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

Proposed health insurance rate hikes up to 32.3% merit close scrutiny, raise stakes for containing rising health care costs

Many of Oregon’s biggest health insurers have proposed large double-digit rate hikes for 2017, and according to new OSPIRG Foundation analysis released today, these proposals highlight not only the need for close scrutiny of health insurance rates, but also the urgency of action to contain the rising cost of health care services.

> Keep Reading
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.

> Keep Reading
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.

> Keep Reading
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.

> Keep Reading
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.

> Keep Reading

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Media Hit | Health Care

Regence BlueCross BlueShield defends proposed rate hike at Salem hearing

Escalating medical and prescription drug costs have given Regence BlueCross BlueShield executives little choice but to raise rates an average 9.6 percent for people who buy their own insurance, an executive told Oregon insurance regulators Monday.

Jesse Ellis O'Brien of the OSPIRG Foundation said Oregonians will face less choice and more costs as a result of the proposal.

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Media Hit | Health Care

Regence Reduces Payments to Healthcare Professionals

July 26, 2012 -- Physicians and other healthcare professionals are being hit with a rate reduction from Regence BlueCross BlueShield on October 1, while the insurer is asking the Insurance Division to approve a 9.6 percent increase for roughly 53,000 people who buy their own coverage. A public hearing on that rate request will be held next Monday at 3 p.m. in Salem.

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News Release | OSPIRG Foundation | Health Care

Providence Customers May See Rates Rise As Much As 18.6%

 

More than 12,000 Oregonians with individual health insurance plans will see rate hikes of 15.7% on average, and as high as 18.6%, if the premium rate hike posted today by Providence Health Plans goes forward. Many customers will also see increased out-of-pocket costs.

 

> Keep Reading
News Release | OSPIRG Foundation | Health Care

Regence Rate Hike To Reach 16.4% for Some Customers

More than 52,000 Oregonians with individual health insurance plans will see rate hikes of 9.6% on average, and as high as 16.4%, if the premium rate hike posted today by Regence BlueCross BlueShield goes forward. At the same time, customers in lower-deductible plans will face out-of-pocket costs starting at $2,500 before coverage kicks in, and consumers in the Portland metro area may need to change providers.

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Media Hit | Health Care

Portland-area Regence BlueCross BlueShield individual members could see rate hikes as high as 15.3 percent

Individual members of Regence BlueCross BlueShield could see an average 9.6-percent rate increase statewide, requested by the insurer months after announcing network changes to cut costs.

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Report | OSPIRG Foundation | Health Care

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

 

Moda Health Plan—formerly known as ODS Health Plan—has proposed premium rates for its individual and family plans for 2014. Moda’s proposed rates are the lowest filed for an insurer in Oregon’s Individual market. While Moda’s product is inexpensive relative to the competition, it remains critical to examine the justification for their rate.

 

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Report | OSPIRG Foundation | Health Care

Advancing Accountability, Cutting Health Care Waste

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 a new OSPIRG Foundation report. 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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Report | OSPIRG Foundation | Health Care

Comments on PacificSource Health Plans Proposal to Increase Small Group Health Insurance Rates

PacificSource Health Plans is proposing a rate increase on small business plans that will affect over 36,000 Oregonians, with an average increase of 8.62% and ranging up to 14.5% for some customers. If approved, the increase would go into effect January 1, 2013.

> Keep Reading
Report | OSPIRG Foundation | Health Care

Comments on Providence Health Plans Proposal to Increase Individual Health Insurance Rates

More than 12,000 Oregonians with individual health insurance plans will see rate hikes of 15.7% on average, and as high as 18.6%, if the premium rate hike proposed by Providence Health Plans goes forward. OSPIRG Foundation's analysis raises questions about the insurer's justification for the rate increase.

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Report | OSPIRG Foundation | Health Care

Comments on Regence BlueCross BlueShield's Proposal to Increase Individual Health Insurance Rates

More than 52,000 Oregonians with individual health insurance plans will see rate hikes of 9.6% on average, and as high as 16.4%, if the premium rate hike proposed by Regence BlueCross BlueShield of Oregon goes forward.

OSPIRG Foundation's analysis finds problems and information gaps in the insurer's filing.

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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.

> Keep Reading
Blog Post | Health Care

Here’s that Rx refill you didn’t order | Jesse O'Brien

Is your pharmacy refilling your prescription without your knowledge or approval, and billing your insurance company for the cost? If so, it’s the latest example of waste we shouldn't tolerate in our health care system.

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Blog Post | Health Care

A wake-up call on health insurance costs | Jesse Ellis O'Brien

Governor Kitzhaber’s office just released a report that should serve as a wake-up call for everyone in Oregon who is affected by the rising cost of health insurance.

This report just underlines what we’ve been saying all along—that it’s time to get serious about the cost of health care.

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Blog Post | Health Care

Regence alters course in response to consumer outcry | Jesse Ellis O'Brien

It's a difficult and confusing time to be a Regence customer. After announcing drastic network cutbacks last month, Regence altered course today in the wake of widespread criticism. But Regence customers can still expect to be paying more and getting less.

> Keep Reading
Blog Post | Health Care

Regence Rate Increase Hearing

Health insurance premiums are going up again. The latest request for a rate hike came from Regence for their small group plans. The average increase requested over the next year will be 8%, but some businesses will see increases in excess of 15%. At OSPIRG Foundation, we’re concerned that Regence has not adequately justified this increase request.

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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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