Price Transparency

Oregon's Hospitals, Legislators Celebrate Landmark Price Transparency Bill

The Oregon Association of Hospitals and Health Systems (OAHHS), which represents all of Oregon's 62 community hospitals, today celebrated the passage of a bill that will set up a groundbreaking hospital price transparency website. The bipartisan bill, SB 900, supported by OAHHS and other stakeholders, passed the legislature on July 6, 2015.

The bill directs the state to set up a user-friendly website that displays median prices for the most common inpatient and outpatient hospital procedures, as paid by commercial insurers, giving Oregonians a clearer view of the cost of care.

"Senate Bill 900 gives Oregonians a new resource for patient-friendly price transparency," said Andy Davidson, president and CEO of OAHHS. "With a broad, bipartisan coalition of legislators and stakeholders behind the bill, Oregon should be proud that it will be leading the way in bringing price transparency to patients. Oregon hospitals applaud the efforts of all those involved, from legislators, to hospitals, to health care partners and beyond. This bill, in combination with hospitals' other price transparency initiatives, will make a difference in our state.

"SB 900 will allow me to better serve my patients in my practice as a physician," said Senator Alan Bates (D-Ashland). "I will be able to get a sense of what my referrals will mean financially to my patients. Price transparency in the health care sector is long overdue, and today Oregon took a big step forward. I applaud the hospitals for championing this approach and look forward to working with them on implementation."

"The health care system in Oregon is a national leader in many ways, and today we have taken a step toward leading on price transparency," said Senator Jeff Kruse, (R-Roseburg). "Like other industries, health care needs to compete on price and seek to deliver the best value to its customers. SB 900 will move our state and its system in that direction and I commend all those involved in this effort."

"Price transparency in Oregon got a huge boost when we passed SB 900," said Representative John Lively, (D-Springfield). "Our constituents asked for tools to manage health care expenses and we heard them loud and clear. In passing this bill, we have set in motion a process that will lead to a valuable source of information for Oregonians, which will allows them to make informed choices about health care."

Currently, Oregon receives an "F" on the influential Catalyst for Payment Reform Price Transparency scorecard, and SB 900 was designed with the intention of moving Oregon toward an "A." According to the group, one of the most important steps to receive an "A" is to pass legislation mandating price data be shown on a website in a consumer-friendly manner. SB 900 will accomplish that goal and will help move Oregon significantly up the ranks on the scorecard.

"We've worked hard to understand how to provide patients meaningful price information," added Davidson. "This measure will serve as a starting point to ensure our state becomes a national leader in providing price information patients can use. Oregonians will now be able to see the prices paid for common procedures at hospitals, which is an important step forward."

The price transparency bill is an integral piece of a three-pronged approach put forward by hospitals, which would allow Oregonians to understand health care prices in advance of care. Beyond the passage of the bill, OAHHS is:

  • Working with members of the Oregon Health Leadership Council to build a plan that would provide insured Oregonians with cost estimates directly from their insurer and;
  • Pledging to provide good-faith estimates to out-of-network patients in advance of care.

"Our three-pronged approach means that whether an Oregonian has insurance or not, whether they are in-network or out, they are able find out what a procedure will cost them ahead of time," concluded Davidson. "We needed SB 900 to ensure that all the pieces are there to serve Oregonians."

OAHHS' push for price transparency follows the recent launch of a transparency website, to provide patients with user-friendly government data about the quality of care in Oregon hospitals. The website can be found at www.orhospitalguide.org.

Media Coverage of Price Transparency


Want to Price Shop for Surgery?

by Lisa Balick, KOIN 6 News

A legislative bill would require the Oregon Health Authority to post average prices for the top 50 most common hospital surgeries and top 100 most common outpatient procedures in one spot.

The Oregon Association of Hospitals and Health Systems behind the bill would provide consumers and estimate of the average cost of a procedure at various hospitals, based on what an insurance company pays the hospital.

The measure would also require hospitals to give patients without insurance an estimate for a scheduled procedure, if asked.

There is currently nothing to prevent a consumer from requesting that information now.

Several states already have hospital transparency websites that provide ways to compare hospital prices. But some of those don’t factor in what insurance is often paying.

While many consumers are paying more with higher deductibles now, it’s a way to shop around to price a specific procedure. It’s often best to call your insurance company to find out how much would be your responsibility.

The hospital pricing measure is scheduled to be heard in two weeks.

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Hospital Transparency Bill To Shed Light On Cost

By Aaron Nilsson, KTVL Medford

The future of healthcare in Oregon is on the brink of changing.

Oregon lawmakers are discussing possible “window shopping” for healthcare. 

Healthcare providers in Oregon said a new state website will lay out the prices for the 50 most common inpatient procedures and the 100 most common outpatient procedures.

