Mark Cuban says hospitals ‘don’t know their costs’ — why they need to be run ‘as a startup’

Billionaire entrepreneur Mark Cuban has spent the past several years trying to shake up the U.S. healthcare industry. Now, he’s taking aim at a fundamental problem inside hospitals: Many, he says, don’t actually know what their services cost.

In a recent appearance on KFF Health News’ What the Health? podcast, Cuban argued the debate over whether the government or the private sector should have a bigger role in healthcare overlooks the issue of costs.

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“The fundamental issue is transparency and trust,” Cuban said, adding that “there are a lot of hospitals … that don’t know their costs.”

Some hospitals, he argued, can track their overall finances but struggle to identify the actual cost of providing a particular service. In his words, “they just know their cash balance.”

Cuban compared that lack of cost discipline to what he would expect from entrepreneurs appearing on Shark Tank, the business reality show where he spent years grilling founders about their companies and funding pitches.

“If we brought them on Shark Tank … and we asked them, ‘What are your costs for this, this, and this?'” Cuban said, hospital executives might not have an answer grounded in their actual costs. For Cuban, that gets to the heart of why simply changing who runs healthcare may not solve its underlying economic problems.

“It doesn’t matter who runs it,” he said. “Whether it’s the government or private enterprise running it, if it’s the same people either way, you’re gonna have the same problems.”

“You’ve got to think of your hospital as a startup,” Cuban said, where knowing exactly what things cost is essential to running a successful operation.

The murky economics of hospital care

Cuban’s criticism goes beyond whether individual hospitals are being run efficiently. Hospitals account for nearly a third of all U.S. healthcare spending, making questions about their costs and prices consequential for patients and insurers.

Total U.S. hospital spending reached $1.63 trillion in 2024, up 8.9% from the previous year, according to data from the Centers for Medicare & Medicaid Services (CMS). That spending is expected to keep climbing, with CMS forecasting average annual growth of 5.4% through 2034.

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While much of the recent spending surge has been driven by greater use of hospital services, prices are rising too. Per CMS, hospital prices increased by 3.4% in 2024, the fastest pace since 2007. That also exceeded the 2.9% average inflation rate that year, according to Bureau of Labor Statistics data.

Other data shows just how much rising prices can drive hospital spending. The Health Care Cost Institute, a D.C.-based nonprofit research group, found that outpatient hospital spending per person rose 18% from 2018 to 2022, with price increases driving most of that growth, rather than greater utilization. For inpatient care, spending increased 6% even as utilization fell 11%, as prices jumped 20%.

More recently, KFF found that prices paid by private insurers for hospital care rose 30% from April 2019 to April 2026, compared with 21% for Medicare. Hospitals also accounted for 40% of the increase in total U.S. health spending between 2022 and 2024.

White House pushes for more transparency

Rising prices have put hospitals under greater scrutiny, with policymakers pushing for more transparency around what they charge. In a February 2025 executive order, the Trump administration directed federal agencies to strengthen enforcement of existing healthcare price-transparency rules, including requirements that hospitals disclose actual prices rather than estimates.

The executive order cited a 2023 economic analysis that estimated greater price transparency could save consumers, employers and insurers as much as $80 billion a year.

CMS subsequently finalized new rules that took effect this year. Hospitals must now disclose more of the rates they negotiate with insurers in actual dollar amounts and certify that their public pricing files are accurate and complete. They must also name the CEO or executive responsible for overseeing the accuracy of the pricing data.

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This article originally appeared on Moneywise.com under the title: Mark Cuban says hospitals ‘don’t know their costs’ — why they need to be run ‘as a startup’

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