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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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  • Marketplace Enrollees with Unpredictable Incomes Could Face Bigger Penalties Under House Reconciliation Bill Provision

    Issue Brief

    This analysis illustrates how provisions included in the House budget reconciliation bill could expose Marketplace enrollees with unpredictable incomes to higher penalties when filing taxes if they underestimate their incomes. About one in four potential Marketplace shoppers had incomes that varied at least 20 percent from the beginning to the end of the year.

  • 2024 Calculadora del Mercado de Seguros Médicos

    Feature

    2024 Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de su familia para obtener un estimado de…

  • Calculator: ACA Enhanced Premium Tax Credit

    Feature

    The ACA's enhanced premium tax credits expired at the end of 2025. This calculator estimates how much out-of-pocket premium payments would increase for families without the enhanced credits. The projected premium increases are estimated based on family income, zip code, size, ages, and 2026 ACA Marketplace premiums.

  • Lowering the Age of Medicare Eligibility to 60 Could Reduce the Cost of Health Care and Have a Modest Effect on the Number of People Who Are Uninsured

    News Release

    A new KFF analysis shows that lowering the age of Medicare eligibility to 60 could improve the affordability of coverage for people who are already insured and expand coverage to over a million of the nation’s 30 million uninsured. Such a policy could provide a path to Medicare coverage for up to 11.7 million people with employer-based insurance and 2.4 million with private, non-group coverage who are ages 60 to 64, although it is unclear…

  • Marketplace Sign-ups Increased by 21% in 2022

    Feature

    Forty-seven states saw Marketplace enrollment increase, ranging from 1% in Rhode Island to 42% in Texas. In 20 states, enrollment increased by more than 20%.

  • Health Insurer Financial Performance in 2024

    Issue Brief

    This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.

  • Outpatient Visits Are Growing More Complex: Implications for Health Costs

    Issue Brief

    This analysis for the Peterson-KFF Health System Tracker uses claims data from private, large employer-based plan to examine trends in complexity coding across outpatient practice settings from 2004 to 2021. It finds a trend toward higher complexity codes that contributes to higher outpatient spending.

  • How Have Costs Associated With Obesity Changed Over Time?

    Issue Brief

    This analysis finds that, among people with large employer health plans, those with an obesity diagnosis on average have higher total and out-of-pocket spending than those without an obesity diagnosis. It also examines the cost of common surgical and pharmacological treatments for obesity.