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 Whole Shebang at a Glance: Proposed Health Insurance Rates for 2016 | Jesse Ellis O'Brien

Here’s the skinny on OSPIRG Foundation’s new analysis of 2016 rates proposed by four Oregon insurers—LifeWise, Moda, PacificSource 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 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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News Release | OSPIRG Foundation | Health Care

Public Comments Due on Regence Rate Hike

Oregonians impacted by Regence’s small business rate increase proposal have until the end of the day Tuesday, January 10th to submit public comments to the Oregon Insurance Division. 

 

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News Release | OSPIRG Foundation | Health Care

15%+ Regence Rate Hikes for Some Small Businesses

If Regence BlueCross BlueShield’s proposal is approved, small businesses will see rates rise 8.0% on average, with some jumping more than 15% in the next year, according to a new analysis by OSPIRG Foundation’s Health Insurance Rate Watch project.

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News Release | OSPIRG Foundation | Health Care

ODS Rate Hike Nudged Down to 8.94%

Officials at the Oregon Department of Consumer and Business Services (DCBS) announced approval of an of an 8.94% rate increase on ODS individual policies, down one percentage point from the proposed 9.94% average rate hike.

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Media Hit | Health Care

Oregon Eyes Insurance Rate Increase

SALEM, Ore. - Customers of one of Oregon's largest health insurance companies may see a large rate increase soon. State insurance regulators held a rare public hearing Wednesday on the request by ODS Health Plan to hike its rates an average of 10 percent.

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Media Hit | Health Care

Testing a new reflex on health care

Earlier this year, Regence BlueCross BlueShield of Oregon found itself under a powerful spotlight. At a public hearing -- the first such hearing in more than two decades -- Regence had to justify its 22.1 percent rate increase request to state regulators, as well as to the more than 150 Oregonians in attendance.

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Report | OSPIRG Foundation | Health Care

Making the Grade

By providing better options and better information, and negotiating on behalf of its enrollees, the exchange can level the playing field for consumers.

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Report | OSPIRG Foundation | Health Care

Comments on ODS Health Plan's Proposal to Increase Rates 9.94%

ODS Health Plan (ODS) is proposing to raise rates an average of 9.94%, impacting 26,333 Oregon consumers and families with individual plans, effective November 1, 2011. The nearly 10% rate increase comes after two back-to-back years of increases exceeding 17%. If approved, the average rate will have increased 52% for individual policyholders over the last three years.

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Report | OSPIRG Foundation | Health Care

Comments on Regence Proposal to Increase Rates 22%

Regence BlueCross BlueShield of Oregon (Regence) is proposing to raise rates an average of 22.1% on individual plans. These are plans for people who do not have employer-based coverage. If approved, this rate increase will impact 59,477 Oregonians effective August 1, 2011.

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Report | OSPIRG Foundation | Health Care

Comments on Regence Proposal to Raise Small Businesses Rates

Regence Blue Cross Blue Shield (Regence) is proposing a rate increase on small business plans, with an average increase of 10.8%, impacting 54,299 Oregonians, effective July 1, 2011.

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Report | OSPIRG Foundation | Health Care

Building a Better Health Care Marketplace: Negotiating for a Better Deal

A well-made state exchange can help deliver lower costs for individuals and small businesses. Just as big businesses negotiate with insurers, using the bargaining power of their employees to push for lower premiums, so too can exchange enrollees benefit from a muscular exchange that negotiates on their behalf for better choices and lower costs.

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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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