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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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  • How are Large Private Insurers Covering At-Home Rapid Tests?

    News Release

    Less than a week after a new federal mandate to cover such products took effect, about half of the nation’s largest private insurers allow enrollees to directly obtain rapid at-home COVID-19 tests from specific sources without having to pay anything upfront, a new KFF analysis finds. The new coverage requirement took effect Jan. 15, just five days after the Biden administration released detailed guidance about implementing the new requirements originally announced on Dec. 2.. The…

  • Premiums and Worker Contributions Among Workers Covered by Employer-Sponsored Coverage, 1999-2021

    Interactive

    This graphing tool allows users to explore trends in workplace-sponsored health insurance premiums and worker contributions over time for different categories of employers based on results from the annual Employer Health Benefits Survey. Breakouts are available by firm size, region and industry, as well as for firms with relatively few or many part-time workers, higher- or lower-wage workers, and older or younger workers.

  • Nearly 9 Million Uninsured Americans Could Get Free or Subsidized Health Insurance if the Biden Administration Re-Opens ACA Marketplace Enrollment in Response to COVID-19

    News Release

    Four million uninsured people could get an ACA bronze plan with no premium payment and 4.9 million others could get subsidies to offset the cost of such a plan if the Biden Administration were to re-open ACA marketplace enrollment, a KFF analysis finds. Four million uninsured people could get an ACA bronze plan with no premium payment and 4.9 million others could get subsidies to offset the cost of such a plan if the Biden…

  • Ten Changes to Watch in Open Enrollment 2022

    Issue Brief

    Even as the ninth annual Open Enrollment period gets underway, the Affordable Care Act (ACA) Marketplaces continue to evolve and important changes are expected. This issue brief discusses what changes to watch out for in the coming enrollment period.

  • Analysis of Insurer Participation in 2016 Marketplaces

    Issue Brief

    As Marketplace enrollees begin to shop for coverage starting in 2016, the number of insurance choices available to them is changing in some parts of the country.  In early 2015, an average of 6.1 insurer groups offered coverage in each state, up from an average of 5.0 in 2014.  Since then, some insurers have announced their exit or been required to withdraw from the Marketplaces, most notably a number of nonprofit Consumer Operated and Oriented…

  • The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey

    Report

    To date, there has been little research providing a quantitative look at the causes of medical bill problems and the impacts they have on people’s families, their finances, and their access to health care. To fill this gap, the Kaiser Family Foundation and The New York Times conducted an in-depth survey with 1,204 adults ages 18-64 who report that they or someone in their household had problems paying or an inability to pay medical bills…

  • Patient Cost-Sharing in Marketplace Plans, 2016

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

  • Average Individual Mandate Penalty to Rise 47 Percent to $969 in 2016 for Uninsured People Eligible for ACA Plans

    News Release

     3.5 Million Could Have a Zero-Dollar Premium Contribution or Pay Less for Health Insurance than Penalty Due to Premium Subsidies; 7.1 Million Would Pay More to Get Coverage A new analysis from the Kaiser Family Foundation finds that among uninsured people who are eligible for an Affordable Care Act marketplace plan, the average penalty for remaining without coverage in 2016 would be $969 per household – 47 percent higher than the 2015 estimated average of $661.…