PBGH Applauds House Ways and Means Committee Continued Bipartisan Examination of Healthcare Affordability

Purchaser Business Group on Health (PBGH) applauds the House Ways and Means Committee for continuing its bipartisan examination of healthcare affordability, with a focus on hospital transparency and market accountability at its April 28 hearing with health system CEOs.

This hearing builds on the Committee’s January 2026 oversight of health insurance markets and represents a critical next step in addressing the largest and fastest-growing driver of healthcare costs: hospitals and health systems.

The rising cost of hospital care is having real consequences for patients.

“Increased healthcare costs are forcing families to make impossible trade-offs,” said PBGH President and CEO Elizabeth Mitchell. “Recent data show that two in five Americans have delayed care due to cost, and more than half of low-income Americans are making daily sacrifices to afford healthcare.”

At the same time, some hospitals have pursued aggressive collection practices against patients, even among nonprofit institutions that receive tax exemptions.

“Employers and working families are facing a healthcare affordability crisis, and hospitals are at the center of that challenge,” said Mitchell. “We commend the Committee for turning its attention to hospital pricing, transparency, and market behavior—areas where greater accountability is urgently needed.”

PBGH, a nonprofit coalition representing large employers and public purchasers that spend over $350 billion annually on health care for more than 21 million Americans, recently testified (recording/written testimony) before Congress on the urgent need for reforms to improve price transparency, competition, and value in the hospital sector.

Hospital Prices Rising Without Better Quality

Despite longstanding claims that consolidation and integration would improve care, evidence shows otherwise.

“Despite pre-merger claims of increased efficiency and quality, all the independent research shows that prices have gone up while quality and access have – if anything – diminished,” Mitchell said. “There are no discernible differences in clinical quality or safety scores in vertically integrated systems.”

PBGH’s own Transparency Data Demonstration Project confirmed a troubling trend: “There is a near-complete lack of correlation between price and quality across health care markets.” In many cases, the data showed hospitals with lower safety grades charge more than higher-quality competitors, raising serious concerns about value for patients and purchasers.

Consolidation Driving Higher Costs

The Committee’s focus is especially timely given the widespread consolidation across hospital markets nationwide.

“Four out of five metropolitan areas are now dominated by one or two health systems controlling over 75% of the market, the predictable result of decades of unchecked consolidation.” Mitchell said. “Even if consolidation leads to reduced operating costs – as the American Hospital Association has claimed – those savings are not being passed on to employers or patients.”

Research shows that hospital mergers increase prices by 3 to 65 percent, while physician practices acquired by hospitals raise prices by an average of 14.1 percent. These market dynamics limit competition and leave employers and patients with few affordable options.

Transparency Is Working—But More Is Needed

PBGH strongly believes that recent federal transparency requirements are beginning to deliver results but require stronger enforcement and expansion.

“Price transparency has already demonstrated its value,” Mitchell said. “For the first time, employers can see what they are paying and compare it to quality. But transparency alone is not enough—we need policies that ensure this information can be used to drive competition and accountability.”

Call for Action

PBGH urges policymakers advance reforms that:

• Strengthen and enforce hospital price transparency requirements.
• Address anticompetitive contracting practices.
• Promote site-neutral payments and fair pricing.
• Support competition and high-value care delivery models.

“We appreciate the Committee’s leadership in tackling one of the most pressing issues facing American workers and businesses,” Mitchell said. “A more transparent and competitive hospital market is essential to lowering costs and improving care for everyone.”

About Purchaser Business Group on Health

The Purchaser Business Group on Health (PBGH) is a nonprofit coalition representing more than 40 private employers and public entities across the U.S. that collectively spend more than $350 billion annually purchasing health care services for over 21 million Americans. PBGH is committed to transforming the U.S. health care system to deliver better value, higher quality, and more affordable care.