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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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  • New Analysis Maps Prevalence of Pre-Existing Conditions by Metro Area

    News Release

    A new Kaiser Family Foundation analysis maps rates of pre-existing conditions across 129 metropolitan and micropolitan areas in the U.S., finding that even within the same state, the prevalence of such conditions can vary substantially. For example, 34 percent of residents of Florence, South Carolina have a pre-existing condition, but further south in Charleston and Hilton Head, the rate is 24 percent. The share of non-elderly adults with a pre-existing condition ranges from 41 percent…

  • Mapping Pre-existing Conditions across the U.S.

    Issue Brief

    This brief estimates the share of adults with pre-existing conditions by metropolitan and micropolitan statistical area (MMSA), and finds that in some areas, nearly four in ten have so-called declinable medical conditions that could lead to denials of individual insurance coverage based on pre-ACA underwriting guidelines.

  • 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.

  • Analysis: For Patients with Large Employer Coverage, About 1 in 6 Hospital Stays Includes an Out-of-Network Bill

    News Release

    A new Kaiser Family Foundation analysis of medical bills from large employer plans finds that a significant share of inpatient hospital admissions includes bills from providers not in the health plan’s networks, generally leaving patients subject to higher cost-sharing and potential additional bills from providers. Almost 18 percent of inpatient admissions result in non-network claims for patients with large employer coverage. Even when enrollees choose in-network facilities, 15 percent of admissions include a bill from…

  • Enrollment in the Individual Insurance Market Continued to Fall in the First Quarter of 2018, With the 12 Percent Overall Decline Concentrated in Off-Exchange Plans

    News Release

    Enrollment in the individual insurance market continued to shrink in the first quarter of 2018, declining by 12 percent compared to the first quarter of 2017, according to a new analysis from the Kaiser Family Foundation. The decline was concentrated in off-exchange plans where enrollees are not eligible for Affordable Care Act subsidies and have had to pay the full cost of recent premium increases. At the same time, enrollment in plans sold through the…

  • Short-Term Limited Duration Plans and HIV

    Issue Brief

    Given the Trump Administration’s promotion of short-term limited-duration (STLD) health insurance policies, this brief examines what they mean for people with HIV. The analysis assesses whether people with HIV could enroll in STLD plans by applying to 38 plans across five states and getting in each case. It also assesses whether such plans could meet basic HIV care and treatment needs for someone diagnosed once enrolled. This finding takes on new importance in light of…