New Report Details Consequences of High Health Care Prices in West Virginia and Policy Recommendations

For Immediate Release: October 15, 2025

Contact: Renee Alves, (559)-916-5939

Charleston, WV— Commercial and private health care costs in the United States and West Virginia are rising at a concerning rate. West Virginia outpaces the nation with the highest health care spending of any state, comprising more than one-fourth of the state’s gross domestic product. A groundbreaking RAND Corporation study found that West Virginia residents bear the cost, as the Mountain State has private and commercial health care costs higher than any other state, even those with greater access to health care services and specialization. In 2022, West Virginia spent about $6,000 per capita on hospital care, nearly $2,000 more than the national average, much of which fell on patients to pay.

It is imperative to address high health care costs in West Virginia. These costs have had a pervasive impact on patients, labor and wages, and the state economy. Our new research investigates the role of concentrated provider networks on health care costs and outcomes. While there are many contributing factors, West Virginia has the highest health care costs in the nation and a high rate of consolidated services, with just two networks owning 70 percent of hospitals in the state. Hospitals, as well as the care providers and support staff who work within them, serve communities and protect peoples’ health and safety. However, the concentration of market power—and the lack of policy to mitigate the consequences of this concentration—has had significant repercussions for the state.

Out today, our newest report focuses on hospitals in West Virginia and how provider consolidation trends impact the state and consumers by reallocating market power to just a few hospital networks. This market consolidation is an important area of study for policymakers as well as patients, as it directly impacts their ability to access and afford care and services.

“While West Virginia’s health care system is already quite consolidated and it is infeasible to reverse these trends, our state can and should implement a range of policies to increase transparency and affordability for consumers while limiting future harm,” says Rhonda Rogombé, health and safety net policy analyst and report author. “Policymakers should focus on ways to reduce health care costs, like improving price transparency, limiting facility fees, and more.”

Some evidence also points to hospital consolidation as a factor in the reduction of services, leading to care deserts for critical services in rural and other underserved communities, which the WVCBP will investigate in the future. 

You can find the report’s key findings and policy recommendation summary below. 

Key Findings

• West Virginia has the highest commercial and private health care costs in the country, with annual expenditures totaling 28.7 percent of the state’s gross domestic product. 
• A range of research supports that hospital consolidation increases prices with mixed findings on consolidation’s impact on quality of care. 
• On average, West Virginia hospitals charged patients 140 percent above what it cost for them to break even.
• Nonprofit West Virginia hospitals spent as little as two percent of operating expenses on charitable care, while their charitable tax status was worth nearly five percent.
• Two hospital systems, WVU Medicine and the Vandalia Health System, own 70 percent of hospitals across the state.
• In 2021, 13 percent of West Virginians reported having medical debt, leading to delayed care, foregone necessities like food and heat, and further debt.
• Heightened health care prices driven by hospital consolidation are associated with depressed wages, higher unemployment, and increased deaths across entire communities.

Policy Recommendation Summary

There is a range of policies available to help rein in hospital health care costs at different points in the process. These include, but are certainly not limited to, strengthening antitrust and merger review policy on the federal and state levels, improving cost and price transparency, and setting a threshold for how much hospitals must spend in charity care to maintain their nonprofit status. Addressing exorbitant health care prices also necessitates finding mechanisms for lowering the high health care costs unique to the United States.

However West Virginia chooses to address high health care costs driven by hospital consolidations, the state must also collect data around prices and the efficacy of various policies to ensure that each tool is functioning as intended. By putting patients—not profits—at the crux of health care, West Virginia can become a healthier, more affordable place for all who call it home.

Please note: The data and analysis for this report was compiled prior to the passage of HR 1, the “One Big Beautiful Bill,” which will have deeply harmful impacts on West Virginians and the state’s health care system by reducing federal funding for health care, making Medicaid more difficult to access, and shifting significant health care costs onto the state budget and charitable entities including nonprofit hospitals. The findings of this report do not change the imperative of policymakers to reverse harmful funding cuts in order to ensure health care remains accessible in rural areas around the state. 

For example, in the report, we cite that the difference between the tax benefits nonprofit hospitals in West Virginia received and the amount of charity, uninsured, and uncompensated care they provided totaled $132 million in a single year, enough to completely cover the medical debts of 77,000 West Virginians or the state’s rural hospital losses 13 times over. That amount is still less than one-sixth of the amount of federal health care funds West Virginia will lose once HR 1 is fully phased in. Policymakers should work to implement the policies outlined in this report  as they work to mitigate and reverse the deep, harmful cuts in HR 1. 

Read the full report.