New federal transparency requirements are raising important questions about healthcare costs. For HR and Total Rewards leaders, the bigger opportunity may be understanding whether existing benefits are truly meeting the needs of their workforce.
Healthcare spending has become one of the most significant financial pressures facing American employers. Each year, organizations evaluate insurance premiums, prescription drug expenses, utilization trends, wellness programs, and employee benefits in an effort to control costs while remaining competitive.
Yet despite these investments, many employers continue to face rising healthcare expenses, employee health concerns, absenteeism, productivity challenges, and growing demands for better benefits.
A recent federal action adds another dimension to this conversation.
On October 29, 2026, the U.S. Department of Labor announced a final rule requiring pharmacy benefit managers (PBMs) and certain affiliated service providers to disclose compensation and fees to fiduciaries of large, self-insured employer health plans.
The requirements apply to plan years beginning July 1, 2027, or later.
The purpose is to give plan fiduciaries greater visibility into prescription drug spending and the compensation arrangements that influence those costs.
But this development raises a much broader question for employers.
If organizations are being asked to understand where their healthcare dollars are going, shouldn't they also be evaluating whether those dollars are improving the health of the people they employ?
Healthcare Transparency Is Becoming a Business Priority
The Department of Labor's new rule focuses specifically on pharmacy benefit management arrangements. It requires disclosures involving compensation, manufacturer payments, pricing differences, and other financial relationships that can influence prescription drug costs.
For affected employers, greater transparency provides an opportunity to evaluate contracts, question expenses, and negotiate more effectively.
The rule does not require employers to redesign their wellness programs or introduce women's health initiatives. However, it reflects a broader movement toward accountability in employer-sponsored healthcare spending.
And that movement presents an important opportunity for HR, Benefits, and Total Rewards leadership.
Traditionally, benefits evaluations have focused heavily on financial measures: premiums, claims, utilization, and year-over-year spending.
Those numbers matter. But they do not always reveal whether employees understand their benefits, receive appropriate care, or know how to access the resources already available to them.
Healthcare spending and healthcare value are not necessarily the same thing.
An employer can offer an extensive benefits package while employees continue to struggle with unresolved health concerns, fragmented care, and uncertainty about where to turn for help.
This is where a more comprehensive workforce health strategy becomes important.
The Overlooked Healthcare Expense: When Employees Cannot Find the Right Care
Consider an experienced female employee in her late 40s.
She begins experiencing disrupted sleep, fatigue, difficulty concentrating, mood changes, and unexplained weight gain.
She schedules an appointment with her primary care provider. Routine laboratory results are reported as normal. She may be advised to reduce stress, improve her diet, or get more sleep.
But her symptoms continue.
Over time, she may seek additional appointments, request more testing, consult specialists, or begin treatments directed at individual symptoms.
Meanwhile, she is still trying to perform at work, manage responsibilities, and maintain the level of productivity she previously enjoyed.
What may be missing is a comprehensive evaluation that considers the physiological changes occurring during perimenopause and menopause.
Not every symptom in midlife is caused by menopause, and appropriate assessment must consider other medical conditions. However, hormonal changes can influence sleep, mood, metabolic health, and cognitive symptoms, making midlife women's health an important part of the clinical conversation.
Without that connection, care may become fragmented.
For the employer, this can create challenges that extend beyond the cost of individual medical visits. Repeated appointments, ongoing symptoms, missed work, and reduced productivity can all affect the employee experience.
The opportunity is not to discourage healthcare utilization. It is to help employees access appropriate, coordinated care sooner.
Midlife Women's Health Deserves a Place in Benefits Strategy
Women in midlife represent an important segment of the workforce. Many are experienced professionals, managers, healthcare workers, educators, and organizational leaders.
They are also navigating a stage of life associated with meaningful changes in long-term health risks.
The menopause transition is associated with changes in cholesterol levels, body composition, insulin sensitivity, and cardiovascular risk factors. Declining estrogen levels also contribute to accelerated bone loss, while sleep disturbances and mood symptoms can affect daily functioning.
These changes do not occur identically in every woman. Each woman brings a unique combination of genetics, medical history, lifestyle, metabolic health, and individual risk factors.
This is precisely why a one-size-fits-all approach to women's healthcare can fall short.
A meaningful wellness strategy should encourage individualized assessment, evidence-based screening, appropriate treatment, and long-term prevention.
For employers, recognizing these health needs can support better benefits education and more informed decisions about available care.
It can also help organizations identify an area of workforce health that may not be adequately addressed through traditional wellness programming.
Employers May Already Be Paying for Resources Employees Do Not Know How to Use
Many organizations offer valuable resources through their benefits packages.
