Tackling Hospital Prices to Improve Affordability

Why hospital prices?

Rapidly increasing hospital prices are a primary driver of skyrocketing commercial health insurance costs, worsening the health care affordability crisis nationwide. High and growing health care costs are straining state budgets, burdening local businesses, hindering patient access, and undermining household financial stability as consumers are increasingly forced to choose between paying for health care and meeting other essential needs such as rent or groceries. 

States are building momentum to address excessive hospital prices

To confront this affordability crisis, states across the political spectrum are taking action to rein in excessive hospital prices. Recent and pending state initiatives reflect a growing recognition that tackling hospital prices is a key piece of the affordability puzzle. These efforts demonstrate that states can make meaningful progress using evidence-informed strategies tailored to state policy goals.

State Hospital Pricing Strategies

Explore approaches and state examples to improve affordability and rein in excessive hospital prices.  

The State Hub for Hospital Pricing Strategies refers to hospital “prices” as the contractual rates that commercial insurers pay to hospitals, rather than the list or billed price, unless otherwise indicated. 

Hospital Price Caps icon

Hospital Price Caps

Limits hospital payments to a specified level.

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Hospital Price Growth Caps icon

Hospital Price Growth Caps

Limits how much hospital prices can grow each year.

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Hospital Price Growth Targets icon

Hospital Price Growth Targets

Establishes a public expectation for hospital price growth each year.

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Hospital Global Budgets icon

Hospital Global Budgets

Provides fixed payment amounts to hospitals for a set of defined services.

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Site-Neutral Payments icon

Site-Neutral Payments

Eliminates the price differential for certain outpatient services delivered within hospital-owned settings and other lower-cost settings.

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Facility Fee Bans icon

Facility Fee Bans

Bans additional fees for certain outpatient services delivered within hospital-owned settings.

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Allocation of Savings Generated by Hospital Pricing Policies  icon

Allocation of Savings Generated by Hospital Pricing Policies 

Provides examples of how states can choose to allocate savings produced by hospital pricing strategies.

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State Regulatory Levers for Implementation and Enforcement   icon

State Regulatory Levers for Implementation and Enforcement  

Provides options for state regulatory approaches to implementing and enforcing hospital pricing strategies.

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Need Supporting Resources?

Explore the resources library to learn more about the hospital pricing strategies or sign up to receive Hub updates.