Care Navigation as a Benefit: The 2027 Employer Cost Guide

Care navigation as a benefit is a service that helps employees find the right provider, understand their coverage, and reach appropriate care faster — and for 2027 it has become one of the few cost levers that does not simply move the bill onto workers. Employer health costs rose 6.7% in 2026, pushing the average above $18,500 per employee — the largest increase in 15 years (Mercer). In response, most large employers plan to raise what employees pay in 2027. Navigation is the strategy that tries to bend spend by steering people to higher-value care instead of blunt cost-shifting. This guide explains what it is, what the evidence does and does not support, and how to evaluate a partner.

The short version

• Costs are up and employers are shifting the burden. 2026 health-benefit cost growth hit 6.7% (>$18,500/employee); for 2027, two-thirds of large employers plan to raise employee premiums and 48% plan to raise deductibles or copays (Mercer).

• Cost-shifting is not cost management. Raising deductibles moves dollars from the plan to the employee; it does not lower the underlying cost of care, and it can push people to skip needed care.

• Navigation aims at the underlying cost by routing members to higher-quality, appropriate, in-network providers — the single strategy employers rated most promising for improving care quality (82%, Business Group on Health).

• The ROI evidence is real but uneven. The strongest savings figures come from vendors with a commercial interest; independent validation is thinner. Treat vendor ROI claims as vendor-reported and ask for methodology.

• GLP-1s make navigation urgent. With drug costs up ~9% and GLP-1 coverage under pressure, routing members to the right clinical pathway is a more durable lever than dropping clinically indicated therapy.

• Buyers are consolidating. "Point-solution fatigue" is pushing employers to simplify a fragmented benefits ecosystem — a role navigation is positioned to play.

Why 2027 is a cost-shifting year

The 2027 planning cycle is unfolding against the worst affordability backdrop in over a decade. Mercer's national survey of employer-sponsored health plans projects 2026 total health-benefit cost growth of 6.7%, which pushes the average cost above $18,500 per employee — the highest increase in 15 years and the fourth straight year above 6%, after a decade when annual increases hovered near 3% (Mercer; SHRM). The Business Group on Health's survey of large employers similarly projected a roughly 9% cost increase for 2026 before mitigation (Business Group on Health).

Faced with that trend, employers are turning to the most direct lever: shifting cost to employees. In Mercer's survey of 604 U.S. organizations (fielded April–May 2026), two-thirds of large employers said they expect to raise employee premiums through payroll deductions in 2027, and 48% plan changes such as higher deductibles or copays (Mercer; Healthcare Dive).

Here is the problem with that lever, and the reason navigation is getting a second look.

The cost-trend stat block (dated; refresh annually)

• 2026 employer health-benefit cost growth: 6.7%, average cost >$18,500/employee — largest in 15 years (Mercer, 2026).

• 2027 employer intentions: ~two-thirds raise employee premiums; 48% raise deductibles/copays (Mercer, 2026).

• Prescription-drug spending rose ~9.4% for large employers in 2025, a leading driver of the trend (Mercer, 2026).

• Navigation to higher-quality providers was the quality strategy the most employers called promising: 82% (Business Group on Health, 2026).

These figures come from employer surveys and refresh annually; treat them as dated survey data, not permanent facts.

What "care navigation as a benefit" actually means

Care navigation is a benefit that helps a member answer the questions the system makes hard: Which kind of provider do I need? Who is in my network and taking new patients? Is this covered? What will it cost? Where do I go for a second opinion? Depending on the vendor, it may combine some or all of the following:

• Provider search and steerage — matching a member to an appropriate, high-quality, in-network clinician for their need, rather than leaving them to a generic directory.

• Clinical guidance — helping a member understand what a symptom, result, or referral means and what level of care fits, without diagnosing or treating.

• Benefits and cost transparency — explaining coverage, in-network vs. out-of-network implications, and expected cost before care happens.

• Coordination — connecting the member across primary care, specialists, testing, and point solutions so care is not fragmented.

