, HCTN will continue educating employer members on the state healthcare legislative agenda and will schedule meetings with Tennessee’s federal delegation to advance the conversations started in 2025. This is a meaningful opportunity to ensure the employer voice is heard on healthcare policy issues that directly impact your organization. HCTN is inviting employer members to join us for these legislative meetings so be on the lookout for invitations in the coming weeks!