Garner Health

The individual market is entering a difficult cycle and employers will feel the downstream impact. As Dr. Mandy Cohen explains in our latest Margin of Care episode, major price jumps in the individual market are pushing younger and healthier people out of the risk pool. That leaves a sicker population behind, which drives premiums even higher. In some regions, insurers may stop offering individual coverage entirely because they cannot price the risk. And when that market becomes strained, the effects do not stay contained. Mispricing, market exits, and deteriorating risk pools all create additional pressure on employer plans. Employers need to understand these dynamics now, not after the system shifts under them. Watch the full episode with Dr. Mandy Cohen here: https://lnkd.in/eKPXu_dK

We unpack two important topics for employers on the Margin of Care podcast -- strain in the individual market and AI's healthcare cost impact: 1. The individual market is at a critical moment - prices rising; younger, healthier people leaving the risk pool. When the individual market strains, costs shift and employers eventually feel the impact. A functioning individual market matters for the entire system. This is why employers need to be at the table in healthcare policy conversations. 2. There is major upside for AI in healthcare - it has the potential to expand access, reduce clinician burden and support better clinical decisions. BUT - AI is not lowering costs today. Payers and Providers are investing heavily and both want to recoup those investments. This is an arms race, not a cost reduction strategy....and employers need to factor that into their thinking about healthcare costs over the next 3-5 years. Plus -- some lessons learned from leading through the pandemic. Listen to the full convo with Kirk Czonstka on Margin of Care. https://lnkd.in/eRn_cnYW

Many employers assume that improving access to primary care will naturally reduce healthcare costs. But the data tells a more complex story. Garner research shows that access challenges are overstated, and the real driver of cost and outcomes is quality. Join us for The Primary Care Myth, a live webinar breaking down: ✅ What the data actually says about access vs. quality ✅ Why improving outcomes requires focusing on provider performance ✅ How employers can act on these insights to reduce spend and improve care 📅 November 19, 2025 — 12:30 PM PT / 3:30 PM ET 🔗https://lnkd.in/ewwKqw7r

Employers are facing more cost pressure than ever. As Brian Marcotte shared on the latest episode of Margin of Care, vendors that want to earn trust need to do more than talk about ROI — they need to prove it. The easiest way to build that trust is through outcomes-based pricing and de-risked partnerships that only pay when results are delivered. It helps employers justify the investment internally and shows vendors have true confidence in their impact. 🎧 Watch the clip or listen to the full episode: https://lnkd.in/eFigSKyd

Healthcare benefits are evolving, and so are the conversations shaping them. This week, we had the privilege of hosting some of the top consultants in the country for our Strategic Advisors Summit in Park City, Utah. The focus of this event was to bring top minds together to share what's working, challenge assumptions, and build toward smarter solutions. We were honored to welcome a standout group of speakers, including: Dr. Mandy Cohen, Courtney Rodriquez, Steve Reszczynski, SPHR, SHRM SCP, Melanie Fowler, MPH, Andrew Fondow, and Garrett Hohimer — each of whom brought powerful perspective and expertise to the table. And we had some fun exploring Park City, too! Thank you to all who joined us and made this event such a success! If you’re an employer or benefits consultant interested in future Garner events, reach out to us at events@getgarner.com.

Employers have a bigger role to play in protecting their workforce than ever before. Under H.R. 1, new Medicaid work requirements will take effect in 2027. Millions of lower-income and hourly workers could lose coverage if they cannot prove employment or exemption status. Employers can help close that gap. 1.) Offer guidance to employees on Medicaid eligibility 2.) Share necessary employment data to verify work status 3.) Partner with state Medicaid agencies to support verification These steps help maintain access to care for workers who rely on both employer coverage and public programs. In this episode of Margin of Care, Patricia Boozang from Manatt Health explains how employers can prepare now to protect their people later. 🎧 Watch the clip or listen to the full episode: https://lnkd.in/e7e-teyb