The premise is simple: a large share of avoidable spend comes not from people using too much care, but from people reaching the wrong care — an out-of-network specialist, a duplicative test, an ER visit that a same-day virtual visit could have handled, a delayed diagnosis that becomes an expensive one. Navigation attacks that misrouting. This is the same journey your employees actually experience when they try to find and choose the right healthcare provider or figure out which type of doctor they even need.

Cost-shifting vs. cost management: why the distinction matters

Raising an employee's deductible does something specific: it moves dollars from the plan's ledger to the employee's. It does not change the price of an MRI, the rate a specialist charges, or whether a member ends up in the right setting. The underlying cost of care is unchanged; only who pays first has moved.

That distinction matters for two reasons. First, cost-shifting has a well-documented side effect: when out-of-pocket costs rise, some people defer or skip care — including care that is worth having — which can raise costs later. Second, it does nothing for the affordability problem employers say they are worried about; it relocates it. Mercer's own framing is that employers are "shifting health care costs to employees but also leveraging new approaches to minimize impact" (Mercer) — and navigation to higher-value care is one of those approaches.

The honest way to hold both ideas: cost-shifting is a lever many employers will pull in 2027 because it is fast and predictable. Navigation is a lever aimed at the cost itself, but it is slower, its returns are less certain, and it has to be bought and implemented well. A serious 2027 strategy usually blends the two rather than pretending either is sufficient alone.

What the evidence actually says about navigation ROI

This is where a neutral guide has to be careful, because the buy-side query space is dominated by vendors quoting their own numbers.

What is well-supported: Employers themselves rate provider navigation as their most promising quality strategy — 82% named "navigation to higher-quality providers," tied with greater transparency of quality data (82%) and just ahead of integrated care teams (79%) (Business Group on Health). There is also strong, independent evidence that provider quality varies widely and that steering to higher-quality providers can reduce complications and downstream cost. The mechanism — better routing lowers avoidable spend — is credible and grounded.

What to treat with caution: Specific savings multiples ("we returned 3:1," "we cut spend 15%") most often come from navigation vendors reporting on their own book of business, frequently without independent audit or a matched control group. These are vendor-reported figures, not independent validation, and they belong in a different bucket than survey data or peer-reviewed research. That does not make them false — but a benefits buyer should ask for methodology (control group, baseline, who measured it) before underwriting a decision on them.

The practical takeaway: buy navigation because the routing mechanism is sound and your members demonstrably struggle to reach the right care — not because a vendor deck promises a specific multiple. Then hold the vendor to measurable, pre-agreed outcomes. Being skeptical of unaudited ROI is not being anti-navigation; it is how you buy the good version of it.

The GLP-1 wedge: navigation instead of blunt coverage cuts

Nothing has forced the cost conversation faster than GLP-1 medications. Prescription-drug spending rose about 9.4% for large employers, with GLP-1 utilization a major driver (Mercer). In the Business Group on Health's GLP-1 survey, nearly 8 in 10 employers said GLP-1s are driving up their health-care costs; about 67% cover GLP-1s for weight management, but only 72% of those said they were likely to continue that coverage in 2027, while 10% said they likely would not (Business Group on Health; Fierce Healthcare). The pressure is intensifying now that oral GLP-1s are reaching the market and, in some cases, far lower price points.

Employers face a real dilemma, and there is no cost-free answer. But the choice is not binary between "cover everything" and "drop coverage." The strategies BGH found employers using are largely about appropriate routing: validating clinical eligibility with objective data, requiring participation in a supporting program, and limiting prescribing to appropriate providers (Business Group on Health). Every one of those is a navigation function — getting the right member to the right clinician for a genuine clinical decision, rather than paying for misaligned prescribing or, at the other extreme, cutting a clinically indicated therapy across the board.

The consumer side of this is a question your members are actively asking — which doctor actually prescribes GLP-1s and manages this care. Navigation connects the employer's cost concern to that member's clinical question.

