Monday August 3, 2026
Benefits Survey Insights
How hospitals manage benefit costs differently, where performance can improve, and the actions that matter most
Drawing on Lockton’s annual national employee benefits survey and insights from its work with healthcare organizations nationwide, this analysis compares benefits trends among hospitals and health systems with those of employers across all industries. The findings highlight emerging challenges, evolving workforce expectations, and total rewards strategies that can help ASHHRA members benchmark their offerings, evaluate opportunities for improvement, and support informed benefits planning.
ASHHRA 2026 Hospital and Health System Benefits Survey Insights
EXECUTIVE SUMMARY
Hospitals and health systems bear a tremendous responsibility for caring for patients, training and supporting clinicians and many other professionals, and being pillars of the communities you serve. The vastness of operations also carries wide-ranging pressures that include:
- Mounting margin pressure coupled with heavy capital requirements and debt burdens.
- Reimbursement and payer headwinds.
- Staffing shortages along with diminishing engagement and high turnover.
- Labor and supply cost inflation.
- Regulatory scrutiny and growing risk management requirements.
A critical part of success requires finding a balance between dealing with financial and administrative pressures and having engaged team members who feel supported by the total rewards you offer. While employee benefits are not any organization’s core business, their structure and the way in which they support (or detract from) total rewards has significant impact on employee value perception, which in turn affects engagement, retention and recruitment. When looking at human capital-intensive industries such as healthcare, this linkage can either become a significant enabler for an organization’s goals or become a heavy burden on financials, people goals, and administrative efforts.
Specific to financial impact, hospitals and health systems face many of the same cost pressures specific to employee benefits as other employers, but they manage those pressures through a more controlled operating model. In addition, they face unique challenges that come with being a provider of health services.
Become an ASHHRA member to access the full report.
WEBINAR
Hospital and Health System Benefit Trends and Insights
Tuesday, Aug. 11, 2026 | 1:00 p.m. CT (2:00 p.m. ET)
Based on Lockton’s 2026 national benefits survey and healthcare practice insights, the webinar will explore how hospitals manage benefit costs and engagement differently, where performance can improve, and the actions that matter most.
Learn more
Background
Each year, Lockton conducts a national employee benefit survey of HR leaders to understand the challenges, practices, and trends of benefit plan sponsors across all industries. The survey commonly receives 1,700-1,800 unique responses. This report compares those broad findings against responses from hospitals and health systems (often referred to here as “H&HS” or “hospitals” for brevity). The H&HS sample consists of 80% non-profits/20% for-profits, with 50% over 5,000 employees and 33% over 10,000 employees.
In addition to survey results, this report’s commentary reflects Lockton’s qualitative observations from our work across the U.S. with H&HS. Since healthcare clients consist of over 25% of Lockton’s health and welfare consulting work, the augmented survey findings share information aimed to support your strategy as an ASHHRA member.
The intent of this document is to identify:
- Prevailing benefits dynamics in H&HS vs the broader market, so you can compare where your organization may be lagging or present a case for adoption.
- Strategies available to address your challenges.
- Additional total rewards insights intended to support your planning efforts.
About Lockton
Lockton
supports healthcare organizations in addressing margin pressure, workforce shortages, and operational complexity through benefits and total rewards design. We partner with HR and Finance leaders across hospitals, health systems, senior living, specialty care, and many other critical services to solve issues impacting cost, retention, and culture.
While Lockton is the world’s largest independent, privately held consultancy with over 13,000 global Associates, we devote over 25% of our focus specifically to 1,800 healthcare organizations, supporting them across total rewards (benefits, comp, retirement, TR optimization, leave, HRIS, etc.) and insurance risk management to enable solutions unique to this industry’s workforce and finance pressures.
We recognize that healthcare leaders are navigating unprecedented pressure from soaring labor costs and GLP-1 spend to external margin pressures, fragmented systems, leave complexity, and retention risk. Our approach combines healthcare fluency with execution. We don’t just recommend change—we implement and measure it. From pharmacy coverage modeling and 340B alignment to domestic steerage to workforce segmentation and financial scenarios, our work connects people strategy to business outcomes.
Healthcare organizations often face internal tension between HR, Finance, and Clinical leadership. We help bridge those silos—delivering integrated solutions backed by data, governance frameworks, and measurable results. With in-house experts in pharmacy, leave, actuarial modeling, and care delivery optimization, we act as an extension of your internal team.
We also put our own advice into practice. For 15 consecutive years, Business Insurance magazine has recognized Lockton as a “Best Place to Work in Insurance.” In an environment where Total Rewards strategies are under more pressure than ever, Lockton brings insight, structure, and focus to help HR leaders drive change with confidence.
That expertise has allowed us to produce this report. For questions regarding this survey and its findings, please contact Leo Tokar at leo.tokar@lockton.com or 303-884-4894.