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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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  • ACA Mandate Repeal May Be Less Popular Than GOP Thinks

    From Drew Altman

    In this Axios column, Drew Altman discusses how public opinion seems to flip on eliminating the individual mandate as part of the tax legislation, from for it to against, when the public considers the consequences.

  • Why are Healthcare Prices So High, and What can be Done about Them?

    Event Date:
    Event

    An archived webcast of this forum is now available at www.healthsystemtracker.org . Nearly a fifth of the United States’ economy goes to healthcare spending – a far larger share than in any other large, wealthy country in the world. Research suggests that price, rather than the volume of services, is the main driver of this disparity, and price is also a primary factor in pushing up the nation’s health spending over time. On May 9, 2018,…

  • Analysis: Individual Market Insurers Experienced Their Best Financial Year under the ACA in 2017, Though Subsequent Political and Policy Changes Complicate the Outlook for Future Years

    News Release

    Insurers in 2017 had their best financial year selling individual market health insurance since the Affordable Care Act began requiring guaranteed access to coverage for people with pre-existing conditions in 2014, though recent political and policy changes create new challenges for insurers trying to succeed in this market, new Kaiser Family Foundation analysis finds. This analysis finds insurers posted their strongest performance in the individual market using two different financial indicators: The average share of…

  • Employer Responsibility Under the Affordable Care Act

    Other Post

    The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how…

  • The Cost of the Individual Mandate Penalty for the Remaining Uninsured

    Issue Brief

    This analysis provides estimates of the share of uninsured people eligible to enroll in the Affordable Care Act marketplaces who will be subject to the individual mandate penalty, and how those penalties are increasing for 2016. It also provides estimates of the number of people who could have a zero-dollar contribution or pay less for health insurance than the penalty, due to premium subsidies, and the number of people who would pay more for a…

  • New Kaiser/New York Times Survey Finds One in Five Working-Age Americans With Health Insurance Report Problems Paying Medical Bills

    News Release

    Among the Insured with Medical Bill Problems, 63% Report Using Up Most or All Their Savings and 42% Took on an Extra Job or Worked More Hours Half of People Without Health Insurance Report Problems With Medical Bills, and They Face Similar Financial and Personal Consequences As Those With Insurance Among people with health insurance, one in five (20%) working-age Americans report having problems paying medical bills in the past year that often cause serious…

  • Surprise Medical Bills

    Issue Brief

    This brief explores the problem of "surprise medical bills" -- charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.

  • Employer Family Health Premiums Rise 4 Percent to $17,545 in 2015, Extending a Decade-Long Trend of Relatively Moderate Increases

    News Release

    Since 2010, Deductibles for All Workers Have Risen Almost Three Times as Fast as Premiums and About Seven Times as Fast as Wages and Inflation Facing New Requirements, Few Employers Make Changes to Workers' Hours Menlo Park, Calif. – Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2015 Employer Health Benefits…