A note on framing: obesity is a chronic medical condition, and coverage decisions carry clinical weight. Nothing here is a recommendation to cover or drop any therapy; those decisions belong to your clinical, benefits, and legal advisors alongside affected employees.

Point-solution fatigue: navigation as consolidation, not another vendor

Over the last decade, employers stacked point solutions — one for diabetes, one for musculoskeletal, one for mental health, one for fertility — each promising outcomes that would pay for themselves. The result, for many, is a fragmented ecosystem that is hard for employees to use and expensive to administer. The Business Group on Health now advises employers to "remove underperforming or duplicative programs and look for opportunities to simplify the ecosystem to reduce fragmentation and administrative costs," with 37% conducting a medical RFP in the survey year (Business Group on Health).

This reframes navigation. Its highest value may not be as another point solution but as the connective layer that makes the rest of the stack usable — the front door that gets a member to the right existing program instead of adding a new one. Evaluated that way, navigation competes not on "add me" but on "I make what you already bought actually get used." That is a stronger buy-side story in a consolidation year, and it is the mirror image of the provider side of the market, where clinicians increasingly compete on being discoverable and chosen by the right patients.

How to evaluate a navigation partner

If you are running a 2027 or 2028 RFP, the following separate a substantive partner from a well-designed deck:

• Measurable, pre-agreed outcomes. Insist on defined metrics (in-network steerage rate, avoidable-ER reduction, time-to-appropriate-care, member utilization) with a baseline and, ideally, a control comparison — not a retrospective self-graded ROI multiple.

• Real provider intelligence. Ask how the partner determines "higher-quality" and "appropriate," and whether steerage reflects genuine quality data or just network status and availability.

• Clinical guardrails. Navigation should guide, not diagnose or treat, and should route to qualified clinicians. Confirm the compliance posture and where the human clinician sits.

• Integration, not addition. Can it connect members to your existing plans and point solutions, or is it a walled garden that deepens fragmentation?

• Member experience and adoption. Savings only accrue if people use it. Ask for real engagement rates, not eligible-lives counts.

• Data and privacy. Understand what member data is used, how it is protected, and who sees it.

• Independent validation. Distinguish vendor-reported results from third-party-audited or peer-reviewed evidence, and weight accordingly.

For members with chronic conditions, also ask how navigation connects to monitoring and ongoing management — the economics of remote patient monitoring and chronic-care coverage increasingly sit inside the same value case.

Where Manifold and Sidewalk fit

Manifold Health builds the preventive-health and navigation layer that this guide describes: identifying elevated risk earlier and connecting members to the right provider and the right pathway before avoidable cost develops. Sidewalk is the member-facing experience — the front door that helps employees understand their health, interpret testing, and reach appropriate functional, integrative, primary, and specialty care. For employers, the value proposition is the one BGH's data points to: route members to higher-value care, make the existing benefits stack usable, and attack avoidable spend at its source rather than shifting it onto workers. This pillar sits alongside our employer's guide to preventive-care ROI, which covers the early-detection side of the same thesis.

Frequently asked questions

What is care navigation as a benefit?
It is an employer-sponsored service that helps employees find the right provider, understand their coverage and costs, and reach appropriate care faster. The goal is to reduce avoidable spend by steering members to higher-quality, in-network, appropriate care rather than leaving them to navigate a fragmented system alone.

Does care navigation actually save money?
The mechanism is well-grounded — provider quality varies, and better routing can lower avoidable costs — and employers rate navigation their most promising quality strategy (82%, Business Group on Health, 2026). But specific savings multiples usually come from vendors reporting on their own results without independent audit. Treat those as vendor-reported and ask for methodology before underwriting a decision.

Is navigation the same as a point solution?
Not necessarily. Many employers now suffer "point-solution fatigue" from too many disconnected programs. Navigation's strongest role is often as a connective layer that helps members use the programs you already offer, rather than as one more standalone vendor.

