The headlines are everywhere: healthcare costs are rising, hospitals are under pressure, and employers are balancing quality care with affordability. But according to healthcare leaders across the industry, the conversation is far more nuanced than many organizations realize. 

During our recent provider panels at Swerve featuring leaders from hospitals and health systems, including Casey Guber of HCA HealthONE Rose, Ed Rafalski of Denver Health and Dan Frank of Craig Hospital, one theme surfaced repeatedly: the math isn’t “mathing.”  

Hospitals are facing rising labor, supply, technology, and pharmaceutical costs while reimbursement rates continue to tighten. At the same time, employers are working to build sustainable benefits strategies that support employees without driving unsustainable spending. 

The result is a structural imbalance: costs continue to rise faster than reimbursement and funding models can support. 

The reality is that healthcare affordability isn’t owned by any one group. Employers, providers, payers, and employees all play a role in improving access, managing costs, and driving better outcomes. 

One of the biggest misconceptions discussed during the panel was the belief that hospitals are operating with large profit margins. 

In reality, many hospitals are under significant financial strain. According to The State of Hospital Financial Health 2026, about 70% of hospitals across the country are under serious financial stress. In some cases, they’re actually losing money on vital services, but they keep them open because people in their communities literally depend on them to survive. 

“We’re not making bank,” one leader admitted. It was a candid moment that really highlighted the struggle. 

Hospitals are navigating rising labor costs, expensive pharmaceuticals, cybersecurity investments, medical technology upgrades, and growing compliance requirements, all while reimbursement rates continue to shrink. 

For organizations like HCA HealthONE Rose and Denver Health, serving large Medicare and Medicaid populations adds another layer of complexity. Panelists discussed how Medicaid reimbursement often does not fully cover the cost of care, requiring providers to offset those services elsewhere. 

Even essential services such as obstetrics are not always major revenue generators, yet hospitals continue to provide them as critical components of community care. 

The panel also highlighted the complexity within the healthcare system itself, where administrative layers and intermediary processes can divert resources without directly improving patient outcomes. 

One of the most important points made was about access, especially for people in rural areas or underserved neighborhoods. 

Financial pressures have already forced some hospitals and specialty services to close or consolidate, creating additional barriers for patients seeking timely treatment. In many regions, employees may only have access to one hospital system or may need to travel significant distances for specialized care. 

For employers, this means that when you’re looking at health plans, “low cost” doesn’t matter much if the network is so small that your team can’t actually use it. 

The panel emphasized the importance of maximizing existing community resources and thoughtfully expanding services rather than duplicating facilities that can unintentionally drive costs higher. 

Several leaders also discussed the rapid growth of freestanding healthcare facilities and outpatient models, predicting continued shifts away from traditional inpatient settings over the next three to five years as healthcare delivery evolves. 

Technology remains both an opportunity and a challenge across healthcare. 

Hospitals continue investing heavily in robotics, advanced surgical equipment, cybersecurity infrastructure, and digital tools designed to improve patient outcomes and operational efficiency. But panelists cautioned that not every new innovation immediately delivers measurable value. 

“There’s pressure to adopt the newest and sexiest technology,” one panelist noted. “But organizations also have to ask whether it’s truly improving care.”  

This creates an ongoing tension between innovation and affordability. Healthcare organizations must balance staying competitive with ensuring that new investments deliver meaningful improvements in patient outcomes or operational efficiency. 

At the same time, examples of operational innovation are already producing results. One system highlighted programs focused on reducing patient length of stay through earlier intervention and more coordinated care. 

For employers and healthcare consumers alike, the takeaway is clear: innovation is essential, but it comes at a cost—and evaluating its impact requires a thoughtful, long-term perspective. 

One of the most practical themes shared during the panel centered on employee education and healthcare navigation. 

Leaders emphasized the importance of helping employees better understand where to seek care. For example, does a minor issue require a 2 a.m. emergency room visit, or could it be addressed through telehealth or urgent care? 

The concept is simple: 
Right place. Right time. Right cost. 

When employees are equipped to make informed decisions, organizations can reduce unnecessary healthcare spending while improving outcomes and overall experience. 

Panelists also highlighted the value of preventive care initiatives, including annual physicals, chronic condition management, family history assessments, genetic testing, and wellness programs designed to keep employees healthier over time. 

Virtual care, preventive exercise programs, and expanded telehealth access were all cited as strategies that can improve accessibility while helping control long-term costs. 

A recurring theme throughout the discussion was the need for longer-term thinking around healthcare spending. 

Investing in prevention doesn’t always show a profit by next quarter. But a healthier workforce means fewer emergency room visits and fewer major health complications down the road. 

Employers were urged to look past the annual insurance renewal and think about what keeps their people healthy for the next decade. 

As one panelist summarized, the goal is helping people seek care in the right location and ideally before healthcare issues become more serious and expensive. 

As healthcare costs continue to rise, panelists agreed that collaboration and transparency between employers, providers, and payers will be critical. 

There is no single solution to controlling healthcare costs. But improving access, educating employees, investing in preventive care, and building thoughtful benefits strategies can help organizations move toward a more sustainable future. 

Because at the center of every healthcare conversation is the same goal: ensuring employees and communities receive the care they need at the right time, in the right place, and at the right cost.