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’s manufactured affordability crisis, the study shows that health care executives at a handful of corporations are setting “high and irrational prices” in every state and charging patients almost three times what Medicare pays for the exact same service.

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.

More from Whitney Curry Wimbish

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.

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 “controlled at least half of all hospital care in 2023,” 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 “can charge basically whatever they want, because they can,” said Anthony Wright, executive director of Families USA.

“The question is what Congress will do to confront these corporations and contain these health care costs,” he said. “Americans cannot afford the care they need.”

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 have closed or are considering doing so, or have stopped providing certain services, and millions have lost insurance coverage.

According to a new analysis by Protect Our Care, “4,382,930 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 coverage through the ACA and 2,484,257 Americans who relied on Medicaid.” The group warned that “this is just the beginning,” and that within the next eight years, about 14 million Americans will lose their health coverage.

But Republicans at the House Ways and Means Committee hearing last month 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.

Executives pointed the finger back; in his opening remarks, HCA chief executive Samuel Hazen agreed that health care “is too expensive for too many people,” but added that ensuring access “to Medicaid, Medicare, and the individual insurance marketplace is one of the most direct and efficient ways to lower health care costs,” 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. “This is more a deflection hearing than a hospital hearing,” said Rep. Lloyd Doggett (D-TX).

Days later, Republicans used Democrats’ stance against them to pretend 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.

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.

Hazen’s 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’s translated into billions in profit. In 2025, HCA Healthcare’s net income was $6.8 billion, $1 billion more than the year before, a Securities and Exchange Commission disclosure shows.

Its first-quarter profits 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’s compensation “competitive.” He made $26.5 million last year, $2.7 million more than the year before. That’s about 420 times the salary of the median worker at the company.

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.

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’t there before the takeover, though the service was the same.

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.

Families USA called on Congress to enact “site-neutral payments,” so costs are the same everywhere; require that hospitals and health plans give patients “full price transparency”; ban anti-competitive practices between hospital systems and insurers; strengthen oversight of nonprofit hospitals; and cap prices and inflation relative to Medicare benchmarks.

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 in the first three months alone than the year before, throwing $1.8 million into preserving their ability to profiteer. Lobbying reports show executives are taking aim at a bill that would force hospitals and insurers to provide price transparency, among other measures.

A Securities and Exchange Commission filing shows that executives are likewise fighting their own shareholders, who want more information about consolidation and cost. A shareholder of HCA submitted a proposal to the board that asked them to produce a report “describing the healthcare consequences and impacts its hospital acquisitions in the last decade have had on impacted communities,” this year. She proposed that the report would include how many physicians left after the acquisition, patient satisfaction ratings before and after the takeover, the compensation of staff, and “an assessment of the impacted community’s perception of HCA.”

Board members, also handsomely compensated to attend a handful of meetings per year, said no. (Members’ total compensation ranged between nearly $231,000 and almost $450,000 last year.) The system has won a lot of awards, directors responded, and “we believe our scale provides advantages to our patients,” which should be good enough. Besides, they said, it would be too hard.

Read more

Whitney Curry Wimbish is a staff writer at The American Prospect. She previously worked in the Financial Times newsletters division, The Cambodia Daily in Phnom Penh, and the Herald News in New Jersey. Her work has been published in multiple outlets, including The New York Times, The Baffler, Los Angeles Review of Books, Music & Literature, North American Review, Sentient, Semafor, and elsewhere. She is a coauthor of The Majority Report’s daily newsletter and publishes short fiction in a range of literary magazines. She can be reached on Signal at wwimbish.07.