A 26% rise in hospital charges after mergers in the Capital Region is a warning about the region’s pricing trajectory—but it is not a finding that patients’ bills rose by 26%. The distinction matters as Albany Med Health System and Ellis Medicine consider a possible combination and New York weighs how to oversee health care transactions.
The Community Service Society of New York’s study examined hospital charges from 2009 through 2024. The Times Union’s account of the report says eight Capital Region hospitals were involved in mergers during that period. Within nine years of combining, merged hospitals’ charges rose 26% on average, while their actual costs rose 17%—about 1.5 times as fast. Statewide, the report found average charges increased more than 182%, against a 44% rise in medical inflation.
The report examined charges associated with appendectomies, vaginal childbirths and knee replacements, and found increases after mergers took effect. It also concluded that cost savings from consolidation were not passed along to patients or insurers. Those findings raise questions about how consolidation affects affordability, but the charge figures alone do not establish how much a particular patient or insurer paid.
Charges and prices paid are different measures
Federal hospital price-transparency rules distinguish gross charges from payer-specific negotiated charges, according to the eCFR. The study’s reported increase in charges should therefore not be treated as the same increase in negotiated prices, out-of-pocket spending or insurance payments. The report describes a change in hospitals’ charges; it does not, on that figure alone, show how household bills changed.
A national comparison underscores why the measures should not be conflated. RAND found that prices paid to hospitals for privately insured patients in its analysis of 25 states averaged 241% of Medicare prices in 2017. That is a comparison of negotiated prices with Medicare rates—not a measure of gross charges, and not a Capital Region estimate. It offers broader context on hospital pricing, but it cannot establish what local patients paid after the mergers examined by the society.
What oversight can—and cannot—do
The society characterizes the Capital Region hospital market as highly concentrated and calls for stronger limits on post-merger charge increases. The Times Union reports that the Public Health and Health Planning Council reviews hospital mergers, while the society says the council lacks authority to cap those increases. The possible Albany Med–Ellis combination would be another test of the state’s approach, but the study’s historical findings do not predict the outcome or effects of that proposal.
New York also has a transaction-notice requirement. The state Department of Health says a law that took effect Aug. 1, 2023, requires health care entities involved in material transactions to notify the department at least 30 days before closing. The department says the threshold includes transactions, or related transactions within a rolling 12-month period, that increase an entity’s gross in-state revenues by $25 million or more. That is a notice process; it is not itself a price cap.
The study gives policymakers a local account of how charges and costs changed around mergers, while leaving an important affordability question unresolved: how those changes translated into negotiated rates and payments. The figures support scrutiny of consolidation and pricing, but do not show that every merger has the same effect or that any particular patient faced the same increase. More complete price comparisons would be needed to connect hospital charges to what insurers and households actually paid.
