Health
Health care costs up to 300% higher for privately insured patients than those with Medicare, report reveals
Most Americans — more than 65% — have private health insurance, but a new report has revealed a potentially very expensive drawback.
Patients who have private (commercial) coverage may end up paying significantly more for their medical care compared to those who have public health insurance, such as Medicare, according to recent data from RAND Corp. in Washington, D.C.
As of 2022, employers and private insurance companies paid an average of 254% more for medical services than what Medicare programs would have paid.
HEALTH CARE COSTS UP TO 300% HIGHER FOR PRIVATELY INSURED PATIENTS THAN THOSE WITH MEDICARE
Several states — California, Florida, Georgia, New York, South Carolina, West Virginia, and Wisconsin — had medical costs that were more than 300% higher than Medicare prices, the report stated.
The researchers analyzed medical claims data from a “large population” of privately insured patients who were treated at over 4,000 hospitals across the country between 2020 and 2022.
Patients who have private coverage may end up paying significantly more for their medical care compared to those who have public health insurance, such as Medicare. (iStock)
The report also included the names and prices of each hospital.
“Calculating 4,000-plus U.S. hospitals’ overall relative prices has never been done before this study, because it’s so difficult to collect the requisite data and to get permissions to publish the hospital and health system names associated with each relative price,” said Brian Briscombe, a health care analyst at RAND and one of the study authors, to Fox News Digital.
AS CHOLERA CASES RISE WORLDWIDE, HEALTH OFFICIALS SOUND ‘CONCERNING’ ALARM ABOUT VACCINE SHORTAGES
“This is real price transparency — naming the hospitals and presenting their overall relative prices in a way that anyone could understand.”
The report gives employers a tool they can use to become “better-informed purchasers” of health care services, Peter Hussey, director of RAND Health Care in Santa Monica, California, noted in a news release.
“Hospitals account for the largest share of health care spending in the U.S., so this report also provides valuable information that may aid policymakers interested in curbing health care costs,” Hussey also said in the release.
The researchers analyzed medical claims data from a “large population” of privately insured patients who were treated at more than 4,000 hospitals across the country between 2020 and 2022. (iStock)
The wide variance of prices across hospitals is the most important takeaway, according to Briscombe.
“Within a single city, you can find a hospital that (on average across all its services) charges privately insured patients about twice as much as Medicare charges for those same services — but down the street, another hospital charges three times what Medicare charges,” he told Fox News Digital.
The difference in prices cannot be explained by differences in quality, he added.
“This is real price transparency — naming the hospitals and presenting their overall relative prices in a way that anyone could understand.”
Dr. Brett Osborn, a Florida neurologist and longevity expert, was not involved in the RAND study but said the findings are “concerning.”
“Hospitals bill private insurers multiples of the Medicare allowable,” he told Fox News Digital.
“The elevated costs are passed onto patients, resulting in higher premiums and out-of-pocket expenses.”
As of 2022, employers and private insurance companies paid an average of 254% more for medical services than what Medicare programs would have paid, according to a new study. (iStock)
And these costs are on the rise, Osborn warned.
“People accept job offers because the employer offers health insurance — otherwise, for many, the premiums would be unaffordable,” he added.
Osborn emphasized the significant price variations among states.
SOME PATIENTS WHO SEE FEMALE DOCTORS COULD LIVE LONGER, STUDY SUGGESTS: ‘HIGHER EMPATHY’
“Hospitals in some states charge less than 200% of Medicare rates, while others exceed 300%,” he said.
“Due to its size, Medicare can negotiate lower payments — but private insurers lack this leverage.”
“This discrepancy is due to some hospitals’ market power, making it hard for employers to avoid them. Due to its size, Medicare can negotiate lower payments — but private insurers lack this leverage.”
The doctor also called for greater price transparency from hospitals.
