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Hospital Prices Have Risen Much Faster for Private Insurance Than Medicare Since 2019

Hospitals account for nearly one-third of US health spending and 40% of spending growth from 2022-2024. Analysis shows hospital prices paid by private insurers have risen faster than Medicare rates since 2019, a trend with implications for affordability.

Hospital prices paid by private insurers rose 30% from 2019-2026, compared to a 21% increase in Medicare payment rates. The disparate growth widened an existing gap between what Medicare and private plans pay for hospital services.

What Are the Recent Trends in Employer-Based Health Coverage?

Policy Changes Bring Renewed Focus on High-Deductible Health Plans

Health Insurer Financial Performance in 2024

Examining Short-Term Limited-Duration Health Plans

Health Care Affordability

BTD Health Policy in 2026

Health Policy in 2026

President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”

View all of Drew’s Beyond the Data Columns

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  • How Accessible is Individual Health Insurance for Consumer in Less-Than-Perfect Health?

    Report

    This report documents the findings of a study examining access to health insurance coverage in the individual market for people with health problems. Seven hypothetical consumers with varying health conditions were defined and insurers and HMOs in eight different markets around the country were asked to consider them as though they were real consumers applying for coverage. Report

  • Understanding Individual Health Insurance Markets

    Other Post

    : Structure, Practices, and Products in Ten States New Study of Individual Health Insurance Market: Major Barriers Identified in Individual Health Insurance Market for People with Health Problems. Rates and Regulations Vary Across Ten States Studied Denials, Waiting Periods, and High Premiums Pose Problems for Pre-Medicare Population For Immediate Release Tuesday, March 17, 1998 Washington, DC - For many people who have health problems or who are approaching the age of retirement, coverage through the…

  • How Private Insurers Are Using Telehealth to Respond to the Pandemic

    Issue Brief

    Private insurance plans have taken a variety of steps to expand telemedicine uptake and access during the COVID-19 pandemic. A new issue brief on the Peterson-KFF Health System Tracker examines four actions private insurers have taken to promote telehealth usage among plan enrollees.

  • Cost-Sharing Waivers and Premium Relief by Private Plans in Response to COVID-19 (Nov. 2020 Update)

    Issue Brief

    An updated issue brief estimates the number of enrollees in individual and fully-insured group market plans that have waived cost-sharing – out-of-pocket costs including coinsurance, copayments, and deductibles – for COVID-19 treatment. The analysis also estimates the number of enrollees whose insurer is offering various forms of premium payment relief. The updated analysis finds that, as of November 2020, about half (49%) of fully-insured plan enrollees have coverage that waives cost-sharing for COVID-19 treatment through…

  • What Have Pandemic-Related Job Losses Meant for Health Coverage?

    Policy Watch

    Surprisingly, in comparison to the nearly 9% drop in employment from March to June, early data suggests that employers had kept coverage rates remarkably steady, at least through mid-summer. We find that enrollment in the fully-insured group market dropped by just 1.3% from the end of March through the end of June.

  • President Trump’s Record on Health Care

    Issue Brief

    This issue brief provides a detailed overview of the Trump Administration’s record on health care issues relating to: the Administration’s response to the COVID-19 pandemic, the ACA and private insurance markets, Medicaid, Medicare, reducing prescription drug and other health care costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.

  • From the Federal Response to COVID-19 to Ongoing Efforts to Repeal the ACA and Proposals for Lowering Drug Prices, President Trump Has an Extensive Record on Health Care

    News Release

    Since taking office in 2017, President Trump has laid down an extensive record on health care, including his response to the COVID-19 pandemic, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency. President Trump’s record on health care provides a window into…

  • Is COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned

    Policy Watch

    If the ACA is overturned, federal law protection for people with pre-existing health conditions would end.  This post examines what that could mean for people in the time of COVID-19, including whether and how insurers could deny coverage to people who have had COVID or other pre-existing conditions.