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

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.

> Keep Reading
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.

> Keep Reading
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.

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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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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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News Release | OSPIRG Foundation | Health Care

Regence rate hike scaled back

State officials have decided to trim Regence BlueCross BlueShield of Oregon’s proposal to raise rates for more than 52,000 Oregonians with individual health insurance plans. Instead of the 9.6% rate hike proposed, the Oregon Insurance Division approved an 8.9% average increase, with some consumers seeing increases as high as 15.6%. Regence does not appear to have resolved many of the problems identified in OSPIRG Foundation's analysis of their proposal. In addition, elements of the decision were based on information that was not made available to the public.

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News Release | OSPIRG Foundation | Health Care

Regence Rate Hike Not Justified

Regence BlueCross BlueShield of Oregon’s proposal to raise rates for Oregonians with individual health insurance plans does not measure up, according to a new OSPIRG Foundation analysis.

> Keep Reading
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.

> Keep Reading
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.

 

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Report | OSPIRG Foundation | Health Care

Comments on LifeWise Health Plan's Proposal for Individual Health Insurance Rates

LifeWise Health Plan of Oregon has proposed premium rates for its individual and family plans for 2014. After careful analysis of LifeWise’s initial filing and the supplemental information provided, OSPIRG Foundation's analysis questions whether the insurer has provided sufficient information to evaluate the justification for their proposed rate.

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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.

 

> Keep Reading
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.

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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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Pages

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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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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