The new report published the names and pricing models of more than 4,000 U.S. hospitals. (iStock)
“Despite a federal rule for price transparency, only 24.5% of hospitals comply — highlighting the need for informed health care purchasing and policy changes to manage costs,” he said.
“The system is fundamentally flawed, designed to profit from illness rather than promote health,” Osborn continued.
“It clearly favors hospital systems, not the patients, reinforcing the harsh reality: There is money in the sick.”
HEALTH CARE IS ‘OVERWHELMINGLY COMPLEX’ FOR OLDER ADULTS, EXPERTS SAY: ‘EVER-INCREASING HURDLE’
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said the issue of price variations is complex.
“Sometimes these are hidden costs, and sometimes hospitals and other health organizations know they can get away with charging private insurers more while obscuring prices from both the insurer and the patient to help compensate for the shrinking reimbursements from public insurances,” Siegel told Fox News Digital.
“At the same time, more out-of-pocket costs are transferred to the consumer in terms of copays and deductibles, as middlemen take the profits.”
“The system is fundamentally flawed, designed to profit from illness rather than promote health.”
With the lack of price transparency, there is no way to introduce competition, Siegel said, as the true costs and prices are hidden.
The study did have some limitations, the researchers acknowledged.
CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER
“We didn’t have sufficient claims data to publish all U.S. hospitals’ relative prices,” Briscombe told Fox News Digital.
“Some states in the U.S. don’t have All Payor Claims Databases (APCDs), so we have to collect claims from one data contributor at a time – usually from employers that operate in that location and whose employees and dependents use those hospitals.”
“Despite a federal rule for price transparency, only 24.5% of hospitals comply, highlighting the need for informed health care purchasing and policy changes to manage costs,” according to a doctor who spoke with Fox News Digital. (iStock)
Overall, he said, the researchers had a “sufficiently large sample of data” to estimate the overall relative price of each hospital and health system included in the report, Briscombe said, “but it would be nice to have even more claims data in order to publish the relative prices for all U.S. hospitals.”
Fox News Digital reached out to the Centers for Medicare & Medicaid Services and the American Hospital Association requesting comment.
For more Health articles, visit www.foxnews.com/health.
NEWYou can now listen to Fox News articles!
The Trump administration has taken a new approach to the food pyramid.
The Department of Health and Human Services (HHS) announced new guidelines on Wednesday with an updated, inverted pyramid. The top of the pyramid, which is now the wider part of the structure, is built on meat, fats, fruits and vegetables, while whole grains are at the narrow bottom.
This follows HHS Secretary Robert F. Kennedy Jr.’s mission to “Make America Healthy Again” (MAHA), aimed at addressing chronic disease, childhood illnesses and ultraprocessed foods.
DOCTORS WARN SOME POPULAR FOODS AND DRINKS COULD BE SECRETLY SABOTAGING MEN’S TESTOSTERONE LEVELS
“The new guidelines recognize that whole, nutrient-dense food is the most effective path to better health and lower health care costs,” Kennedy said during a press briefing in Washington, D.C.
“Protein and healthy fats are essential, and were wrongly discouraged in prior dietary guidelines. We are ending the war on saturated fats.”
The Trump administration announces the 2025-2030 Dietary Guidelines for Americans, putting “real food” back at the center of health. (realfood.gov)
The HHS secretary rallied against refined carbohydrates, food additives and added sugar, highlighting the health risks associated with sugar-sweetened beverages.
Kennedy’s main message to Americans was to “eat real food.”
TRUMP ADMIN’S NEW NUTRITION GUIDELINES TARGET ULTRA-PROCESSED FOODS, EASE UP ON RED MEAT AND SATURATED FATS
The announcement triggered reactions from top health and wellness voices, including Stanford neuroscientist Dr. Andrew Huberman, host of the “Huberman Lab” podcast.
In a post on X, Huberman shared the White House’s graphic of the new pyramid, praising the decisions that were made.
