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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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  • Millions of Uninsured People Can Get Free ACA Plans

    Policy Watch

    This post estimates that about 5 million uninsured people across the country could get coverage through an Affordable Care Act (ACA) Marketplace health plan with virtually no monthly premium if they enroll during the 2023 open enrollment period, which runs through Jan. 15 in most states.

  • New KFF Analysis Examines Rapidly Evolving Federal Policies For Substance Use Disorder Treatment for the Opioid Epidemic  

    News Release

    A new KFF analysis finds that 24 percent more buprenorphine, a medication to treat opioid use disorder, was dispensed in 2022 than in 2019, the year before the pandemic brought a surge of opioid overdose deaths – and a focus on how to expand access and treatment. This upward trend in buprenorphine distribution, already in motion before the pandemic, continued throughout the COVID public health crisis, suggesting continued improvements in access to treatment even as…

  • Testimony: Wellness Programs and Nondiscrimination Under Employer-Sponsored Group Health Plans

    Issue Brief

    This testimony by the Foundation's Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.

  • Employer-Sponsored Health Insurance 101

    Feature

    This Health Policy 101 chapter explores employer-sponsored health insurance (ESI), the primary health coverage source for U.S. residents under age 65. In addition to detailing ESI requirements and incentives, structure, availability, and costs, the chapter examines ongoing challenges related to affordability and access to care for those with ESI coverage. 

  • Potential Costs of Coronavirus Treatment for People with Employer Coverage

    Issue Brief

    As COVID-19 spreads within the United States, questions have arisen over the potential costs people may face if they become severely ill and need treatment. While many large insurers have agreed to waive copayments and deductibles for COVID-19 tests, people with private insurance who face deductibles could still be on the hook for large treatment costs. A new brief examines the potential cost of COVID-19 treatment to employer health plans and their enrollees by looking…

  • When Cost-Sharing Waivers for COVID-19 Treatment Expire for People with Private Insurance Plans

    Feature

    About 88% – nearly nine in ten – enrollees in the individual and fully-insured group markets are covered by plans that have taken action to limit out-of-pocket costs for patients undergoing treatment for COVID-19 since the start of the pandemic. However, after accounting for waivers that have already expired (20%) or are scheduled to expire by the end of September (16%), just over half of enrollees in these plans will still be eligible for waived…

  • How Unaffordable is Health Care?

    Perspective

    In his latest JAMA Forum column, KFF’s Larry Levitt explores how unaffordable health care is in the U.S. in the context of the debate over extending enhanced Affordable Care Act premium tax credits and an upcoming election where affordability will likely be front and center.