Medical Price Transparency

OSPIRG Foundation is working to make sure consumers get to see health care prices up front.

SECRET PRICES CONTRIBUTE TO HIGH COSTS

Recent studies show that one third of every dollar we spend on health care is wasted on something that doesn’t improve our health.[1] One reason why is that hospitals get to keep their prices—and the extra charges and fees often tacked on—hidden from patients. Take a look at some of these examples:

IT’S TIME FOR UP FRONT PRICES

We can bring down the cost of care in Oregon by making sure consumers get to see health care prices up front, such as by requiring health care providers to post their prices online or to give patients the price of a recommended procedure in real time. 
 
There has been a robust public discussion of this issue in the national news media, as well as a spirited debate in the Oregon Legislature this year about one specific policy framework crafted by OSPIRG Foundation in 2014. The policy requires Hospitals and other providers to publicly post their prices online for the most common services and procedures, and if a consumer is looking for an estimate for a specific procedure, he should be able to get that in a reasonable amount of time from either his provider or insurance company. Public support for such solutions is high, but the health care industry has successfully resisted most meaningful efforts at change. We believe that momentum is on our side and that a breakthrough in the next few years is achievable.
 
OSPIRG Foundation is committed to reaching that tipping point through the following activities:
• Expand our multi-ideological coalition of support for meaningful price transparency to include Oregon business leaders, software developers and medical professionals.
• Continue to promote our policy framework through speaking engagements and presentations to regulators and other health care thought leaders in Oregon and nationally. Develop at least one variant of our basic policy aimed at expanding public access to health insurance price calculators, currently only available to a small number of people.
• Continue to educate the public, state policymakers and reporters about the merits of transparent health care prices.

[1] Institute of Medicine at the National Academies, Sept 2012, "Best Care at Lower Cost: The Path to Continuously Learning Health Care in America".
[2] CNN, March 2010, "Prescription for Waste" 
[3] OSPIRG blog, October 2013, "Thousand Dollar Ointment".
[4] Medicare Provider Utilization and Payment Data

Issue updates

Blog Post | Health Care

Why Get Insured? My Coverage Saved me $16,278 After a Climbing Accident. | Numi Lee Griffith

OSPIRG Health Care Advocate Numi Griffith breaks down how health insurance reduced her medical bills by over $16,000 after a climbing accident.

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Blog Post | Health Care

OPEN ENROLLMENT FOR 2020: WHAT YOU NEED TO KNOW | Numi Lee Griffith

It's open enrollment season for health insurance in Oregon's individual market, from November 1 until December 15th.  What's new in the marketplace, and what do you need to know in order to gt covered?

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Blog Post | Health Care

What’s at Stake for Oregon if the Fifth Circuit Rules Against the ACA? | Numi Lee Griffith

The Fifth Circuit head oral arguments in the Texas v. Azar Lawsuit on July 9, 2019.  Oregon has a lot at stake if the Affordable Care Act is overturned - hundreds of thousands of consumers will face higher premiums or lose insurance outright, and dozens of important cosumer protections could be rolled back.

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News Release | OSPIRG Foundation | Health Care

Oregon’s Insurance Market Faces Rising Premiums, but the State has Options to Stabilize the Marketplace

Oregon consumers face rising health insurance premiums on the individual market, due to rising health care costs and recent changes to federal policy.  A new report from OSPIRG Foundaiton and Frontier Group explores the drivers of market instability and policy options for the state to stabilize the marketplace and expand consumer choice.

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Report | OSPIRG Foundation | Health Care

A Better Health Insurance Market For Oregon

New report from OSPIRG Foundation and Frontier Group details rising health care costs and federal disruptions to the individual insurance market; explores policy options to stabilize prices and expand consumer choice.

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News Release | OSPIRG Foundation | Health Care

OSPIRG Seeks Consumer Stories about Health Care in Oregon

 

OSPIRG Foundation is conducting a statewide survey of consumers about experiences and challenges with the health care system in Oregon.

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News Release | U.S. PIRG | Public Health, Consumer Protection, Health Care

Second recall of King Bio’s homeopathic drugs in the past month

King Bio Inc. issued the second significant voluntary recall since late July of their homeopathic drugs on Wednesday. Safety concerns over homeopathic drugs extend beyond King Bio as over the past several years, the FDA has issued recalls to several companies for a variety of health products from zinc-containing intranasal medicine to asthma drugs with toxic ingredients. 

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News Release | OSPIRG Foundation | Health Care

Providence’s proposed double-digit rate hike merits close scrutiny, may overcharge consumers

Providence Health Plan has proposed a rate hike of 13.6% on average—as high as 24.1% for some—on over 90,000 Oregonians. According to a new OSPIRG Foundation analysis released today, this rate hike proposal may overstate costs and overcharge consumers for health coverage.

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News Release | OSPIRG Foundation | Health Care

Oregonians Need Better Information on Health Care Costs

Oregon consumers are paying more and have less ability to make informed decisions about their health care due to opaque prices for health care services, according to a report released today by OSPIRG Foundation and Frontier Group. The report provides an in-depth analysis of the power of price transparency to contain costs and improve the experience of care for patients and health care providers, and identifies evidence-based policies and strategies for Oregon to advance health care price transparency. 