How does navigation help with GLP-1 costs?
GLP-1s are a top cost driver, and nearly 8 in 10 employers say they raise costs (Business Group on Health, 2026). Navigation supports the appropriate-use strategies employers are adopting — validating clinical eligibility, connecting members to the right prescriber, and coordinating supporting care — instead of relying only on blunt coverage cuts. Coverage decisions themselves remain clinical and benefits-legal choices for your advisors.

Why is 2027 the moment to consider it?
2026 costs rose 6.7% to over $18,500 per employee, and for 2027 two-thirds of large employers plan to raise premiums and 48% plan higher deductibles or copays (Mercer, 2026). Employers are deciding 2027 strategy now, in the planning and RFP window, which makes it the natural moment to weigh navigation against pure cost-shifting.

Isn't cost-shifting simpler?
It is faster and more predictable, which is why many employers will use it. But raising deductibles moves cost to employees without lowering the underlying price of care, and it can lead people to skip needed care. Most durable 2027 strategies blend limited cost-shifting with approaches — like navigation — that target the cost itself.

Key takeaways

• Employer health costs rose 6.7% in 2026 to over $18,500 per employee, the largest increase in 15 years, and most employers plan to shift more cost to workers in 2027.

• Cost-shifting relocates the bill; it does not lower the underlying cost of care and can suppress needed care.

• Care navigation targets the underlying cost by steering members to higher-quality, appropriate care — employers' most-cited promising quality strategy (82%).

• The ROI mechanism is credible, but vendor savings figures are often self-reported; demand pre-agreed, measurable outcomes.

• GLP-1 pressure and point-solution fatigue both strengthen the case for navigation — as appropriate routing and as a consolidating layer, respectively.

For benefits leaders and brokers: See how Manifold and Sidewalk deliver care navigation as a benefit — request an employer demo or the benefits white paper at joinsidewalk.com.

This article is educational business and strategy information for employers and benefits professionals. It is not medical, legal, actuarial, or financial advice, and it does not diagnose, treat, or make coverage recommendations for any individual. Cost and coverage decisions — including those involving GLP-1 medications and obesity care — should be made with your clinical, benefits, legal, and actuarial advisors. Cost figures are dated employer-survey data and refresh annually.

References

• Mercer, US employers and workers face affordability crunch (2026). https://www.mercer.com/en-us/about/newsroom/employers-and-workers-face-affordability-crunch-as-health-insurnace-cost-is-expected-to-exceed-18500-per-employee-in-2026/

• Mercer, Employers are shifting health care costs to employees (2026). https://www.mercer.com/en-us/about/newsroom/employers-are-shifting-healthcare-costs-to-employees/

• Mercer, Highest health benefit cost increase in 15 years (2026). https://www.mercer.com/en-us/insights/us-health-news/employers-prepare-for-the-highest-health-benefit-cost-increase-in-15-years/

• Healthcare Dive, Employers plan to shift more health costs to employees (2026). https://www.healthcaredive.com/news/employers-shift-more-health-costs-on-employees-mercer/822891/

• SHRM, Health Benefit Costs on Pace to Rise 6.7% in 2026 (2026). https://www.shrm.org/topics-tools/news/benefits-compensation/health-benefit-costs-rise-employers

• Business Group on Health, 2026 Employer Health Care Strategy Survey: Executive Summary (2026). https://www.businessgrouphealth.org/resources/2026-employer-health-care-strategy-survey-executive-summary

• Business Group on Health, 2026 Employer Health Care Strategy Survey (2026). https://www.businessgrouphealth.org/newsroom/news-and-press-releases/press-releases/2026-employer-health-care-strategy-survey

• Business Group on Health, GLP-1 Costs Loom Large for Employers (2026). https://www.businessgrouphealth.org/newsroom/news-and-press-releases/press-releases/2026-glp-1-survey

• Fierce Healthcare, Nearly 8 in 10 employers say GLP-1 coverage is spiking benefit costs (2026). https://www.fiercehealthcare.com/finance/nearly-8-10-employers-say-glp-1-coverage-spiking-benefit-costs-business-group-health

Medically and editorially reviewed by the Manifold Health Clinical & Benefits Editorial Review. Published July 12, 2026.