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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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  • 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…

  • Remember the People Outside of the Exchanges

    Perspective

    There has been a substantial amount of focus on the recently released draft regulations governing state-based health insurance exchanges under the Affordable Care Act (ACA). And that's appropriate, since the exchanges have the important roles under reform of providing consumers with easier access to insurance and facilitating tax credits and cost-sharing subsidies that make coverage more affordable. But, as central as exchanges will likely be, it's important to remember that there are other key provisions that help…

  • Insurance Coverage of Contraceptives

    Perspective

    In this post, we answer some of the key questions about the new contraceptive coverage policy generally, and more specifically, how it will be applied to religious organizations.

  • A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan

    Report

    Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for by health plans. Health plans are required to follow state and federal rules for handling their enrollee’s complaints and appeals inside the health plan, known…

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • California Health Care Chartbook: Key Data and Trends

    Report

    This chartbook provides California and U.S. data and trend analysis on a broad range of health system and financing indicators, including demographics and health status data, insurance coverage and the uninsured, employer health insurance premiums and offer rates, Medicaid and Medicare enrollment and spending, and health care industry trends. Chartbook (.pdf)

  • External Review of Health Plan Decisions: An Overview of Key Program Features in the States and Medicare

    Report

    In 1978, the state of Michigan established a system to call on independent medical experts to help resolve disputes between health plans and patients about the medical necessity and appropriateness of care. Since then, twelve other states and the Medicare program have established similar kinds of external review programs. In the first half of 1998, five more states enacted external review laws (and two states passed laws modifying or expanding existing programs). The term "external…

  • Explaining Health Care Reform: Medical Loss Ratio (MLR)

    Fact Sheet

    This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and…

  • Employer-Sponsored Family Health Premiums Rise a Modest 4 Percent in 2013, National Benchmark Employer Survey Finds

    News Release

    Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2013 Employer Health Benefits Survey. This year's rise in premiums remains moderate by historical standards. The 15th annual Kaiser/HRET survey of more than 2,000 small and large employers provides a detailed picture of the status…