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

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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Report | OSPIRG Foundation | Health Care

Accountability in Action: Rate Review Cuts Over $24 Million in Waste 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. This brings the total waste cut by Oregon’s rate review program to over $179 million since 2010.

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Blog Post | Health Care

Health Insurance Rates for 2015 Announced Today | Jesse Ellis O'Brien

Today, the Oregon Insurance Division—the state’s insurance regulator—announced its decisions on health insurers’ rate proposals for next year. These decisions come after OSPIRG Foundation’s in-depth analysis raised numerous questions about some of the larger proposed rate increases.

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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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News Release | OSPIRG Foundation | Health Care

Oregon Officials Cut Regence Rate Hike from 22.1% to 12.8%

We commend the Oregon Department of Consumer and Business Services for shielding 60,000 Regence customers from what could have been a devastating 22.1% rate hike this year.

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Media Hit | Health Care

Oregon Insurance Division OKs 12.8 percent health insurance rate increase, rejects 22 percent

The Oregon Insurance Division will allow the state's largest health insurer to raise rates on individual premiums an average 12.8 percent, far lower than the 22.1 percent the company had requested.

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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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Report | OSPIRG Foundation | Health Care

Premiums on the Rise

In 2008, over 400,000 Oregonians received an average rate increase over 4 times the rate of inflation, with 133,000 Oregonians hit with premium increases over 21%.

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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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