What MECC 2026 revealed about the next phase of the medical excess market
By Susan Arsenault, Senior Vice President, Head of Audit Solutions, Davies
The conversations at this year’s Medical Excess Claims Conference (MECC) reinforced just how quickly the medical excess and stop-loss landscape is evolving.
Throughout the conference, attendees explored a wide range of challenges, from the growing impact of high-cost therapies and increasingly sophisticated cost-containment arrangements to operational pressures in claims administration. While the topics varied, a common thread emerged: organizations across the market are struggling with many of the same issues.
In fact, one of the most striking observations from the event was how often attendees recognized their own experiences in those of their peers. A comment frequently heard in the industry is, “You’re the only one asking for that documentation.” Yet one of the clearest messages from this year’s conference was that everyone is asking for it. Whether the topic was claims issues, vendor fees, reimbursement methodologies, or emerging therapies, carriers, reinsurers and MGUs are facing many of the same questions and working through many of the same challenges.
Although many attendees compete in the same markets, the conference showed a strong willingness to share experiences, compare approaches, and support one another. That spirit of collaboration proved essential as discussions moved to some of the most urgent issues confronting the market today.
Cost containment under rising scrutiny
Few topics generated more discussion than cost containment practices and the growing complexity of associated fee structures.
Although attendees clearly recognized the need of vendor-supported cost containment in this industry sector, attendees debated the appropriateness of certain case management fees, and the increasing use of multiple vendors within claims programs. Questions about transparency, consistency, and accountability surfaced repeatedly, showing a broader desire to better understand where value is delivered and how costs are incurred.
There was widespread agreement that greater visibility and stronger governance are becoming increasingly important. As claims costs continue to rise, organizations are taking a closer look at the mechanisms designed to control them.
High-cost therapies continue to reshape the market
The impact of gene therapies, CAR-T treatments, oncology innovations, and other specialty care remains one of the defining challenges facing the industry.
These treatments represent extraordinary advances in patient care, but they also introduce significant financial and operational complexity. Discussions throughout the conference highlighted not only the scale of the claims involved but also the challenges associated with evaluating, managing, and auditing them effectively.
For many organizations, the conversation has moved beyond getting ready for these therapies. They are already part of the claims landscape, and the focus is increasingly on developing sustainable approaches to managing their long-term impact.
Operational excellence matters more than ever
Alongside the headline issues of cost and clinical complexity, many discussions focused on the actual realities of claims administration.
Documentation delays, data-sharing limitations, claim-closure challenges, and the ongoing effects of regulatory processes continue to put pressure on claims operations. While these issues may appear administrative, they directly impact claim outcomes, timelines, and program performance.
As a result, many organizations are placing renewed emphasis on governance, audit processes, and documentation standards to improve consistency and reduce friction throughout the claims lifecycle.
Standardization is still a challenge
Another recurring theme was the significant variation that still exists across the market.
Whether discussing fee reimbursement, vendor management, claim handling protocols, or approaches to emerging therapies, attendees regularly highlighted differences in practice between organizations. The conference’s interactive sessions and roundtable discussions were especially useful in exploring these differences, allowing participants to compare approaches and challenge assumptions in an open and constructive environment.
What was perhaps most notable was the level of alignment on the magnitude of the challenges, even where opinions differed on the solutions. Many of the issues discussed are no longer isolated concerns yet increasingly systemic across the market.
Collaboration will be critical.
If there was one conclusion that emerged from MECC 2026, it is that the industry’s challenges are becoming more and more interconnected.
Over the next 12 months, the market is likely to remain focused on the continued escalation of high-cost claims, increasing scrutiny of cost-containment models and vendor economics, operational challenges related to claims processing and transparency, and the growing role of data and real-world evidence in driving better outcomes and cost control.
Dealing with these issues will require continued collaboration between carriers, reinsurers, MGUs, TPAs, and service partners. No single organization has all the answers, but events such as MECC provide an opportunity to share insights, challenge thinking, and identify practical solutions.
While the agenda tackled some serious industry challenges, the event also provided opportunities for attendees to connect away from the conference room. Conversations continued during a traditional New England lobster bake and Davies’ prohibition-themed speakeasy evening, reinforcing one of the conference’s greatest strengths: bringing people together to learn from one another.
As the conference concluded, one fact was clear: although the challenges facing the medical excess and stop-loss market are significant, they are also widely shared. That collective understanding provides a firm foundation for the collaboration, innovation, and effective problem-solving the industry will need in the years ahead.
On behalf of Davies, I would like to thank all attendees, speakers, and panel participants for contributing to this year’s event. The willingness to share experiences, ask difficult questions, and take part in open discussion is what makes MECC such a valuable forum for the industry.
MECC has become an important part of the Davies Audit Solutions calendar and a highlight of our year. The quality of discussion, the willingness of attendees to share their experiences, and the opportunity to bring together professionals from across the market are what make the event so valuable. We are proud to host it and look forward to continuing the conversation next year.
If you would like to continue the conversation, get in touch with Susan Arsenault, Senior Vice President, Head of Audit Solutions, Davies at Susan.Arsenault@us.davies-group.com
