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

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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Blog Post | Health Care

OSPIRG Seeks Consumer Stories about Health Care in Oregon | Charlie Fisher

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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Report | OSPIRG Foundation | Health Care

OSPIRG FOUNDATION COMMENTS ON THE PROVIDENCE HEALTH PLAN PROPOSAL FOR INDIVIDUAL HEALTH RATES EFFECTIVE JANUARY 2019

Providence Health Plan’s 91,425 members with individual health insurance plans will see rate hikes of 13.6% on average, and as high as 24.1%, if the premium increase proposed by Providence goes forward. 

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Pages

News Release | OSPIRG Foundation | Health Care

Over $24 Million in Waste Cut from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses, according to a new OSPIRG Foundation report released today. The cuts come after OSPIRG Foundation’s analysis questioned the justifications of four major rate proposals. Taken together with cuts made since new standards were implemented, state officials have required insurers to cut $179 million in waste since 2010.

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News Release | OSPIRG Foundation | Health Care

Four proposed health insurance rate hikes lack adequate justification

New OSPIRG Foundation analysis of 2015 rates proposed by four Oregon insurers—Moda, PacificSource, United and Health Net—identifies problems and gaps in the insurers’ filings, and calls for increased scrutiny of insurers’ efforts to cut waste and improve quality of care.

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News Release | OSPIRG | Health Care

Consumer Tips: Keep Your Health Plan or Switch for 2014?

OSPIRG offers top tips and a checklist to help consumers weigh their options.

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Media Hit | Health Care

Oregon Adopts New Rules To Slow Rise Of Health Care Costs

New Oregon Health Policy Board rules require that insurance companies better justify increases in their premiums.

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News Release | OSPIRG | Health Care

Kitzhaber Administration takes action on health care costs

At the direction of Gov. Kitzhaber, the Oregon Health Policy Board has adopted an OSPIRG-backed proposal to take steps toward cutting the waste out of our health care system, estimated to make up as much as 1/3 of every dollar we spend on care.

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Report | OSPIRG Foundation | Health Care

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

PacificSource Health Plan members with individual health insurance plans will see rate hikes of 42.7% on average, and as high as 60.4%, if the premium rate hike proposed by PacificSource goes forward. PacificSource’s increase is the largest proposed by a major health insurance carrier in Oregon’s individual market since 2010, when new rules heightening scrutiny of health insurance rates were implemented.

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Report | OSPIRG Foundation | Health Care

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

Regence BlueCross BlueShield’s membership of more than 24,000 Oregonians with individual health insurance plans will see rate hikes of 12.3% on average, if the premium rate hike proposed by Regence goes forward. Some Regence members in transitional plans that will be discontinued at the end of the current year, which do not include the consumer protections of the federal health reform law, may see increases of up to 235% if they stick with Regence.

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Report | OSPIRG Foundation | Health Care

Comments on LifeWise Health Plan of Oregon's proposal to raise individual health insurance rates

LifeWise Health Plan of Oregon’s 26,405 members with individual health insurance plans will see rate hikes of 37.2%on average, and as high as 45%, if the premium rate hike proposed by LifeWise 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 membership of more than 102,000 Oregonians with individual health insurance plans will see rate hikes of 25.6% on average, and as high as 54.12%, if the premium rate hike proposed by Moda goes forward. Moda currently has the largest market share in Oregon’s Individual market. Moda’s increase is the largest proposed by the dominant carrier in the individual market since 2010, when new rules heightening scrutiny of health insurance rates were implemented.

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Report | OSPIRG Foundation | Health Care

Accountability in Action: Rate Review Cuts Over $24 Million in Waste from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses. This brings the total waste cut by Oregon’s rate review program to over $179 million since 2010.

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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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Blog Post | Health Care

Proposed Health Insurance Rates for 2017: What You Need to Know | Jesse Ellis O'Brien

Here’s the skinny on OSPIRG Foundation’s new analysis of 2017 rates proposed by five Oregon insurers—Kaiser, Moda, PacificSource, Providence and Regence. There’s some good news, some concerning news, and some very concerning news, but the best news of all is that thanks to Oregon’s health insurance rate review process, the insurers don’t get the last word.

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Blog Post | Health Care

New data on health care prices raises questions for policymakers | Jesse O'Brien

A New York Times report released yesterday put the spotlight on health care prices. We all know that health care still costs too much, but too often, we have little information about how much it does cost and why.

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Blog Post | Health Care

Open Enrollment: Shop Before You Buy, Shop Before You Renew | Jesse Ellis O'Brien

It’s that time again: Time to enroll in health insurance for 2016. Health care and health insurance remain in the news in Oregon, and with everything that’s happening, it’s more important than ever to get the facts about what’s happening and how you and your family can get coverage that works for you. Here’s our guide to Oregon’s open enrollment period, which starts November 1.

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Blog Post | Health Care

Will Oregon’s health reforms deliver results for consumers? A new study raises some tough questions. | Jesse Ellis O'Brien

According to a new study, Oregon’s efforts to transform health care are not yet delivering on their potential to improve the consumer experience.

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Blog Post

OSPIRG Foundation has prepared this guide to help you understand how you can get health coverage if you’re at risk of losing employer sponsored insurance, what special protections have been created for insured consumers in Oregon, what insurance coverage can help you with during the outbreak, and what benefits are available to all Oregonians under emergency measures.

Report | OSPIRG Foundation

People living in the United States have access to some of the best medical care in the world, from life-saving drugs to cutting-edge surgical techniques. But our system is deeply flawed, with spiraling costs forcing many Americans to spend more on care and often receiving poor quality care for all the extra money spent.

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.

Blog Post

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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