The Big Employer Health Care Decisions for 2026 - with Ellen Kelsay from Business Group on Health

In this episode of The Health Literacy 2.0 Podcast, host Seth Serxner welcomes Ellen Kelsay, President and CEO of the Business Group on Health, for a timely conversation on the findings of the 2026 Employer Health Care Strategy Survey and what they signal for employers heading into the next phase of workforce health strategy.

The survey offers one of the clearest snapshots available of how large employers are responding to accelerating health care costs, mounting pharmacy pressure, and growing concerns about care quality.

As President and CEO of the Business Group on Health, Ellen Kelsay brings more than 30 years of experience in employer-sponsored health care, including senior leadership roles at Mercer and Aetna. Since 2019, she has led the organization’s strategy, advocacy, and research agenda, working directly with self-funded employers as they confront some of the most consequential health care decisions of the past decade.

Drawing directly on the 2026 survey findings, Seth and Ellen explore:

Health care costs at a critical inflection point: Employers reported a 9% increase in health care costs, the highest level in more than a decade, underscoring why cost containment alone is no longer a viable long-term strategy.

A forced reset in health care strategy: The survey shows employers actively reassessing benefit designs and vendor ecosystems, with a growing focus on integration, transparency, and coordination as levers to improve both cost control and care quality.

Shifting from reaction to prevention: Findings point to renewed employer attention on primary care, prevention, and healthy behaviors, alongside careful experimentation with supply-side innovations such as value-based care and alternative health plan models.

Engagement as a make-or-break factor: Survey insights reinforce that even well-designed programs fail without sustained engagement, prompting employers to simplify offerings, improve communications, and clarify shared accountability for outcomes.

Employers as trusted guides: The survey highlights an expanding role for employers as credible sources of health information, particularly as employees navigate misinformation, complex benefits, and rapidly changing care options.

Wellbeing investments under scrutiny, not retreat: Contrary to expectations, the findings show continued and in some cases growing investment in wellbeing initiatives, reflecting their perceived role in addressing downstream cost and productivity challenges.

Health literacy moving to the center of strategy: While not always named explicitly, the survey reinforces the importance of equipping employees to understand benefits, evaluate care options, and make informed decisions, especially as AI accelerates access to health information.

Preparing for longer working lives: The findings also point to the need for employers to adapt health and wellbeing strategies to support an aging workforce with evolving needs across longer career spans.

Ellen and Seth discuss why the 2026 Employer Health Care Strategy Survey is becoming a practical guide for employers navigating rising costs, limited options, and growing complexity.

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