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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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  • The Language of Health Care Reform

    Perspective

    Published in the Jan. 19 edition of JAMA, this article from KFF Executive Vice President for Health Policy Larry Levitt lays out the major health policy challenges that will confront President-elect Biden and potential approaches to major reform.While a big reform debate may not be likely this year, one is likely coming as the nation will need to confront much higher costs than in other high-income countries, worse outcomes in many cases, tens of millions…

  • Get Ready for a Lot of Biden Executive Orders on Health Care

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt explores what President-elect Biden might do to advance his health care vision both through legislation and through executive orders and waivers and demonstrations.

  • Health Insurer Financial Performance Through September 2020

    Issue Brief

    In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related care returned in the summer and fall.

  • How Has the Pandemic Affected Health Coverage in the U.S.?

    Policy Watch

    Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces.

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • For 3rd Year in a Row, More Insurers are Entering the ACA Marketplaces, Creating More Options for Consumers

    News Release

    For the third straight year, more insurers are entering the Affordable Care Act’s marketplaces and expanding their service areas, creating more options for consumers seeking to buy their own insurance for 2021, a new KFF analysis finds.  The analysis finds 30 insurers joining the marketplace across 20 states, and another 61 insurers are expanding their services within states that they already served. More than a third of counties (1,207, or 38%) will have more insurers…

  • Insurer Participation on the ACA Marketplaces, 2014-2021

    Issue Brief

    For the third straight year, more insurers are entering the ACA Marketplaces or expanding their service area in 2021, creating more choices for consumers shopping for coverage during the 2021 open enrollment period.

  • 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…