Executive Summary

Hospital care is a major source of financial concern for many Alaska residents. Findings from Altarum’s Consumer Healthcare Experience State Survey (CHESS), conducted among more than 340 Alaska adults from July 8 – August 31, 2026, highlight widespread worry about hospital costs. The results also point to challenges understanding hospital costs and quality information and broad support for government action.

Key findings include:

• Worry about hospital costs is widespread: Seventy-eight percent of respondents reported worry about affording health care now or in the future, including hospital services.
• Hospital care is a common source of medical bills: Over a third of respondents (37%) experienced a financial burden from medical bills, and 22% reported outstanding medical bills; among those with outstanding bills, 66% reported at least one hospital bill.
• Challenges finding hospital cost and quality information: Respondents reported lower confidence finding procedure costs in advance, locating hospital quality ratings, and resolving billing issues compared to navigating routine health care decisions.
• Broad, bipartisan support for solutions: Respondents across political affiliations expressed support for government actions related to hospital pricing, billing practices, and oversight of health system consolidation.

Together, these findings show that hospital care represents a significant source of financial risk for many respondents, often alongside challenges anticipating costs and assessing quality. At the same time, there is broad public support for efforts to improve hospital cost transparency and oversight.

Background

Hospitals provide essential care, but the cost of hospital services can be difficult for consumers to anticipate and afford. Findings from Altarum’s Consumer Healthcare Experience State Survey (CHESS) show widespread concern about hospital costs and gaps in consumers’ ability to find and interpret information about hospital prices, billing and quality. This brief summarizes responses from more than 355 Alaska adults surveyed from July 8^th – August 31^st, 2026, focusing on hospital affordability, access to cost and quality information, and support for related policy solutions. More detailed information on survey methods and respondent characteristics is available in the Appendix.

Worry about Affording Hospital Services

Seventy-eight percent of Alaska respondents reported being worried about affording health care, both now and in the future, including affording services commonly provided in hospitals. Respondents frequently reported worry related to hospital-associated services and situations that may involve high out‑of‑pocket costs, including medical care for a serious illness or accident (54%), ambulance services in an emergency (51%), and maternity care (30%).

These concerns reflect respondents’ experiences after receiving care. Over a third of respondents (37%) reported experiencing a financial burden due to medical bills and 22% of respondents reported having outstanding medical bills. Among the respondents who reported having outstanding medical bills, two-thirds of respondents (66%) reported that at least one of those bills came from a hospital.

Together, these findings show that hospital services are a major source of financial worry and medical bills for many respondents. Challenges affording care and anticipating hospital costs contribute to this concern, especially when information about prices, billing, and quality is difficult to find.

Challenges Finding Hospital Cost and Quality Information

Survey results indicate that respondents experience distinct challenges related to understanding costs, billing, and quality information before hospital services are provided. While many respondents report confidence navigating routine health care decisions, confidence is lower for tasks that involve anticipating or managing hospital costs and quality information.

Why this Matters

These gaps in confidence suggest that consumers may have limited ability to plan for potential out‑of‑pocket expenses or assess quality before hospital care. Challenges finding clear, usable hospital cost and quality information may increase the likelihood of unexpected medical bills and make billing problems harder to resolve after care.

Figure 1 illustrates this contrast across common health care–related tasks. Respondents were more likely to report high confidence in their ability to perform activities such as filling a prescription (74%) or following instructions from a provider (82%). In contrast, fewer respondents reported high confidence in tasks that are especially relevant to hospital care, including finding the cost of a procedure in advance (60%), locating quality ratings for hospitals (48%), and disputing a medical bill (53%). Of particular note, fewer respondents reported that they were “very” or “extremely” confident in their ability to navigate the Alaska Health Care system than any other option in the survey.

Figure 1. Percentage of Respondents Who Feel “Very” or “Extremely” Confident They Can Complete Select Health Care Related Tasks

Source: 2026 Survey of Alaska Adults, Ages 18+, Altarum Healthcare Value Hub’s Consumer Healthcare Experience State Survey

Understanding Insurance Terms

Figure 2 shows that while most respondents were able to correctly define “premium,” and “deductible,” fewer than half (44%) were able to accurately define “coinsurance”, a key component of hospital cost‑sharing after a deductible is met. Misunderstanding coinsurance can be particularly consequential for hospital services, where charges are often higher and cost‑sharing amounts are less predictable. 

Why this Matters

Understanding how insurance applies to hospital services often requires familiarity with terms that determine what patients pay out-of-pocket, such as deductibles, coinsurance, and copays. Survey results suggest that many respondents have difficulty accurately defining these terms, which can make it challenging to anticipate hospital charges before receiving care. Research indicates that nearly half of insured adults find at least one aspect of their insurance difficult to understand.¹

Figure 2. Percent Who Chose the Correct Insurance Term Definition

Source: 2026 Survey of Alaska Adults, Ages 18+, Altarum Healthcare Value Hub’s Consumer Healthcare Experience State Survey
*Note: Totals may not equal 100% due to rounding.
Definitions: “Premium” is a fee paid on a regular schedule for an insurance policy; “Deductible” is the money you pay before an insurance company will pay a claim; “Coinsurance” is the percentage of a health care bill you pay after the deductible is met; “Copay” is the portion you pay for using specific covered services.

Perceptions of Who Drives High Costs

Survey respondents identified several actors as contributing to high health care costs. Drug manufacturers were most frequently cited (69%) followed by health insurance companies (57%). More than half of Alaska respondents (56%) also identified hospitals as contributors to high health care costs, placing hospitals among the institutions commonly associated with rising health care expenses.

Support for Solutions to Address Hospital Costs and Transparency

Survey respondents expressed broad support for government actions aimed at addressing health care affordability, including strategies that relate specifically to hospital costs. Across political affiliations, respondents reported that it is important for the state to play a role in protecting consumers from high and unexpected medical costs and in improving access to information needed to navigate care (Table 1).

Alaska respondents supported a range of policy approaches relevant to hospital care, including limiting excessive hospital prices, addressing billing practices that increase costs without improving care, and strengthening oversight of health system consolidation that may contribute to higher prices. Support for these strategies was observed among Republicans, Democrats, and Independents, suggesting shared concern about the impact of hospital costs on patients and families.

Together, these findings indicate that concerns about hospital affordability and transparency are accompanied by broad public support for government efforts to improve how hospital prices are set, communicated, and regulated.

Table 1. Percent of Respondents Who “Agree” or “Strongly Agree” with Selected Statements, by Political Affiliation

Source: 2026 Survey of Alaska Adults, Ages 18+, Altarum Healthcare Value Hub’s Consumer Healthcare Experience State Survey

Conclusion

Findings from the Alaska Consumer Healthcare Experience State Survey show that hospital care is a significant source of financial concern for many respondents. Widespread worry about affording hospital services is accompanied by challenges finding and understanding hospital cost, billing, and quality information before care is received.

These findings show how difficulty anticipating hospital costs and assessing quality may increase the risk of unexpected medical bills and financial strain. At the same time, respondents across political affiliations express support for government efforts to improve hospital cost transparency and accountability, underscoring shared concern about the impact of hospital costs on patients and families.

Notes

1. Pollitz, K., Pestaina, K., Montero, A., Lopes, L., Valdes, I., Kirzinger, A., Brodie, M., KFF Survey of Consumer Experiences with Health Insurance, (KFF, June 15, 2023) https://www.kff.org/report-section/kff-survey-of-consumer-experiences-with-health-insurance-methodology/ (Accessed December 5, 2024).