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

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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News Release | OSPIRG Foundation | Health Care

Providence’s proposed 22.7% rate hike merits close scrutiny, underscores stakes for consumers in health reform debate

Providence Health Plan has proposed a rate hike of 22.7% on average—as high as 68.3% for some—on over 104,000 Oregonians. According to a new OSPIRG Foundation analysis released today, this rate hike proposal highlights not only the need for close scrutiny of health insurance rates, but also the high stakes for consumers in the federal health reform debate and the urgency of action to contain the rising cost of health care services.

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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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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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Pages

Media Hit | Health Care

OSPIRG: 16 Health Insurance Companies Need To Justify Rates

An Oregon consumer group says the 16 companies that have proposed insurance rates for the state's new health exchange haven't offered adequate justification for prices.

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News Release | OSPIRG Foundation | Health Care

Proposed 2014 health insurance rates lack adequate justification

Sixteen Oregon health insurance companies have proposed their premium rates for next year, and according to new OSPIRG Foundation analysis released today, many have failed to adequately justify their prices.“With some insurers proposing rates twice as high as others for identical coverage, it is more critical than ever to scrutinize the basis for these rates,” said Jesse O’Brien, OSPIRG Foundation Health Care Advocate.

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News Release | OSPIRG Foundation | Health Care

$80 Million In Health Insurance Waste Cut Since 2010

Since 2010, close scrutiny of health insurance rate hikes has cut over $80 million in waste and unjustified costs from health insurance premiums in Oregon, according to an OSPIRG Foundation report released today. The report also identifies changes to Oregon’s rate review program that would effectively tackle the biggest driver of costs: waste in the health care delivery system.

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Media Hit | Health Care

Public comment sought on rules for Oregon health insurance exchange

State officials are holding a hearing Wednesday to receive public comment on rules for the state's health insurance exchange -- essentially an online marketplace for consumers called for by federal health reforms.

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Media Hit | Health Care

What's Next on Health Care Costs?

Now that the election is over, talk has turned to the need to work together and get results for America. It's a tall order, and on the polarized issue of health care, it may seem at first like an impossible task. But I am hopeful that we can make significant progress together.

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Pages

Report | OSPIRG | Health Care

Should I Stay or Should I Go?

Tips for consumers deciding whether to keep their individual health insurance plan or switch to a new plan for 2014.

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Report | OSPIRG Foundation | Health Care

Accountability in Action

Close scrutiny of proposed health insurance premiums for 2014 has cut over $69 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 $155 million since 2010, providing more evidence that Oregon’s effort to create accountability for health insurers is starting to pay off.

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Report | OSPIRG Foundation | Health Care

Comment on Providence Health Plan's Proposed Individual Health Insurance Rates

Providence Health Plan has proposed premium rates for its individual and family plans for 2014. The insurer initially filed for significantly higher rates than Oregon’s other top insurance companies,   but then proposed lowering the rates. Doing so would bring the rates in line with those of competing insurers. OSPIRG Foundation's analysis of Providence's initial filing and the supplemental information provided raises some concerns about the insurer's proposal and its justification.

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Report | OSPIRG Foundation | Health Care

Comment on Kaiser Foundation Health Plan's Proposed Individual Health Insurance Rates

Kaiser Foundation Health Plan of the Northwest has proposed premium rates for its individual and family plans for 2014. Since its initial rate filing, the insurer has submitted a proposal to reduce those rates. OSPIRG Foundation's analysis of Kaiser’s initial filing and the supplemental information provided raises some concerns about the insurer's proposal and its justification.

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Report | OSPIRG Foundation | Health Care

Comment on BridgeSpan Health Company's Proposed Individual Health Insurance Rates

BridgeSpan Health Company—a new health insurer affiliated with Regence BlueCross BlueShield of Oregon through a parent company, Cambia Health Solutions—has proposed premium rates for its individual and family plans for 2014. OSPIRG Foundation's analysis raises questions about the insurer's justification for the proposal, and about BridgeSpan's efforts to reduce costs by cutting waste and focusing on prevention.

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Blog Post | Health Care

A New Health Care Marketplace is Coming: Get Informed and Protect Yourself from Fraud | Jesse Ellis O'Brien

In just a few weeks, Oregon’s new health insurance marketplace, Cover Oregon, will be open for business. Any new program can be confusing for people at first, and scam artists and unscrupulous business ventures may try to take advantage of that confusion to rip off consumers. To make sure this doesn’t happen to you, be sure to check out these top tips for protecting yourself from fraud.

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Blog Post | Health Care

All you need to know about the 2014 health insurance rate decisions--in one chart! | Jesse Ellis O'Brien

Scrutiny of health insurance rates has cut over $69 million in waste and unjustified costs from 2014 premiums. This chart breaks it down for you.

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Blog Post | Health Care

Few Oregonians will receive health insurance rebate checks this year—Here’s why that’s a good thing | Jesse Ellis O'Brien

This summer, consumers and businesses nationwide will receive $500 million in rebates from health insurance companies. Only 1 in every 200 Oregonians will see a dime as a result of this program, and that’s great news for our state. Here’s why.

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Blog Post | Health Care

Competition and Transparency Bring Down Health Insurance Costs—Here’s the Proof | Jesse O'Brien

Something remarkable just happened to health insurance costs here in Oregon. Last week, after the state’s health insurers posted their proposed premium rates for next year, two insurers publicly reversed course and moved to cut their prices.

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Blog Post | Health Care

A new way of shopping for health insurance gets a trial run | Jesse Ellis O'Brien

 

For the first time, the Oregon Health Insurance Exchange brought in consumers and outside experts to review their designs for their online marketplace. I was there, and here’s some of what I learned.

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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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