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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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  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Other Post

    The December 2012 Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. See the full-size infographic at The Journal of the American Medical Association. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). Each month’s infographic is freely available on JAMA’s website and is published in the print edition of the journal.

  • Lower-Income People with Employer Coverage are More Likely to Report Negative Outcomes Due to Insurance Problems Than Their Higher-Income Peers

    News Release

    Lower-income adults with employer coverage are more likely than their higher-income peers to report negative outcomes due to problems using their insurance, a new KFF analysis shows. Drawing on data from the KFF Survey of Consumer Experiences with Health Insurance, the analysis shows that similar shares of lower- and higher-income adults with employer coverage report having common problems with their insurance such as denied claims or prior authorization issues. At the same time, those with lower incomes…

  • Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets

    News Release

    A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured group (employer) markets. In 2021, Medicare Advantage insurers reported gross margins averaging $1,730 per enrollee, at least double the margins reported by insurers in the…

  • KFF News Release

    KFF Survey Shows Complexity, Red Tape, Denials, Confusion Rivals Affordability as a Problem for Insured Consumers, With Some Saying It Caused Them to Go Without or Delay Care

    News Release

    Most (58%) people with health insurance say they encountered at least one problem using their coverage in the past year, with even larger shares of people with the greatest health care needs reporting such problems, finds a new KFF survey of consumer experiences with health insurance. Such problems vary across types of insurance but include such things as denied claims for care they thought was covered, difficulty finding an in-network doctor or other provider, and…

  • Survey of Kentucky Residents on State Health Policy

    Poll Finding

    This survey of Kentucky residents gauges their views on health care policy in the state, including their preferences for the future of the Medicaid expansion and the state-based health insurance marketplace, Kynect. Kentucky has received national attention as the only Southern state to fully embrace the Affordable Care Act, though the state elected a new governor in November 2015 who campaigned on rolling back the Medicaid expansion and ending Kynect.

  • Visualizing Health Policy: Recent Trends in Employer-Sponsored Health Insurance Premiums

    Other Post

    This Visualizing Health Policy infographic charts recent trends in employer-sponsored health insurance premiums. Between 1999 and 2015, premiums increased by 203 percent, outpacing both inflation and workers’ earnings. However, growth of premiums for family coverage slowed toward the end of that time period, from an average of 11 percent a year between 1999 and 2005, to 5 percent between 2005 and 2015. In recent years, deductibles rose faster than both premiums and wages, with the…

  • 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…

  • Contraception X Article: Out-of-Pocket Spending for Oral Contraceptives Among Women with Private Insurance Coverage After the Affordable Care Act

    Issue Brief

    In an article for Contraception X, KFF's Brittni Frederiksen, Matthew Rae, and Alina Salganicoff examine large employer plans to identify which types and brands of oral contraceptive pills have the largest shares of oral contraceptive users with out-of-pocket spending and which oral contraceptives have the highest average annual out-of-pocket costs after the ACA covered contraception under it's preventive services provisions.