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

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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Report | OSPIRG Foundation | Health Care

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

PacificSource Health Plans’ members with individual health insurance plans will see rate hikes of 15.2% on average, and as high as 25%, if the premium rate hike proposed by PacificSource 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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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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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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News Release | OSPIRG | Health Care

Supreme Court Upholds Affordable Care Act

Today’s decision is good news for consumers in Oregon. Now it’s time for Oregon leaders to move forward on the next steps, and make sure health reform delivers lower costs and better quality coverage.

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News Release | OSPIRG Foundation | Health Care

Health Net Rate Hike Not Justified

If approved, the rate increase would impact 38,492 Oregonians with coverage through a small business employer. Of those enrollees, 14,298 would see rates rise between 11% and 30%.

 

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News Release | OSPIRG Foundation | Health Care

Health Insurance Rates to Rise 8-14% for Many Oregon Small Businesses

If approved, the insurer will raise rates 5.56% on average beginning in July, affecting 35,224 Oregonians enrolled in coverage through a small business employer.

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Pages

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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Report | OSPIRG Foundation | Health Care

Raising the Bar: Strategies to contain cost and improve quality in Oregon’s health insurance exchange

Oregon’s new health insurance exchange has the potential to rein in the rising cost of health insurance and the underlying cost of care, while improving quality and giving consumers better choices. With the purchasing power of hundreds of thousands of Oregonians behind it, the exchange has the power to build better value for consumers, but it can only live up to its promise if it works from the beginning to raise the bar for health insurance in Oregon.

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Report | OSPIRG Foundation | Health Care

At Stake: What's on the Line for Health Care Consumers in the Pending Supreme Court Case

The outcome of the U.S. Supreme Court’s ruling on the Affordable Care Act (ACA) will have far reaching impacts on consumers. The law is already working to improve the quality of care and reduce costs, with millions of Americans experiencing concrete improvements in their coverage. In this issue brief, we highlight the number of people the law has helped so far and the costs already saved to illustrate what’s at stake for Oregon consumers in the pending Supreme Court case.

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Report | OSPIRG Foundation | Health Care

Comments on PacificSource's Small Business Rate Hike Proposal

PacificSource is proposing to increase rates 5.56% on average, affecting 35,224 Oregonians enrolled in small business plans. If approved, this rate increase will have wide ranging impacts. Most enrollees will see increases of between 6% and 10%. Some will see increases of up to 11.2%. Over 27% will see increases of between 8% and 14%.

 

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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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