Employees may have access to preventive care, mental health services, specialty providers, telehealth, disease management programs, health coaching, and other support services.
Yet access alone does not guarantee that employees understand when or how to use these resources.
A woman experiencing persistent fatigue, sleep disruption, and changes in mood may not recognize that these concerns warrant a broader medical evaluation.
She may not know what questions to ask, which providers have relevant expertise, or what services her health plan covers.
Even when appropriate benefits exist, the employee may never fully utilize them.
This creates an opportunity to improve the value of existing healthcare investments through education and care navigation.
Instead of automatically adding another wellness benefit, organizations can begin by asking whether employees understand the resources already available.
Sometimes the greatest opportunity isn't purchasing more benefits. It's helping employees make better use of the benefits they already have.
Five Questions HR and Total Rewards Leaders Should Be Asking
As employers prepare their healthcare and benefits strategies for 2027, several questions deserve consideration.
1. Are We Evaluating Healthcare Outcomes Alongside Healthcare Spending?
Understanding what an organization spends is essential. Understanding whether employees are receiving timely, appropriate care adds another important dimension.
2. Do Our Existing Benefits Address the Health Needs of Women in Midlife?
Benefits leaders should evaluate whether current resources provide meaningful access to education, appropriate clinical evaluation, preventive care, and treatment options.
3. Do Employees Know How to Navigate Their Healthcare Benefits?
Even comprehensive benefits can be underutilized when employees do not understand their options or where to begin.
4. Are Managers Prepared to Recognize and Respond Appropriately to Workplace Health Concerns?
Managers do not need to become healthcare providers. They do need to understand how to support employees, maintain privacy, respond to accommodation requests, and direct individuals toward appropriate resources.
5. Are We Connecting Workforce Health With Retention, Productivity, and Organizational Performance?
Healthcare strategy should not exist independently of broader workforce priorities. Employee health can influence attendance, engagement, performance, and the ability to retain experienced talent.
These questions provide a starting point for a more intentional approach to benefits planning.
A More Strategic Approach to Healthcare Spending
The Department of Labor's new transparency requirements are an important development for the employers and plans they cover. They create additional opportunities to examine pharmacy benefit arrangements and evaluate the reasonableness of associated compensation.
But financial transparency is only one part of understanding healthcare value.
Organizations must also consider the employee experience.
Are employees getting answers to their health concerns? Are they accessing appropriate care? Do they understand their benefits? Are existing programs addressing the health needs of the workforce?
And perhaps most importantly, are employers recognizing opportunities to improve employee health before unresolved concerns become larger personal and organizational challenges?
Midlife women's health offers a meaningful place to begin these conversations.
Education, care navigation, leadership awareness, and evaluation of existing benefits can help organizations develop a more informed workforce health strategy.
These efforts should be measured for their impact rather than assumed to generate savings. Appropriate measures may include employee awareness, benefits navigation, access to care, employee-reported experiences, and relevant workforce outcomes.
The goal is not simply to spend less on healthcare.
The goal is to spend more intentionally while improving the health and well-being of the people those benefits are designed to serve.
Preparing for 2027: An Opportunity for HR and Benefits Leaders
As organizations evaluate their 2027 healthcare investments, now is an important time to examine whether existing strategies are addressing the needs of their workforce.
I work with organizations to connect midlife women's health with employee education, benefits utilization, workforce support, and broader organizational priorities.
Through executive workshops, leadership education, and strategic workforce partnerships, I help employers identify overlooked opportunities and develop practical approaches that support both employees and organizational goals.
For organizations beginning this conversation, a 2026 executive workshop can provide a foundation for understanding the connection between women's health, existing benefits, and workforce performance.
For those ready to move further, 2027 strategic partnerships offer opportunities to implement education, improve awareness of existing resources, and evaluate meaningful outcomes.
Women's health isn't just a healthcare issue. It's a workforce strategy.
If your organization is evaluating healthcare spending, benefits effectiveness, or workforce wellness priorities for 2027, I welcome a conversation about how a more informed approach to midlife women's health could strengthen your strategy.
Marcia Jones, NP
Women's Health & Workforce Strategist
Explore Workplace Women's Health Solutions
Source
U.S. Department of Labor, Employee Benefits Security Administration. Pharmacy Benefit Manager Fee Disclosure Final Rule, October 2026.
Marcia Jones, NP is a women’s health expert, author and speaker with more than 30 years in healthcare. She partners with organizations to bring modern women’s health education into the workplace, helping women protect their health and potential through midlife while helping employers strengthen and retain an experienced female workforce.