Tomorrow’s Costs Today

The 9th annual white paper examines a growing trend with significant care delivery and cost implications: utilization and spend differences across generations and genders.

Every two years, the Olympics remind us what disciplined preparation looks like. Elite athletes train for years, in many cases their whole lives, for a few defining moments. They study the course, refine technique, recover from setbacks, and build environments that support peak performance. 

Success is no accident. It is achieved through focus, data, and relentless discipline.

At this year’s Games, skier Lindsey Vonn offered a reminder that resonates far beyond sport: “And similar to ski racing, we take risks in life. We dream. We love. We jump. And sometimes we fall. Sometimes our hearts are broken. Sometimes we don’t achieve the dream we know we could have. But that is also the beauty of life; we can try…. The only failure in life is not trying.”

Elite performance, whether on the slopes or in the workplace, is shaped long before the moment of competition. At our 2026 In-Value-Able Conference, we unveiled Health Action Council’s new white paper, developed in partnership with UnitedHealthcare Group: “Managing Tomorrow’s Costs Today – a Generational and Gender Lens on Workforce Health.” 

The data makes one thing clear: employers are facing a challenge on two fronts. We are managing high healthcare spend driven by Gen X and Boomers, while seeing rapidly rising trends in younger generations. 

Millennials and Gen Z may look healthy on paper, but early chronic disease, behavioral health needs, and fragmented care are accelerating spend sooner than many expected. In Olympic terms, we are seeing athletes enter the course earlier — and hit difficult terrain faster.

The Environment Matters

The white paper highlights important utilization trends. Millennials have the highest emergency room visit rate, the lowest primary care engagement, and account for more than 40 percent of virtual care visits.

Virtual care offers convenience. It removes barriers. It meets people where they are.

But the data shows that virtual care works best when anchored to a primary care relationship. Members who rely on virtual care without engaging a primary care physician have significantly higher per-member-per-month costs at every risk level. The gap widens as risk increases. 

​​​​​Convenience without continuity creates gaps in care that can lead to missed follow-ups, unmanaged conditions, and higher downstream costs.

We also see that men engage with primary care at significantly lower rates than women, beginning at age 18 and continuing into their mid-60s. While women experience a temporary cost spike in their 40s related to breast cancer, men’s catastrophic burden remains consistently higher over time.

These are not individual failures. They are environmental signals. When emergency rooms and episodic virtual visits become the default entry point into care, outcomes worsen, costs accelerate, and employers feel the impact sooner.

No Shortcuts 

Athletes know they can’t skip conditioning, ignore training, or avoid studying the course and expect to perform at their best. 

The same is true in health benefits strategy. We all have to show up. The employers who will succeed in the years ahead are those willing to examine their data, challenge the status quo, and invest in prevention early, even when the workforce appears relatively healthy.

Younger employees may not yet carry significant chronic disease burdens. But without early primary care engagement, preventive screenings, and coordinated care, those costs compound with age. 

The purpose of the white paper is to identify these trends to empower you to take action before costs escalate. This is what an athlete’s mindset to dare greatly looks like in employer health strategy. “Life is too short,” Vonn reminds us. 

Taking action means encouraging primary care relationships rather than relying solely on virtual convenience. It means supporting preventive care and screenings, identifying behavioral health needs earlier, and aligning benefits design with continuity of care. It means helping employees understand where and how to access the right care at the right time.

We cannot control every outcome. But we can shape the environment. Athletes train for years for a moment on the world stage. Employers build benefits strategies that influence years of health outcomes.

As Lindsey Vonn reminds us, the only failure is not trying.

Looking at your data. Challenging utilization patterns. Investing in prevention. Strengthening primary care engagement. These steps require courage. But they also create the conditions for long-term success — for your employees and for your organization.

At Health Action Council, we are committed to helping you build an environment that supports better health outcomes while keeping benefits affordable. We can be everyday athletes, achieving outcomes not by hoping for better results, but by preparing for them.

Download this year’s white paper report that includes targeted engagement strategies: workable action steps to get your team on a winning path.​​​​​​