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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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  • Private Insurers Are Expected to Pay a Record of At least $1.3 Billion in Rebates to Consumers Beginning in September for Excessive Premiums Relative to Health Care Expenses

    News Release

    Private insurance companies are expecting to pay out a record of at least $1.3 billion in rebates to consumers this fall based on their share of premium revenues devoted to health care expenses in recent years, surpassing the previous record high of $1.1 billion in 2012, according to a new KFF analysis. Individual market insurers are driving this record year, with expected rebate payments of at least $743.3 million, their highest ever, finds the analysis…

  • Average Annual Premiums for Family Health Benefits Top $15,000 in 2011, Up 9 Percent, Substantially More than the Growth in Worker’s Wages, Benchmark Employer Survey Finds

    News Release

    NEWS RELEASESeptember 27, 2011 Average Annual Premiums for Family Health Benefits Top $15,000 in 2011, Up 9 Percent, Substantially More than the Growth in Worker’s Wages, Benchmark Employer Survey FindsAbout 2.3 Million Young Adults Added to Parents’ Plan As a Result of Health Reform At Small Firms, One in Four Covered Workers Face Annual Deductible of $2,000 or More MENLO PARK, Calif. -- After several years of relatively modest premium increases, annual premiums for employer-sponsored…

  • Update on Individual Health Insurance

    Report

    This report provides information about the individual health insurance market using data from the largest vendor of this type of insurance, eHealthInsurance. The report includes who is buying individual insurance, what they are actually paying for the insurance, and buying patterns. It is the first in an up-coming series of reports jointly produced by the Kaiser Family Foundation and eHealthInsurance to provide trend information in such areas of interest as premiums and cost sharing, and…

  • National Survey of Enrollees in Consumer-Directed Health Plans

    Poll Finding

    This Kaiser survey looks at the views and experiences of people enrolled in consumer-directed health plans as compared to people with traditional health insurance. Consumer-directed plans, which involve high deductibles coupled with tax-preferred saving options that consumers can use to pay for their care out of pocket, are intended to make consumers more active participants in decisions about their health care, including on cost issues. The survey was conducted among 1,389 people, including 272 who…

  • Rate Review: Spotlight on State Efforts to Make Health Insurance More Affordable

    Other Post

    The Patient Protection and Affordable Care Act creates a new federal role to examine “unreasonable increases” in the premiums charged for certain individual and small group health plans. Under the health reform law, the U.S. Department of Health and Human Services (HHS) will work with state insurance departments to conduct an annual review of unreasonable rate increases, and insurers must provide justification for such increases to HHS and to the public via their websites. The…

  • National ACA Marketplace Signups Dipped a Modest 3.7 Percent This Year

    News Release

    Overall ACA marketplace signups for 2018 dropped by 3.7 percent compared to last year’s enrollment period, a new analysis from the Kaiser Family Foundation finds. 11,760,533 people signed up for 2018 health insurance coverage on the ACA individual marketplaces, amid steep reductions in federal funding for outreach and navigators, an enrollment period half as long, and a climate of political uncertainty surrounding the law. The federal government also terminated cost-sharing subsidy payments to insurers in…

  • Understanding Short-Term Limited Duration Health Insurance

    Issue Brief

    In late 2017, President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies. This brief provides background information on short-term policies and how they differ from ACA-compliant health plans. It also analyzes the short-term plans available through two major online brokers to assess how often they include coverage for mental health, substance abuse, prescription drugs and maternity care.

  • Analysis: Cost of Treating Opioid Addiction Rose Rapidly for Large Employers as the Number of Prescriptions Has Declined

    News Release

    A new Kaiser Family Foundation analysis finds that while the use of prescription opioids among people with employer-based health coverage has declined to its lowest levels in over a decade, the cost of treating addiction and overdoses has increased sharply. The annual cost of treating opioid addiction and overdose – stemming from both prescription and illicit use -- has increased by more than eight-fold since 2004, from $0.3 billion dollars to $2.6 billion in 2016.…

  • Proposals for Insurance Options That Don’t Comply with ACA Rules: Trade-offs In Cost and Regulation

    Issue Brief

    This brief examines four options to promote the sale of health plan options in the individual or non-group market that are not subject to Affordable Care Act (ACA) requirements for other major medical health plans. It reviews the trade-offs involved if such loosely regulated markets take root as an alternative to the ACA-regulated market, particularly as the repeal of the individual mandate penalty takes effect next year.