Self-Funded Plans Face Rising Fiduciary Pressures — and New Opportunities for Accountability
- mriemer5
- Sep 11, 2025
- 2 min read
The 2025 Pulse of the Purchaser Survey confirms what many of us already know: affordability threats are not easing. For the fifth straight year, employers rank drug prices, hospital costs, and high-cost claims as the top drivers of unsustainable healthcare spending
For self-funded plans, these challenges bring heightened fiduciary obligations. According to the survey, Nearly 70% of employers are focused on identifying cost trends and negotiating better contracts, while 65% are prioritizing fiduciary compliance to ensure only reasonable plan expenses are paid.
Yet, confidence remains low: up to 40% of employers report little or no trust in the safeguards provided by TPAs, PBMs, and hospital billing practices.
The survey also makes clear: data access is the game-changer. Employers with full claims access report far higher confidence in fiduciary safeguards and are more likely to adopt advanced strategies such as direct contracting, centers of excellence, reference-based pricing, and precision oncology.
Without transparency and access to THEIR data, plan sponsors risk breaching fiduciary duty under ERISA and the CAA.
At ClaimInformatics, we help self-funded plans:
🔍 Audit claims to uncover errors and hidden fees
⚖️ Reinforce fiduciary compliance with documented oversight
💰 Recover dollars lost to overpayments and opaque contracts
📊 Turn raw claims data into actionable insights for cost and outcome improvement
The survey underscores the urgent call to action: self-funded plan sponsors must demand full access to their data, scrutinize vendor relationships, and document fiduciary oversight. Anything less exposes plans — and their fiduciaries — to unnecessary financial and legal risk.
Bottom line: Transparency isn’t optional anymore. It’s the foundation of fiduciary compliance and sustainable healthcare spend.
Pulse of the Purchaser 2025 Survey Results | National Alliance of Healthcare Purchaser Coalitions. Learn more about the Pulse of the Purchaser 2024 study findings.
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