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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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  • Testimony: Wellness Programs and Nondiscrimination Under Employer-Sponsored Group Health Plans

    Issue Brief

    This testimony by the Foundation's Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.

  • Summary of the Affordable Care Act

    Fact Sheet

    This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.

  • 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…

  • Medicaid Spending Growth Per Enrollee Has Been Slower than Growth in Private Health Spending

    Feature

    Medicaid Spending Growth Per Enrollee Has Been Slower than Growth in Private Health Spending Download Source Urban Institute, 2010. Estimates based on data from Medicaid Financial Management Reports (HCFA/CMS Form 64), Medicaid Statistical Information System (MSIS), and KCMU/HMA enrollment data. Expenditures exclude prescription drug spending for dual eligible benficiaries to remove the effect of their transition to Medicare Part D in 2006  

  • Health Insurance Market Reforms: Portability

    Fact Sheet

    Most Americans have access to health insurance through an employer-sponsored health plan, a fact that has made changing or losing a job a complex issue for the purposes of maintaining health insurance. Moving to a new job can be hard if the employer does not offer health insurance, or if the new employer’s health plan is not as generous as the previous employer’s plan. And with limited protections for people with pre-existing conditions, many people…

  • Implementing New Private Health Insurance Market Rules

    Issue Brief

    With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance market reforms, essential health benefits and actuarial value, and wellness programs offered or required by employers under group health plans. These regulations deal with aspects…

  • 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.

  • 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…

  • Health Insurance Market Reforms: Rate Review

    Fact Sheet

    Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the Affordable Care Act (ACA), federal regulators may review rate increases in some cases. This fact sheet explains how rate review works and how the ACA…

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…