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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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  • Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

    Fact Sheet

    State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states will be necessary to meet implementation timelines—exchanges must be fully operational by January 1, 2014 and the Department of Health and Human Services will begin…

  • Family Health Premiums Rise 4 Percent to Average of $15,745 in 2012, National Benchmark Employer Survey Finds

    News Release

    Menlo Park, Calif. – Annual premiums for employer-sponsored family health coverage reached $15,745 this year, up 4 percent from last year, with workers on average paying $4,316 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2012 Employer Health Benefits Survey released today. This year’s premium increase is moderate by historical standards, but outpaced the growth in workers’ wages (1.7 percent) and general inflation (2.3 percent). Since…

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

    Report

    Related Resources Study Highlights Role of Geography and Plan Shopping Under Medicare Premium Support System Medicare Part D: A First Look at Part D Plan Offerings in 2013 The Medicare Prescription Drug Benefit - An Updated Fact Sheet Online Consumer Guide to Medicare   The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. Medicare's Role and Future Challenges << Previous Visualizing Health…

  • Grandfathering Explained

    Perspective

    The Republican leadership in the House of Representatives recently indicated that it will be seeking to repeal regulations under the Affordable Care Act (ACA) that govern the “grandfathered” status of health plans. As this aspect of the health reform law gets more scrutiny, it may be useful to review some of the specifics of how grandfathering works. The purpose of grandfathering: As provisions of the ACA go into effect, grandfathering provides for a smoother transition by…

  • An Employer Health Benefits Balance Sheet

    Perspective

    There seems to be growing interest in the question of how many employers will keep offering coverage to their full-time employees once the Affordable Care Act (ACA) is fully implemented in 2014, or instead will choose to stop offering coverage and pay a penalty. While there is some good analysis and plenty of conjecture, it is impossible to predict with any certainty how employers will react at this moment because some of the key rules…

  • Peering Into the Black Box of Insurance Rating

    Perspective

    Recently, the New York Times reported that private health insurers continue to seek large premium increases despite seeing lower than expected use of medical care and booking record profits. The story highlights a significant problem for health policy: the lack of good, public information about how health insurers manage health care use and what they pay for medical services. As a nation, we rely on competition among largely private health plans to ensure that health…

  • Who Will be the H&R Block and TurboTax for Health Insurance?

    Perspective

    There's been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as "producers"). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that would exempt agent and broker commissions for health insurance from minimum medical loss ratio (MLR) thresholds established in the health reform law. (The MLR is…

  • Pop Quiz: Assessing Americans’ Familiarity with the Health Care Law

    Perspective

    Based on the December Kaiser Health Tracking Poll, the latest KFF data note explores Americans’ awareness of what the Affordable Care Act (ACA) will do. As the 112th Congress prepared to take office and the discussion of repeal was on the rise, we 'quizzed' Americans on whether they thought a series of ten provisions were included in the new law, ranging from five items that are part of the law (i.e., Medicaid expansion, changes in…

  • Insurance Brokers and the Medical Loss Ratio

    Perspective

    In a close vote, the National Association of Insurance Commissioners (NAIC) recently adopted a resolution urging Congress and the Department of Health and Human Services (HHS) to exempt insurance broker and agent compensation from medical loss ratio (MLR) requirements or otherwise adjust the requirements to ease their effect. HHS last week released its final MLR rule, maintaining its original decision to count broker compensation as an administrative cost for insurers. H.R. 1206, a bill that…

  • What Do They Mean When They Talk About Pre-Existing Health Conditions?

    Perspective

    One health care issue about which the presidential candidates acknowledge they have differences is how the health care system should treat people with pre-existing health conditions. People who have a health condition (such as an illness or pregnancy) or who are at higher than average risk of needing health care are referred to as having a pre-existing health condition. The insurance reform provisions of the Affordable Care Act (ACA), when they take effect in 2014, will…