Every year, in every large company, the same conversation takes place. HR presents the benefits renewal numbers. The CFO looks at the year-over-year increase, asks what’s being done to control costs, and the team cycles through the same toolkit: plan design changes, network negotiations, pharmacy carve-outs, high-cost claimant reinsurance.

These are all legitimate strategies. But they’re all reactive. They manage costs after they’re incurred. The question that rarely gets asked in the renewal meeting—but should—is whether there’s a way to change the trajectory of costs before they hit the claims system at all.

A recent multi-employer claims analysis suggests there is. And the metric that tells the story most clearly isn’t total spend, utilization rates, or disease prevalence. It’s medical trend.

Why Medical Trend Is the Metric That Matters Most

Medical trend—the year-over-year change in per-user, per-month healthcare costs—is the number that determines whether your benefits program is getting more or less expensive over time. It’s the compound interest of healthcare spending: a 5% annual trend means your costs double in roughly 14 years, even if nothing else about your population changes.

For the employers in this study, the overall medical trend across all adults was +4.8%. That’s roughly in line with national averages for commercial populations, and it’s the number that drives the annual renewal increase.

But that +4.8% is a blended average that masks dramatically different trajectories within the population.

Employees enrolled in a comprehensive preventive care program saw their medical trend come in at -1.3%—a decrease. Employees who got preventive care through traditional primary care providers saw +6.4%. And employees who didn’t engage in prevention at all? +8.0%.

For a CFO, this information should reshape the conversation about preventive care. It’s not a wellness initiative or an employee satisfaction play. It’s a cost trajectory strategy.

Translating Trend Into Dollars

Let’s make the financial impact concrete. For a self-insured employer with 10,000 covered adults and an average per-user, per-month cost in line with these employers, the difference between a +4.8% trend and a -1.3% trend represents a significant swing in annual healthcare expenditure.

The study expressed all costs in per-user, per-month (PUPM) terms. In Period 2 of the analysis, the comprehensive preventive care cohort’s costs were $42 below the overall employer average on a PUPM basis—an 8% differential. The traditional primary care group was $42 above the average.

On a 10,000-employee basis, a $42 PUPM differential translates to roughly $5 million annually. And because the trend lines are diverging—the preventive care group’s costs are declining while the traditional care group’s costs are rising faster than average—the gap widens every year.

This isn’t a one-time savings. It’s a compounding advantage. A -1.3% trend versus a +4.8% trend means the gap between what you’re spending and what you could be spending grows every single year.

The High-Cost Claimant Multiplier

Medical trend captures the broad cost trajectory, but high-cost claimants are what create the volatility that makes budgeting so difficult. A single surgical admission averaging over $70,000 or a complex medical case exceeding $100,000 can blow up an otherwise well-managed benefits budget.

In this study, the overall high-cost claimant incidence was 9.0 per 1,000 adults. The comprehensive preventive care cohort’s incidence was 44% below that average. For a 10,000-employee population, that’s the difference between roughly 90 high-cost claimants and roughly 50—a reduction of 40 cases, each carrying six-figure price tags.

For CFOs, this is the volatility argument. Preventive care doesn’t just lower the average—it reduces the variance. Fewer high-cost claimants means more predictable budgets, better reinsurance positioning, and fewer of the surprise costs that trigger mid-year reserve adjustments.

ER and Inpatient: Where Prevention Avoids the Most Expensive Care

Emergency room visits and inpatient admissions are the highest per-unit cost categories in most employer health plans. The claims analysis showed the comprehensive preventive care cohort’s ER utilization was 25.6% below the employer adult average, and non-maternity inpatient admissions were 34.7% lower, with inpatient days 46.8% lower.

To put unit costs in perspective: ER visits in this study averaged approximately $2,600 each. Non-maternity inpatient admissions had a weighted mean cost of nearly $34,000, with surgical admissions averaging over $70,800. Even modest percentage reductions in these categories translate to significant dollar savings.

The Bundled Fee Model: Predictable Costs on the Prevention Side Too

One additional financial consideration that CFOs should appreciate: the structured preventive care program in this study operates on a bundled fee model. Employers pay a single, fixed charge per completed visit that covers the full spectrum of preventive services—the physical exam, all lab work, screening procedures, immunizations, and year-round health coaching and navigation.

This means the preventive care investment itself is predictable and transparent. There are no surprise bills, no variable costs based on what the physician decides to order, and no out-of-pocket costs passed to employees. For financial planning purposes, the input cost is fixed and the output—lower trend, fewer high-cost claimants, reduced ER and inpatient utilization—is measurable.

Building the Internal Business Case

If you’re an HR or benefits leader who needs CFO buy-in for a preventive care investment, the data from this study gives you a framework built around the financial metrics that matter most in the C-suite.

• Medical trend: The comprehensive preventive care cohort achieved -1.3% trend versus +4.8% overall. That’s the headline number—it speaks directly to long-term cost trajectory.
• Cost differential: 8% lower costs than the overall adult population and 14% lower than traditional primary care, expressed in PUPM terms that translate cleanly to annual budget impact.
• High-cost claimant reduction: 44% fewer high-cost claimants, addressing the volatility problem that makes healthcare budgeting so difficult.
• Utilization avoidance: 25.6% fewer ER visits and 34.7% fewer inpatient admissions, reducing spend in the highest per-unit cost categories.
• Predictable investment: Bundled fee model with fixed per-visit costs and no hidden charges.

This isn’t a soft ROI story about employee satisfaction or culture. It’s a hard-dollar argument about bending the cost curve—supported by a study of real claims data from real employers with real populations.

From Reactive to Proactive: Changing the Renewal Conversation

The annual renewal meeting doesn’t have to be a conversation about how to absorb another 5% to 8% cost increase. It can be a conversation about how to structurally change the trajectory of your healthcare spend.

Preventive care—delivered with clinical rigor, protocol consistency, bundled economics, and meaningful employee engagement—is one of the few levers available that addresses the root cause of healthcare cost escalation rather than just managing its symptoms.

For CFOs who want to see the trend line change, and for HR leaders who need to make the case that it’s possible, the evidence is here. The question is whether you’re willing to invest in prevention before the next renewal makes the decision for you.

This article draws on findings from a multi-employer, multi-year claims analysis conducted by EHE Health, covering more than 35,000 working-age adults. For the full study methodology and detailed findings, download the complete white paper: “Can Increasing Adult Preventive Care Reduce Costs and Lower Medical Trend?”