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 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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Blog Post | Health Care

Tax Season and Health Care: What You Need to Know | Jesse Ellis O'Brien

Tax season is here, and many Oregonians may have questions about new tax forms and provisions, including health premium tax credits and the new requirement to purchase health insurance. Here’s what you need to know.

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Blog Post | Health Care

Open Enrollment: Here’s What You Need to Know | Jesse Ellis O'Brien

The countdown is on for enrolling in health insurance for 2015. With all of the changes coming to health care in Oregon, it’s more important than ever to get the facts about what’s happening and how you and your family can get coverage that works for you. Here’s our guide to Oregon’s open enrollment period, which starts November 15.

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News Release | OSPIRG Foundation | Health Care

Over $24 Million in Waste Cut from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses, according to a new OSPIRG Foundation report released today. The cuts come after OSPIRG Foundation’s analysis questioned the justifications of four major rate proposals. Taken together with cuts made since new standards were implemented, state officials have required insurers to cut $179 million in waste since 2010.

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Pages

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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Media Hit | Health Care

Does Your State Even Care What You Pay for Health Insurance?

After watching health insurance rates balloon in the last several years, you might wonder who has the consumer's back. States are largely responsible for overseeing how much health insurance companies charge for coverage, but they're all over the map in terms of how hard they scrutinize proposed premiums.

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Media Hit | Health Care

Health insurance premiums

Oregon health insurers are having a harder time raising premiums now than they have in the past.

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Media Hit | Health Care

An insurance regulator's 'aha' moment

Teresa Miller was dubious. What value could a public hearing add to the state of Oregon's highly technical review of a Regence BlueCross BlueShield of Oregon's rate increase request?

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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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Report | OSPIRG Foundation | Health Care

Building a Better Health Care Marketplace: Ensuring Accountability

The creation of a new health insurance exchange offers states an opportunity to improve health care and lower costs by pooling consumers’ bargaining power, creating economies of scale, and pushing insurers toward delivering lower costs and higher quality.

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Report | OSPIRG Foundation | Health Care

Comments on Health Net's Rate Increase Proposal

Health Net Health Plan of Oregon is proposing an average 8.27% rate increase on small business plans impacting 37,872 Oregonians, effective April 1, 2011.

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Report | OSPIRG Foundation | Health Care

Comments on United HealthCare's Proposed Rate Hike

In this rate filing, United HealthCare does not appear to justify the proposed 16.8% increase.

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Report | OSPIRG Foundation | Health Care

Delivering on the Promise

The recently passed federal health care reform law will make significant changes in how health insurance and health care work for consumers, businesses, and local and state governments, as well as how insurers and providers operate.  But whether Americans experience improved care, lower costs and greater access depends largely on what happens next.

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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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