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

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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News Release | OSPIRG Foundation | Health Care

Four proposed health insurance rate hikes lack adequate justification

New OSPIRG Foundation analysis of 2015 rates proposed by four Oregon insurers—Moda, PacificSource, United and Health Net—identifies problems and gaps in the insurers’ filings, and calls for increased scrutiny of insurers’ efforts to cut waste and improve quality of care.

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Blog Post | Health Care

The Whole Shebang at a Glance: Proposed Health Insurance Rates for 2015 | Jesse Ellis O'Brien

Here’s the skinny on OSPIRG Foundation’s new analysis of 2015 rates proposed by four Oregon insurers—Moda, PacificSource, United and Health Net. 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 Moda Health Plan's proposal to raise individual health insurance rates

Moda Health Plan’s membership of more than 95,000 Oregonians with individual health insurance plans will see double-digit rate hikes of 12.5% on average, and as high as 13.7%, if the premium rate hike proposed by Moda goes forward.

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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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Media Hit | Health Care

State decision draws reactions from Regence, consumers’ group

The Statesman Journal’s Editorial Board recently met with Regence BlueCross BlueShield of Oregon regarding their proposed increase for individual plans. A ruling by the state’s insurance division prompted these statements today:

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Media Hit | Health Care

22 percent rate increase by Regence BlueCross BlueShield of Oregon brings out strong protest

Concerns about surging health care costs drove more than 150 people Thursday to hear Oregon's largest health insurer defend its request to raise premiums an average 22 percent.

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Media Hit | Health Care

Oregon Insurer Raising Rates

GUESTS:

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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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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. 

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. 

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

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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