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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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  • Poll: Most Democrats Prefer a Presidential Candidate Who Wants to Build on the Affordable Care Act

    News Release

    The latest KFF Health Tracking Poll probes Democrats’ views about the general approaches to expanding health coverage and lowering costs put forward by the candidates. Most Democrats and Democratic-leaning independents (55%) say they prefer a candidate who would build on the Affordable Care Act to achieve those goals. Fewer (40%) prefer a candidate who would replace the ACA with a Medicare-for-all plan. Even among those who prefer a candidate who would replace the ACA with…

  • Brief Examines Efforts to Create Health Plan Options that Don’t Comply with the Affordable Care Act’s Rules

    News Release

    Though Congress last year failed to repeal key Affordable Care Act requirements for non-group health insurance that people buy themselves, the Trump Administration and some states are promoting other types of plans through regulatory changes that would allow the sale of products that skirt many of the ACA’s requirements. A new Kaiser Family Foundation brief examines four of those options and the tradeoffs involved if such loosely regulated markets take root as an alternative to…

  • New KFF Resource Tracks Proposed 2019 Marketplace Premiums By State

    News Release

    The Kaiser Family Foundation today launched a tracker to monitor preliminary 2019 premiums in the Affordable Care Act’s marketplaces as insurers file rate information with state regulators. Beginning with data from eight states (Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia and Washington) plus the District of Columbia, the tracker shows preliminary premium information in nine major cities for the lowest-cost bronze plan and “benchmark” silver plan, which is used to determine the size of the…

  • An analysis of out-of-network claims in large employer health plans

    Issue Brief

    A new Kaiser Family Foundation brief examines out-of-network claims in large employer plans, and finds that a significant share of inpatient hospital admissions includes bills from out-of-network providers, often leaving patients exposed to "surprise medical bills" and high out-of-pocket costs. The analysis of part of the Peterson-Kaiser Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.

  • The Numbers Behind “Young Invincibles” and the Affordable Care Act

    Perspective

    As enrollment statistics in the new health insurance marketplaces start to become available, there is a growing focus on whether the enrollment of so-called “young invincibles” will be sufficient to keep insurance markets stable. Enrollment of young adults is important, but not as important as conventional wisdom suggests since premiums are still permitted to vary substantially by age. Because of this, a premium “death spiral” is highly unlikely. Why does the age distribution of enrollees…

  • A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan

    Report

    Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for by health plans. Health plans are required to follow state and federal rules for handling their enrollee’s complaints and appeals inside the health plan, known…

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • California Health Care Chartbook: Key Data and Trends

    Report

    This chartbook provides California and U.S. data and trend analysis on a broad range of health system and financing indicators, including demographics and health status data, insurance coverage and the uninsured, employer health insurance premiums and offer rates, Medicaid and Medicare enrollment and spending, and health care industry trends. Chartbook (.pdf)

  • External Review of Health Plan Decisions: An Overview of Key Program Features in the States and Medicare

    Report

    In 1978, the state of Michigan established a system to call on independent medical experts to help resolve disputes between health plans and patients about the medical necessity and appropriateness of care. Since then, twelve other states and the Medicare program have established similar kinds of external review programs. In the first half of 1998, five more states enacted external review laws (and two states passed laws modifying or expanding existing programs). The term "external…