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News Release | OSPIRG | Health Care

OSPIRG's Jesse O'Brien Awarded "Health Care Value Advocate of the Year"

Today, OSPIRG Policy Director Jesse O’Brien was awarded “Health Care Value Advocate of the Year,” in recognition of his years of leadership advocating for policies and strategies to improve the value proposition of health care for consumers.

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Report | OSPIRG Foundation | Health Care

OSPIRG Foundation Comments on the Providence Health Plan Proposal for Individual Health Rates Effective January 2018

Providence Health Plan’s 104,747 members with individual health insurance plans will see rate hikes of 22.7% on average, and as high as 68.3%, if the premium rate hike proposed by Providence goes forward.

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Report | OSPIRG Foundation | Health Care

Comments on Providence Health Plan's proposal to raise individual health insurance rates

Providence Health Plan’s 105,406 members with individual health insurance plans will see rate hikes of 29.6% on average, and as high as 72.3%, if the premium rate hike proposed by Providence goes forward. At the same time, the insurer is planning to scale back its service area drastically and no longer offer its plans in many regions of Oregon.

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Report | OSPIRG Foundation | Health Care

Comments on Kaiser Foundation Health Plan of the Northwest's proposal to raise individual health insurance rates

Kaiser Foundation Health Plan of the Northwest’s 26,014 members with individual health insurance plans will see rate hikes of 14.5% on average, and as high as 22.05%, if the premium rate hike proposed by Kaiser goes forward.

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Report | OSPIRG Foundation | Health Care

Comments on Regence BlueCross BlueShield's proposal to raise individual health insurance rates

Regence BlueCross BlueShield’s 14,811 members with individual health insurance plans will see rate hikes of 17.9% on average, and as high as 36.1%, if the premium rate hike proposed by Regence goes forward.

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Report | OSPIRG Foundation | Health Care

Comments on Moda Health Plan's proposal to raise individual health insurance rates

Moda Health Plan’s 58,280 members with individual health insurance plans will see rate hikes of 32.3% on average, and as high as 84.2%,if the premium rate hike proposed by Moda goes forward.

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Pages

Blog Post | Health Care

OPEN ENROLLMENT FOR 2018: WHAT YOU NEED TO KNOW | Jesse O'Brien

It’s that time again: Time to enroll in health insurance for next year. Health care has been a political football in Washington throughout the year, and there has been a lot of confusion and uncertainty about the future. With all of this background noise, it’s more important than ever to get the facts about how you and your family can get coverage that works for you. 

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Blog Post | Health Care

Accountability in Action: Rate Review Cuts More Than $100 Million from 2018 Health Insurance Premiums | Jesse Ellis O'Brien

Close scrutiny of proposed health insurance rates for 2018, along with a new state program to contain rate hikes, has cut more than $100 million from premiums for Oregon consumers. This brings the total in premium cut by Oregon’s rate review program to more than $280 million since 2010.

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Blog Post | Health Care

Open enrollment for 2017: What you need to know | Jesse Ellis O'Brien

It’s that time again: Time to enroll in health insurance for 2017. Here’s our guide to Oregon’s open enrollment period, which starts November 1.

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Blog Post | Health Care

The Last Word on Oregon’s 2017 Health Insurance Rates and Coverage Options | Jesse Ellis O'Brien

An update on the latest developments with health insurance rates for 2017 and what they mean for the future of healthcare in our state.

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Blog Post | Health Care

Oregon awarded a “B” on health care price transparency—but the state is still failing consumers | Jesse O'Brien

OSPIRG has been pushing for years to increase access to accurate, actionable health care price information for Oregon consumers. So you’d think we would be celebrating when a national scorecard from the transparency advocates at Catalyst for Payment Reform recently gave Oregon a “B” rating—up from an “F” in every prior year—for progress toward making price information more widely available. Unfortunately, there’s much less here than meets the eye.

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News Release | OSPIRG

The maker of Humira, the world’s best-selling drug, faces a new legal challenge over alleged anticompetitive tactics. Monday, the U.S. Public Interest Research Group (U.S. PIRG) filed an amicus brief in the 7th Circuit Court of Appeals arguing that AbbVie’s strategies of reverse payment settlements and creating “patent thickets” have delayed the entry of biologically similar generic drugs (biosimilars) onto the market, costing Americans billions of dollars. 

Report | OSPIRG Foundation

COVID-19 is putting incredible stress on the U.S. medical system, including the work of hospital biomedical repair technicians, known as biomeds or BMETs. These technicians are essential; hospitals need working equipment to diagnose and treat patients. But in some cases, manufacturers restrict access to what biomeds need.

News Release | OSPIRG Foundation

The coronavirus (COVID-19) pandemic is putting incredible stress on the U.S. medical system, including the equipment that is essential to diagnose and treat patients, such as ventilators. As that equipment is pressed into round-the-clock use, biomedical repair technicians face increasing pressure to maintain and repair all that equipment. However, in too many cases, manufacturers limit access to the essential tools and information these repair experts need. A new report by the OSPIRG Foundation, Hospital Repair Restrictions, details the challenges that medical professionals face as a result of device manufacturers setting up barriers to repair, and outlines steps to take to help hospitals. 

News Release | OSPIRG

Oregon's Drug Price Transparency Program has released its first annual report.  The progam found that Oregonians, on average, pay five times the highest international price for prescriptions.  

Blog Post

OSPIRG Health Care Advocate Numi Griffith breaks down how health insurance reduced her medical bills by over $16,000 after a climbing accident.

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