“Oatmeal (and I think that’s rice and sourdough) made the cut!” he commented. “In all seriousness, assuming overall calories are kept in check and people exercise & get sun(day)light, this looks spot on.”
He added, “Maybe up the veggies a bit, add low-sugar fermented foods like sauerkraut & this is great.”
CLICK HERE FOR MORE HEALTH STORIES
Huberman said in a thread on the same post that Americans “don’t have to eat all the foods” shown in the diagram.
“You won’t see me drinking milk or eating shrimp,” he said. “Nothing against shrimp, I just don’t like the taste. Aversion to crustaceans.”
“Maybe up the veggies a bit, add low-sugar fermented foods like sauerkraut & this is great,” Huberman commented on X. (Chance Yeh/Getty Images for HubSpot; iStock)
The new guidelines received praise from other major health figures, including former FDA commissioner Dr. David Kessler.
“There should be broad agreement that eating more whole foods and reducing highly processed carbohydrates is a major advance in how we approach diet and health,” Kessler told The Associated Press.
“Protein and healthy fats are essential, and were wrongly discouraged in prior dietary guidelines.”
Dr. Bobby Mukkamala, president of the American Medical Association, shared in a statement that these guidelines “affirm that food is medicine and offer clear direction patients and physicians can use to improve health.”
CLICK HERE TO DOWNLOAD THE FOX NEWS APP
“The American Medical Association applauds the Administration’s new Dietary Guidelines for spotlighting the highly processed foods, sugar-sweetened beverages and excess sodium that fuel heart disease, diabetes, obesity and other chronic illnesses,” Mukkamala wrote.
The American Medical Association applauded the HHS for its updated nutrition guidelines. (iStock)
But not all feedback was positive.
Some people expressed concern about prioritizing red meat and dairy, while calling for the limitation of saturated fat.
CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER
Neal Barnard, president of the Physicians Committee for Responsible Medicine, shared in a reaction to STAT that while the guidelines “do have one or two good points, emphasizing fruits and vegetables and limiting alcohol,” the guidelines are “for the most part a strong reflection of industry influence.”
Christopher Gardner, a nutrition expert at Stanford University, also spoke out against the new guidelines, as reported by NPR.
TEST YOURSELF WITH OUR LATEST LIFESTYLE QUIZ
“I’m very disappointed in the new pyramid that features red meat and saturated fat sources at the very top, as if that’s something to prioritize. It does go against decades and decades of evidence and research,” said Gardner, who was a member of the Dietary Guidelines Advisory Committee.
Fox News Digital’s Rachel Wolf, as well as Alexandria Hoff of Fox News, contributed reporting.
Use left and right arrow keys to navigate between menu items.
Use escape to exit the menu.
Sign Up
Create a free account to access exclusive content, play games, solve puzzles, test your pop-culture knowledge and receive special offers.
Already have an account? Login
NEWYou can now listen to Fox News articles!
A single 10-minute workout may trigger blood changes that help fight colon cancer.
That’s according to new research from scientists at Newcastle University, who found that exercise quickly changes the blood in ways that affect colon cancer cells in the lab.
In the study, the U.K. researchers exposed colon cancer cells to human blood serum collected immediately after exercise, finding that the cells repaired DNA damage faster and showed gene activity patterns linked to slower growth.
SPIKE IN DEADLY CANCER BEFORE 50 LINKED TO COMMON CONVENIENCE FOODS
The blood samples came from 30 adults who had just completed a short, high-intensity cycling workout that lasted about 10 to 12 minutes, according to a press release.
Even a 10-minute burst of intense exercise may send protective signals through the blood that affect colon cancer cells, researchers say. (iStock)
Samuel T. Orange, an associate professor at Newcastle University and one of the study’s authors, spoke with Fox News Digital about the findings.
“Our findings show that exercise rapidly triggers molecular changes in the bloodstream that can act directly on colon cancer cells, reshaping gene activity and supporting DNA damage repair,” he said.
