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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…

  • Individual Insurance Market Performance in 2017

    Issue Brief

    This brief examines recently-released annual financial data from 2017 and finds insurers selling individual market plans had their best financially since 2014, when new ACA insurance market rules took effect that guaranteed access to coverage for people with pre-existing conditions. At the same time, recent political and policy changes, including the repeal of the individual mandate penalty as part of tax reform legislation and proposed regulations to expand loosely-regulated short-term insurance plans, cloud plans’ outlook…

  • 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…