<div class="" data-article-body="true"><p class="mb-4 text-lg md:leading-8 break-words">Health insurance premiums in the U.S. significantly increased between 1999 and 2024, <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2025.47462" rel="nofollow noopener" target="_blank" data-ylk="slk:outpacing the rate of worker earnings by three times;elm:context_link;itc:0;sec:content-canvas" class="link ">outpacing the rate of worker earnings by three times</a>, according to our newly published research in the journal JAMA Network Open.</p><p class="mb-4 text-lg md:leading-8 break-words">Premiums can rise if the costs of the medical services they cover increase. Using consumer price indices for the main components of medical care – such as services provided in clinics and hospitals as well as administrative expenses – based on federal data and data from the Kaiser Family Foundation, we found that <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2025.47462" rel="nofollow noopener" target="_blank" data-ylk="slk:the cost of hospital services increased the most;elm:context_link;itc:0;sec:content-canvas" class="link ">the cost of hospital services increased the most</a>, while the cost of physician services and prescription drugs rose more slowly.</p><p class="mb-4 text-lg md:leading-8 break-words">Some of the premium increases can be attributed to an increase in <a href="https://www.healthsystemtracker.org/brief/outpatient-visits-are-increasingly-billed-at-higher-levels-implications-for-health-costs/" rel="nofollow noopener" target="_blank" data-ylk="slk:hospital outpatient visits;elm:context_link;itc:0;sec:content-canvas" class="link ">hospital outpatient visits</a> and <a href="https://www.kff.org/affordable-care-act/annual-family-premiums-for-employer-coverage-rise-6-in-2025-nearing-27000-with-workers-paying-6850-toward-premiums-out-of-their-paychecks/" rel="nofollow noopener" target="_blank" data-ylk="slk:coverage of GLP-1 drugs;elm:context_link;itc:0;sec:content-canvas" class="link ">coverage of GLP-1 drugs</a>. But research, including our own, suggests that premiums have rapidly escalated mostly because <a href="https://doi.org/10.1377/forefront.20240906.397095" rel="nofollow noopener" target="_blank" data-ylk="slk:health system consolidation;elm:context_link;itc:0;sec:content-canvas" class="link ">health system consolidation</a> – when hospitals and other health care entities merge – has led hospitals to raise prices well above their costs.</p><h2 class="mb-4 text-xl font-bold md:text-2xl">Hospital CEOs prioritize profit</h2><p class="mb-4 text-lg md:leading-8 break-words">Hospitals are aggressively raising their prices because <a href="https://doi.org/10.1097/MLR.0000000000002198" rel="nofollow noopener" target="_blank" data-ylk="slk:hospital CEOs have incentives to do so;elm:context_link;itc:0;sec:content-canvas" class="link ">hospital CEOs have incentives to do so</a>.</p><p class="mb-4 text-lg md:leading-8 break-words">One study found that for nonprofit health systems, the greatest pay increases between 2012 and 2019 <a href="https://doi.org/10.1097/MLR.0000000000002198" rel="nofollow noopener" target="_blank" data-ylk="slk:went to hospital CEOs;elm:context_link;itc:0;sec:content-canvas" class="link ">went to hospital CEOs</a> who grew the profits and size of their organizations the most. However, the financial reward of delivering above-average quality of care declined. Increased <a href="https://www.kff.org/health-costs/hospital-charity-care-how-it-works-and-why-it-matters/" rel="nofollow noopener" target="_blank" data-ylk="slk:charity care;elm:context_link;itc:0;sec:content-canvas" class="link ">charity care</a> – free or discounted health services nonprofit hospitals must provide some of their patients who cannot afford medical care – was not significantly tied to CEO compensation.</p><p class="mb-4 text-lg md:leading-8 break-words">Board members set performance criteria that determine the base salary and bonus payments for CEOs. Over half of board members at top U.S. hospitals have <a href="https://doi.org/10.1007/s11606-023-08056-z" rel="nofollow noopener" target="_blank" data-ylk="slk:professional backgrounds in finance or business;elm:context_link;itc:0;sec:content-canvas" class="link ">professional backgrounds in finance or business</a>. As a result, researchers and advocates have raised concerns that financial success is the dominant priority at these institutions.