payers

Marcello Bevilacqua

Pharmacy benefit managers (PBMs) have come under a lot of pressure lately. They’re accused of raising drug costs and pushing independent pharmacies toward closure. But how did they get so much power?

PBMs negotiate drug prices on behalf of health plans and pharmaceutical manufacturers. They create formularies, which list which drugs health plans cover and reimburse.

Decades ago, PBMs were independent operators, but now, the biggest ones are vertically integrated with healthcare conglomerates, giving these companies major control over drug prices and reimbursement.

The three largest PBMs are all owned by health insurance companies. OptumRx is owned by UnitedHealth Group, Express Scripts is owned by Cigna, and CVS Caremark is owned by CVS Health, which includes Aetna.

Come along with us to learn more about vertical integration.—CM

      

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Payers

Michael Silvano Photography

The average cost of health benefits is expected to climb 6.7% in 2026, placing cost growth at a 15-year high, according to a national survey of employer-sponsored health plans from Mercer, a global professional services firm.

“The current elevated cost trend, which began in 2023 following a decade of growth averaging only about 3% annually, is putting mounting pressure on benefit budgets and, in some organizations, beginning to affect broader business operations,” the report noted.

And—trust—that’s been stressing CFOs out: A third of finance chiefs Mercer polled in February 2026 ranked healthcare costs as one of their top three opex concerns. Compare that with the 19% who ranked health benefit costs as a top three concern in 2024, and you get a sense of the growing problem.

Dive into strategies for reducing healthcare spend here.—NP

      

Tech

Morning Brew Inc.

You might mistake OpenAI’s upcoming device for an AI-powered speaker at first—it has no screen (cue the Jony Ive jokes), uses a more advanced version of ChatGPT’s Voice mode to interact, and can play music.

But, per Bloomberg, the device’s key feature is its personality, which grows more distinctive and proactive as it learns who you are. Insiders say it’s a “new type of home computer for the AI era,” with “mechanical elements that can move on their own.” The pitch appears to be to turn a chatbot people already treat as a confidant into a physical object that can live on your kitchen counter (hello, Alexa) or go wherever you go—and could cost hundreds of dollars, according to the Information.

Details about the device, which OpenAI reportedly aims to launch in 2027, also conveniently come just days after Apple sued the company for allegedly stealing hardware trade secrets (though sources say the product isn’t similar to anything Apple sells).

Learn more about loneliness tech here.—WK

      

vital signs

Francis Scialabba

Today’s top healthcare reads.

Stat: $48 million. That’s how much UPS plans to invest in temperature-controlled facilities as it hopes to cash in on transportation for critical medicines, like GLP-1s. (CNBC)

Quote: “We envision a future where a heart doctor asks patients if they are seeing their dentist regularly, and whether they are aware their periodontal disease could mean they have a much worse heart situation.”—Wenyuan Shi, CEO of ADA Forsyth Institute, on the push to close the gap between dental and healthcare (the Wall Street Journal)

Read: The Consumer Product Safety Commission wants hospitals to share patients’ identifiable health information. (KFF Health News)

Elevance Health

Behavioral health is shifting from crisis response to prevention. Here’s how value-based care is driving better outcomes—and lower costs.

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