The largest corporate health care hospitals in the country are consolidating their power and using it to rip off patients, a new study from Families USA shows. Released amid the GOP\u2019s manufactured affordability crisis, the study shows that health care executives at a handful of corporations are setting \u201chigh and irrational prices\u201d in every state and charging patients almost three times what Medicare pays for the exact same service.<\/p>\n
The 15 largest systems charged an average of 282 percent more than the Medicare rate, the study found, resulting in $22 million in profit per hospital per year.<\/p>\n
More from Whitney Curry Wimbish<\/a><\/p>\n Executives are charging patients the most in Colorado, Florida, Georgia, New Mexico, South Carolina, West Virginia, and Wisconsin, where average corporate hospital prices are even higher, between 320 and 365 percent more than the Medicare rate.<\/p>\n The reason hospital executives can do this is because they are consolidating at a rapid clip, buying up independent providers, and jacking up prices at will. Five or fewer corporations in 42 states and the District of Columbia \u201ccontrolled at least half of all hospital care in 2023,\u201d researchers found. In almost half of all states, just three corporations controlled the majority of hospital care. Hospital executives have no competition or regulations to discipline their price-gouging, so they \u201ccan charge basically whatever they want, because they can,\u201d said Anthony Wright, executive director of Families USA.<\/p>\n \u201cThe question is what Congress will do to confront these corporations and contain these health care costs,\u201d he said. \u201cAmericans cannot afford the care they need.\u201d<\/p>\n SO FAR, THE ANSWER TO THAT QUESTION is not much. At a hearing last week, congressional Republicans playacted caring about astronomical health care costs after they slashed $1 trillion from Medicaid via the One Big Beautiful Bill Act and failed to renew tax subsidies for Obamacare. Under their leadership, 900 hospitals and counting<\/a> have closed or are considering doing so, or have stopped providing certain services, and millions have lost insurance coverage.<\/p>\n According to a new analysis<\/a> by Protect Our Care, \u201c4,382,930 Americans have already lost their coverage after Donald Trump and Republicans in Congress made the largest cuts to health care in history, including 1,898,673 Americans who got <\/a>coverage through the ACA and 2,484,257 Americans who relied<\/a> on Medicaid.\u201d The group warned that \u201cthis is just the beginning,\u201d and that within the next eight years, about 14 million Americans will lose their health coverage.<\/p>\n But Republicans at the House Ways and Means Committee hearing last month<\/a> blamed unaffordable health care on hospital executives alone, and accused them of overcharging patients. They pressed executives from HCA Healthcare, the largest for-profit hospital system in the country, CommonSpirit Health, New York-Presbyterian, and ECU Health, and demanded to know why they charged so much.<\/p>\n Executives pointed the finger back; in his opening remarks<\/a>, HCA chief executive Samuel Hazen agreed that health care \u201cis too expensive for too many people,\u201d but added that ensuring access \u201cto Medicaid, Medicare, and the individual insurance marketplace is one of the most direct and efficient ways to lower health care costs,\u201d which Republican lawmakers worked against. Democrats on the committee spent most of their ammunition on Republicans, saying Republicans were using the hearing to distract from their spending cuts. \u201cThis is more a deflection hearing than a hospital hearing,\u201d said Rep. Lloyd Doggett (D-TX).<\/p>\n Days later, Republicans used Democrats\u2019 stance against them to pretend<\/a> that Democrats are the ones who are to blame for the crisis. The reality is that the lack of hospital regulation is a bipartisan failure. GOP policies, Democratic inaction, and rapacious health care executives are all to blame.<\/p>\n The Families USA studies show that as in other consolidated industries, the biggest players made the most money and had the power to charge the highest prices.<\/p>\n Hazen\u2019s group, HCA Healthcare, charged an average of 339 percent over the Medicare rate and drew $70.3 million in annual profit per hospital, the survey found. Financial filings for the company show that\u2019s translated into billions in profit. In 2025, HCA Healthcare\u2019s net income was $6.8 billion, $1 billion more than the year before, a Securities and Exchange Commission disclosure shows<\/a>.<\/p>\n Its first-quarter profits<\/a> for this year were similarly sunny, with net income increasing again, this time by 0.6 percent to hit $1.6 billion. A sizable chunk of this money goes to keeping Hazen\u2019s compensation \u201ccompetitive.\u201d He made $26.5 million last year, $2.7 million more than the year before. That\u2019s about 420 times the salary of the median worker at the company.<\/p>\n The largest nonprofit health care system, CommonSpirit Health, charged an average of 306 percent above the Medicare rate, drawing $17.4 million in annual profit per hospital, Families USA found. An audit by EY shows that translated into systemwide nonoperating net income of $1.8 billion last year, up from $1.4 billion in 2024. Its highest-paid executive is Chief Information Officer Daniel Barchi, who made $3.8 million in 2024, according to the most recently available tax documents<\/a>.<\/p>\n Families USA found that the biggest factor in price is whether a hospital is independent. At a press conference about the report, one of the speakers, West Virginians for Affordable Health Care Executive Director Ellen Allen, recounted how she herself has seen an increase in fees since a practice she goes to was taken over by a larger system, including a new charge tacked onto the bill that wasn\u2019t there before the takeover, though the service was the same.<\/p>\n Independent hospitals charged less than corporate ones, the study found, though still well above the Medicare rate. Those smaller hospitals charged 221 percent above Medicare, a 61-percentage-point difference.<\/p>\n Families USA called on Congress to enact \u201csite-neutral payments,\u201d so costs are the same everywhere; require that hospitals and health plans give patients \u201cfull price transparency\u201d; ban anti-competitive practices between hospital systems and insurers; strengthen oversight of nonprofit hospitals; and cap prices and inflation relative to Medicare benchmarks.<\/p>\n Lobbying reports and other documentation show that the executives of these massive corporate entities will fight all of those measures. The industry as a whole has already spent a fortune lobbying the government this year, as a new report from The Washington Post shows. It notes that HCA Healthcare executives have spent 285 percent more on lobbying<\/a> in the first three months alone than the year before, throwing $1.8 million into preserving their ability to profiteer. Lobbying reports<\/a> show executives are taking aim at a bill that would force hospitals and insurers to provide price transparency, among other measures.<\/p>\n