</p><figure class="relative mb-4"><div class="relative"><img alt="Close-up of medical bill and credit cards" loading="lazy" width="960" height="640" decoding="async" data-nimg="1" class="rounded-lg" style="color:transparent" src="https://s.yimg.com/ny/api/res/1.2/TZ2I5sYijTsm0WSV3FXmQA--/YXBwaWQ9aGlnaGxhbmRlcjt3PTk2MDtoPTY0MDtjZj13ZWJw/https://media.zenfs.com/en/the_conversation_us_articles_815/a0394ad3237dedbeb9ce96db7ed6f2ab"><button aria-label="View larger image" class="group absolute bottom-3 right-3 size-10 md:size-[50px] lg:inset-0 lg:size-full lg:bg-transparent" data-ylk="elm:expand;itc:1;sec:image-lightbox;slk:lightbox-open;"><span class="absolute bottom-0 right-0 rounded-full bg-white p-3 opacity-100 shadow-elevation-3 transition-opacity duration-300 group-hover:block group-hover:opacity-100 md:p-[17px] lg:bottom-6 lg:right-6 lg:bg-white/90 lg:p-5 lg:opacity-0 lg:shadow-none"><svg viewbox="0 0 22 22" aria-hidden="true" class="size-4 lg:size-6" width="22" height="22"><path d="M12.372.92c0-.506.41-.916.915-.916L21 0l-.004 7.712a.917.917 0 0 1-1.832 0V3.183l-6.827 6.828-1.349-1.348 6.828-6.828h-4.529a.915.915 0 0 1-.915-.915M1.835 17.816l6.828-6.828 1.349 1.349-6.829 6.827h4.529a.915.915 0 0 1 0 1.831L0 21l.004-7.713a.916.916 0 0 1 1.831 0z"></path></svg></span></button><dialog aria-label="Modal Dialog" aria-modal="true" class="fixed inset-0 z-4 size-full max-h-none max-w-none bg-white hidden"></dialog></div><figcaption class="relative text-sm mt-1 pr-2.5"><div style="max-height:none;overflow:visible">Health care is getting more expensive for everyone. <a href="https://www.gettyimages.com/detail/photo/hospital-bill-royalty-free-image/1036961842" rel="nofollow noopener" target="_blank" data-ylk="slk:DNY59/iStock via Getty Images Plus;elm:context_link;itc:0;sec:content-canvas" class="link ">DNY59/iStock via Getty Images Plus</a></div></figcaption></figure><p class="mb-4 text-lg md:leading-8 break-words">One way to help ensure that nonprofit hospitals make the health of their local communities a top priority is to require their boards to <a href="https://www.sec.gov/answers/execcomp.htm#" rel="nofollow noopener" target="_blank" data-ylk="slk:disclose their executive compensation guidelines;elm:context_link;itc:0;sec:content-canvas" class="link ">disclose their executive compensation guidelines</a> for salary and bonuses, similar to the information that for-profit health care companies disclose to their stockholders. The general public could pressure companies to put greater weight on affordability and quality of care when setting performance targets for nonprofit hospital executives.</p><p class="mb-4 text-lg md:leading-8 break-words">Some economists suggest that <a href="https://www.hamiltonproject.org/publication/policy-proposal/a-proposal-to-cap-provider-prices-and-price-growth-in-the-commercial-health-care-market/" rel="nofollow noopener" target="_blank" data-ylk="slk:hospital prices be regulated;elm:context_link;itc:0;sec:content-canvas" class="link ">hospital prices be regulated</a>. This approach involves capping prices for health care services at the most expensive hospitals and restricting price growth for all hospitals. Regulators would also focus on flexible but service-specific oversight to quickly respond to unintended market disruptions.</p><h2 class="mb-4 text-xl font-bold md:text-2xl">What employers can do</h2><p class="mb-4 text-lg md:leading-8 break-words">Costs for health insurance coverage provided by employers are expected to <a href="https://www.wsj.com/health/healthcare/health-insurance-costs-rise-6cc1b934" rel="nofollow noopener" target="_blank" data-ylk="slk:surge by 9.5% in 2026;elm:context_link;itc:0;sec:content-canvas" class="link ">surge by 9.5% in 2026</a>.</p><p class="mb-4 text-lg md:leading-8 break-words">Employers, who <a href="https://www.kff.org/health-costs/2025-employer-health-benefits-survey/" rel="nofollow noopener" target="_blank" data-ylk="slk:bear the bulk of premium increases;elm:context_link;itc:0;sec:content-canvas" class="link ">bear the bulk of premium increases</a> when purchasing insurance for their workers, could include more price sensitivity when designing benefits for their employees to help keep insurance affordable for workers.</p><p class="mb-4 text-lg md:leading-8 break-words">One study found that a health insurance plan that introduced three copayment levels corresponding to three hospital tiers of low, medium and high prices achieved <a href="https://doi.org/10.1257/app.20180422" rel="nofollow noopener" target="_blank" data-ylk="slk:savings of 8% per hospital stay;elm:context_link;itc:0;sec:content-canvas" class="link ">savings of 8% per hospital stay</a> after three years, with no evidence of a reduction in quality.</p><p class="mb-4 text-lg md:leading-8 break-words">Roughly one-third of large employers are <a href="https://www.healthcarefinancenews.com/news/employers-are-looking-control-healthcare-costs-reducing-benefits" rel="nofollow noopener" target="_blank" data-ylk="slk:offering nontraditional health plans;elm:context_link;itc:0;sec:content-canvas" class="link ">offering nontraditional health plans</a> in 2026. For example, a variable copay plan has no or low deductibles and sets higher copayments for services at providers charging higher fees.</p><h2 class="mb-4 text-xl font-bold md:text-2xl">Holding hospitals to account</h2><p class="mb-4 text-lg md:leading-8 break-words">The mission statements of the largest nonprofit health care systems in the U.S. often <a href="https://theconversation.com/nonprofit-hospitals-have-an-obligation-to-help-their-communities-but-the-people-who-live-nearby-may-see-little-benefit-219897" rel="nofollow noopener" target="_blank" data-ylk="slk:express a desire to;elm:context_link;itc:0;sec:content-canvas" class="link ">express a desire to</a> <a href="https://archive.md/6DewY" rel="nofollow noopener" target="_blank" data-ylk="slk:improve the health of the communities;elm:context_link;itc:0;sec:content-canvas" class="link ">improve the health of the communities</a> they serve, <a href="https://archive.md/4pqHX" rel="nofollow noopener" target="_blank" data-ylk="slk:especially the most vulnerable;elm:context_link;itc:0;sec:content-canvas" class="link ">especially the most vulnerable</a>.