COMMON OVER-THE-COUNTER MEDICATION SLASHES COLORECTAL CANCER RECURRENCE IN HALF
The results suggest that even brief activity can make a difference. “Every movement matters. Exercise doesn’t need to last hours or happen in a gym,” Orange added.
The research suggests that exercise quickly triggers changes in the blood that affect colon cancer cells and helps support DNA repair. (iStock)
One of the most surprising findings, according to the researcher, was how strong the biological response was after even a single workout.
CLICK HERE TO SIGN UP FOR OUR HEALTH NEWSLETTER
“Exercise altered the activity of more than 1,000 genes in colon cancer cells,” he shared.
Even brief bouts of activity can make a difference, the researcher said. (iStock)
The study findings suggest that the effect is driven by exercise-triggered molecules released into the bloodstream, sometimes referred to as “exerkines,” which act like chemical messengers and send signals throughout the body.
“Each time you exercise, you trigger biological signals that support health and resilience to diseases such as cancer, diabetes and heart disease,” Orange said.
TEST YOURSELF WITH OUR LATEST LIFESTYLE QUIZ
The researchers cautioned that the study was conducted using cancer cells grown in the laboratory, not in patients.
The findings are based on experiments using colon cancer cells grown in the lab, not studies conducted in people, the researchers noted. (iStock)
The study involved 30 healthy male and female volunteers between the ages of 50 and 78. Their blood samples were used to carry exercise-triggered signals to cancer cells grown in the lab.
CLICK HERE FOR MORE HEALTH STORIES
“These findings now need to be replicated in people with cancer,” Orange said. “We also need to better understand the longer-term effects of repeated exercise signals over time.”
Despite the limitations, the researcher said the findings strengthen the case for exercise as an important part of colon cancer prevention.
CLICK HERE TO DOWNLOAD THE FOX NEWS APP
“Each time you move your body and get a little breathless, you’re contributing to better health and may help influence biological processes linked to bowel cancer,” he added.
Doctors says ‘The Pitt’ reflects the gritty realities of medicine today
Xbox’s Towerborne is switching from a free-to-play game to a paid one
Venezuela teeters as guerrilla groups, cartels exploit Maduro power vacuum
Trump plans to meet with Venezuela opposition leader Maria Corina Machado next week
Health experts react as Andrew Huberman backs Trump admin’s new food pyramid
Florida High School Football Rankings: Top 25 teams – Oct. 21
Cleary's 21 help Le Moyne down Central Connecticut State 69-64 in OT
How old is Bo Nix? What to know about Oregon quarterback ahead of 2024 NFL Draft
99th annual Pony Swim held in Virginia
Video: ‘It Didn’t Have to Happen This Way:’ U.Va. Faculty Call for Review of Police Response to Protests
Trump plans to meet with Venezuela opposition leader Maria Corina Machado next week
Trump says meeting Iran’s ‘Crown Prince’ Pahlavi would not be appropriate
Federal immigration agents shoot 2 people in Portland, Oregon, police say
Video: What Trump Told Us About the ICE Shooting
Trump calls for $1.5T defense budget to build ‘dream military’
-
Detroit, MI5 days ago2 hospitalized after shooting on Lodge Freeway in Detroit
-
Technology3 days agoPower bank feature creep is out of control
-
Dallas, TX4 days agoDefensive coordinator candidates who could improve Cowboys’ brutal secondary in 2026
-
Health5 days agoViral New Year reset routine is helping people adopt healthier habits
-
Nebraska2 days agoOregon State LB transfer Dexter Foster commits to Nebraska
-
Iowa2 days agoPat McAfee praises Audi Crooks, plays hype song for Iowa State star
-
Nebraska2 days agoNebraska-based pizza chain Godfather’s Pizza is set to open a new location in Queen Creek
-
Entertainment2 days agoSpotify digs in on podcasts with new Hollywood studios