Steering Employees to High-Quality Care

Renewal Watch

When every lever that raises employee costs has already been pulled, employers look for ways to lower cost by sending people to better providers. Large employers are moving fast on that idea. A mid-size employer can use it too, with different tools.

Key takeaways

In a 2026 national survey, 58% of employers with 500 or more employees said guiding members to higher-quality care is important or very important, and the strategy moved from fifth place to the top three priorities.
Twelve percent of those large employers plan to offer variable copay plans in 2027, and in a separate survey of 127 large employers, 84% said they would offer at least one center of excellence.
Mid-size employers get most of the value through the carrier’s tiered networks and centers of excellence, plus navigation, not by building programs of their own.

What the surveys say

Two 2026 surveys of large employers point the same way. A national survey reported that steering members to higher-quality care ranked among employers’ top three priorities for the next three to five years, behind managing high-cost claims and measuring program performance, and 12% of large employers plan variable copay plans in 2027, rising to 18% of employers with 20,000 or more employees. A separate survey of 127 large employers found that 84% plan to offer at least one center of excellence in 2027. The savings case is advisory, not proven: consultants describe potential savings from high-performance networks, and the cost is member disruption. We have not seen independent studies that establish a guaranteed figure.

The tools, in plain language

Tiered and high-performance networks: providers are ranked on cost and quality, and members pay less to use the top tier.
Variable copay plans: copays or deductibles drop or disappear when a member chooses a top-performing provider for a specific service.
Centers of excellence: designated facilities for high-cost, high-variation procedures such as joint replacement, bariatric surgery, cancer and transplants. Some employers pay travel.
Advanced primary care and navigation: a care team or advocate who helps people find the right provider before they schedule.

What a 50 to 500 life employer can actually do

Variable copay design and custom centers of excellence are mostly large-employer tools. A mid-size group should start with what its carrier already sells: a tiered network product, the carrier’s own centers of excellence for bariatric, joint, cancer and transplant, and a navigation vendor if the fee is small compared with claims. Before changing networks, ask for a member-disruption report showing how many of your members and which of their doctors would move, and plan the communication before open enrollment. If you are self-funded or level-funded, ask your administrator which steering programs are available without extra cost.

This is also where renewals and quality meet. When a carrier asks for a large increase, steering is one of the few options that does not simply move cost onto employees. Our direct contracting page shows one way we help clients get closer to providers.

Questions we get

Will employees accept a narrower network?

If the savings are shared with them through lower copays and the transition is handled before open enrollment, yes. If they find out when they book an appointment, no.

Does steering reduce cost right away?

Not in the first months. Savings show up as members use the preferred providers, so expect a lag.

Is this the same as a narrow network plan?

Not exactly. A narrow network limits where members can go. Steering rewards members for choosing certain providers but may still allow others.

Sources: 2026 national survey of employer-sponsored health plans (preliminary results, 2026); 2027 large employer health care strategy survey (127 employers, completed June 2026). Survey results describe large employers and may not match a smaller group.

Steering employees to high-quality care: variable copays and centers of excellence