</p><p class="mb-4 text-lg md:leading-8 break-words">Restraining price growth among nonprofit hospitals would <a href="https://www.budget.senate.gov/download/101823-dr-dafny-testimony" rel="nofollow noopener" target="_blank" data-ylk="slk:introduce greater price competition;elm:context_link;itc:0;sec:content-canvas" class="link ">introduce greater price competition</a> to the health care market, likely forcing for-profit providers to lower their prices as well.</p><p class="mb-4 text-lg md:leading-8 break-words"><em>This article is republished from <a href="http://theconversation.com/us?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link-0&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:The Conversation;elm:context_link;itc:0;sec:content-canvas" class="link ">The Conversation</a>, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: <a href="https://theconversation.com/profiles/vivian-ho-2541607?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=byline-link&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:Vivian Ho;elm:context_link;itc:0;sec:content-canvas" class="link ">Vivian Ho</a>, <em><a href="https://theconversation.com/institutions/rice-university-931?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=byline-link&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:Rice University;elm:context_link;itc:0;sec:content-canvas" class="link ">Rice University</a></em> and <a href="https://theconversation.com/profiles/salpy-kanimian-2541612?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=byline-link&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:Salpy Kanimian;elm:context_link;itc:0;sec:content-canvas" class="link ">Salpy Kanimian</a>, <em><a href="https://theconversation.com/institutions/rice-university-931?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=byline-link&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:Rice University;elm:context_link;itc:0;sec:content-canvas" class="link ">Rice University</a></em> </em></p><p class="mb-4 text-lg md:leading-8 break-words"><strong>Read more:</strong><br></p><ul class="mb-4"><li class="ml-4 list-disc"><div class=""><p class="mb-4 text-lg md:leading-8 break-words"><a href="http://theconversation.com/nonprofit-hospitals-have-an-obligation-to-help-their-communities-but-the-people-who-live-nearby-may-see-little-benefit-219897?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link0&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:Nonprofit hospitals have an obligation to help their communities, but the people who live nearby may see little benefit;elm:context_link;itc:0;sec:content-canvas" class="link ">Nonprofit hospitals have an obligation to help their communities, but the people who live nearby may see little benefit</a></p></div></li><li class="ml-4 list-disc"><div class=""><p class="mb-4 text-lg md:leading-8 break-words"><a href="http://theconversation.com/doctors-bills-often-come-with-sticker-shock-for-patients-but-health-insurance-could-be-reinvented-to-provide-costs-upfront-243758?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link1&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:Doctor’s bills often come with sticker shock for patients − but health insurance could be reinvented to provide costs upfront;elm:context_link;itc:0;sec:content-canvas" class="link ">Doctor’s bills often come with sticker shock for patients − but health insurance could be reinvented to provide costs upfront</a></p></div></li><li class="ml-4 list-disc"><div class=""><p class="mb-4 text-lg md:leading-8 break-words"><a href="http://theconversation.com/what-are-pharmacy-benefit-managers-a-health-economist-explains-how-lack-of-competition-drives-up-drug-prices-for-everyone-236772?utm_source=Yahoo&amp;utm_medium=related-link&amp;utm_campaign=related-link2&amp;utm_content=article-271450" rel="nofollow noopener" target="_blank" data-ylk="slk:What are pharmacy benefit managers? A health economist explains how lack of competition drives up drug prices for everyone;elm:context_link;itc:0;sec:content-canvas" class="link ">What are pharmacy benefit managers? A health economist explains how lack of competition drives up drug prices for everyone</a></p></div></li></ul><p class="mb-4 text-lg md:leading-8 break-words"><em><span>Vivian Ho has received grant funding from HCSC Affordability Cures Initiative and ArnoldVentures. She is a Fellow at Rice University's Baker Institute for Public Policy </span></em></p><p class="mb-4 text-lg md:leading-8 break-words"><em><span>Salpy Kanimian does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p></div>

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