Canada (EN)
Ask any C-Suite executive what’s keeping them awake at night and the cost of healthcare is sure to be near the top of the list. Granted, healthcare costs have been steadily rising for years, but recent forecasts are threatening to wipe out any chance of getting a good night’s sleep.
Major healthcare consultancies are predicting the average total health benefit cost per employee will rise at least 9% in 2026, the largest increase since 2010. Notably, costs have exceeded predictions for three of the last five years, adding to the feeling of dread among employers and employees alike.
Numerous factors are driving this trend. Expensive new technologies and drugs, such as GLP-1s and gene therapies, an aging population and increasing rates of chronic conditions like cancer and cardiovascular issues all contribute to greater healthcare needs and higher costs.
At the same time, employees are struggling to understand the immense and confusing healthcare landscape. In part, this is due to the array of new point solutions employers added to their benefit stack as they rushed to meet urgent workforce needs during the pandemic. Their well-intentioned response unintentionally created an even more complex ecosystem that has employees struggling to navigate six to 10 different apps and portals just to access their full suite of benefits and resources.
According to the 2025 Alight Employee Mindset Study, only 60% of workers say they understand their benefits options and feel confident making choices. As a result, 61% regretted a healthcare decision in the last 12 months, primarily because they jumped into treatment without asking the right questions or took advice from someone who was not a healthcare professional.
This is incredibly concerning for employers, who spend vast amounts of dollars and resources each year on health and wellbeing benefits, only to find employees are not reaping the intended return on their investment. While 85% of workers say they have access to at least one wellbeing program, like mental health apps, nutrition coaching or stress management workshops, average utilization hovers around 30-35%.
While this is disappointing, healthcare is complex and validates the need for employees to have access to personalized assistance, not only with selecting their health benefits, but also with understanding what’s available and using it to their best advantage.
Overcoming complexity
In this challenging environment, healthcare navigation support is a critical employee benefit, as employers seek to help workers overcome this complexity and get the care and guidance they need, while saving money along the way. Navigation services reduce the fog around healthcare costs and benefits and help alleviate the anxiety that employees face when making important medical decisions. These services go beyond providing basic information and include high-tech, human-touch comprehensive support, like provider recommendations, cost estimates, prescription reviews, billing advocacy, program referrals and appointment scheduling assistance.
Say, for example, an employee is experiencing joint pain. They don’t have the time or the inclination to search for which app to use; they simply need relief and guidance. A properly designed navigation solution meets them in the moment, connecting them with the appropriate resources, whether that be a highly qualified specialist or a digital physical therapy program.
This support is delivered through multiple channels ranging from digital to telephonic to video conference, with 23% of workers having electronic access and 28% having face-to-face options via phone or virtual meetings.
While the availability of these services hasn’t grown, usage has increased significantly. Nearly two-thirds (64%) of workers with electronic navigation assistance report using it in 2025, a 12-percentage-point increase from 2024. Similarly, 59% of workers with face-to-face services used them, a five-percentage-point increase. This growing adoption suggests that workers are increasingly valuing the support and guidance provided by personalized navigation services.
Next-level navigation
Much of healthcare navigation is very reactive. That is, employees reach out in search of assistance with obtaining answers and support in their time of need. While some solutions do proactively outreach, their engagement is not ideal.
The future of healthcare navigation will be built around the ability to leverage agentic AI and analytics coupled with the human touch to drive curated and personalized experiences. It will have the ability to analyze claims and other personal data.
For example, if an employee has not yet engaged in an annual well visit, dental cleaning or eye exam, by proactively reaching out to that employee, it will be possible to learn whether it’s simply a matter of procrastination or whether that person has moved and is unaware of what providers are located in their vicinity. In an ideal world, the health navigation system will be able to sync to that person’s calendar, make them aware of open appointments at times when they are available and schedule an appointment for them.
Likewise, if an employee adds a new dependent to their health plan, an AI-driven health navigation system can leverage that information and reach out to ask, “Was that a newborn? Do you need a pediatrician?” Or an employee submitting claims related to childbirth can be asked if they are in need of additional resources for lactation or postpartum, common issues for new mothers.
This kind of proactive, anticipatory approach drives higher utilization of primary care and preventative screenings like mammography or colonoscopy that aid in early identification of something catastrophic, such as cancer. By prompting employees to take the time to invest in their wellbeing, potentially serious health problems can be caught and addressed before they reach the point of escalation, when costs will be significantly higher in the form of expensive treatments and leaves of absence.
The healthcare landscape is vast and confusing, and Mindset data shows that employees are consistent in their desire for assistance from their employer. By providing clear guidance and reliable advice, digital healthcare navigation tools combined with the human touch transform stressful processes into manageable achievable tasks. This not only minimizes cost by reducing unnecessary services, it also improves the overall employee experience. This helps contribute to better health outcomes, as individuals are more likely to engage with and utilize their healthcare benefits appropriately and effectively.