Michael Bennett works for Asante as Director of Revenue Cycle and said this is a growing trend throughout the country.

He said other states are looking at options, but Oregon is progressive in pushing towards it now.

"The value of program in Oregon is it's a collaboration between hospitals and that's not being forced on us. We are for making things more transparent for patients and that's a mindset here in Oregon,” Bennett said.

Bennett said this will make the administration's burden lighter and make cost information readily available for patients, letting them know exactly which hospitals supply the information.

Phillip Schmidt is the Director of Public Affairs with the Oregon Association of Hospitals and Health Systems.

He said once the website is up, it will serve as a basic one-stop-shop for patients so they know what they're getting into before they go under the knife.

"If you're in the back of an ambulance with a heart attack, you're probably not price shopping," Schmidt said.

However, if passed, the new state website will allow anyone without life-threatening issues to do just that, shop around.

Schmidt said healthcare is needed by everyone, so it affects everyone.

Besides the new website, the O.A.H.H.S. said it is working on two other items, work with insurers to help patients understand their out-of-pocket expenses, and commit Oregon's hospitals to give a good-faith estimate to patients, upon request, for the cost of a scheduled procedure. 

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Editorial: Oregonians need better healthcare transparency

by The Bend Bulletin Editorial Board

Imagine walking into a car dealership blindfolded. You have to buy a car, but you can’t know the price or the quality.

It would be a crazy way to shop. Consumers wouldn’t be informed and would be making choices that might not make much sense.

But in many cases, consumers have to shop that way when it comes to health care. It’s not easy to find the price. It can be unclear what insurance covers. It can be hard to learn about quality.

“The current system is not transparent enough and presents a moral hazard where both doctor and patient are often not aware of the true costs,” state Rep. Knute Buehler, R-Bend, and a doctor, told us. “This is particularly problematic when others are paying the bill.”

Two bills in the Oregon Legislature attempt to improve the situation.

Senate Bill 900 would require the Oregon Health Authority to post median prices for hospitals and outpatient clinics of the 50 most common inpatient procedures and the 100 most common outpatient procedures.

Senate Bill 891 is slightly different. It requires each health care facility to publish the data. The prices included would be the 100 most common inpatient and 100 most common outpatient services provided in the state. And SB 891 also requires health care facilities to respond to an inquiry from a patient about a bill in a “timely manner.” It’s unclear what timely manner means. The Oregon Health Authority would be given power under the bill to impose penalties on facilities that do not comply.

We urge the Legislature to support SB 900 over SB 891. This law for pricing transparency will be a new law. If we have learned anything about new laws, it’s that they can cause unforeseen problems as they try to fix problems. It’s good to go slow.

SB 900 is a more modest approach. SB 900 will be less onerous to set up and easier to tweak to get it right.

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Oregon bill could make hospital prices transparent

by Chris Willis, KGW News Channel 8

It could be a breakthrough in Oregon health care reform.

The next time you go to the doctor, how would you like to know the price of your procedure before you get it? We usually know prices of other products and services before we buy, so why not at hospitals?

Portlander Michael Rees can't remember how much his last trip to the doctor's cost.

"The thing that ends up being discussed in my house is what the deductible is," he said.

But we're not talking about the deductible. We want to know the total cost. How much did the hospital charge your insurance company? How much was that last medical procedure? Is the price the same at every hospital?

Nobody seems to know for sure.

Portlander Rhonda Zezula recently took her daughter to the hospital for dehydration. Months later, she still doesn't know how much it cost.

"Consumers need to be informed about what they're spending where they're spending it, especially when referring to emergency medicine," she said.

If Senate Bill 900 passes, you will know. And Oregon would be only the second state in the nation to offer this level of medical transparency.

The Oregon Association of Hospitals and Health Systems said every hospital in the state is on board.

"I think you're going to certainly have a sense of what things cost, where there's variation in price maybe begin to ask the questions about variations," said Andy Davidson, President and CEO of the Oregon Association of Hospitals and Health Systems.

There are three key elements to the transparency plan: First, a website that would show all median prices for common hospital procedures.

Davidson says the need for that is obvious. "I think the public doesn't want to hear excuses anymore, they actually want the answers."

Second, a commitment from insurance companies to help consumers with out of pocket expenses.

Third, an up-front estimate from hospitals showing costs for people paying for their own procedures.

Zezula agrees with that. "I want to be able to evaluate what I can spend this money here and there if we need future services."

Health care advocate Jesse O'Brien is with the consumer group OSPIRG, which is proposing a similar bill, SB 891. He says transparency will only help consumers.

"It would enable patients to have a frank conversation with their doctor about how they could get the best value, the best bang for their buck in health care," he said.

Senate Bill 900 has 10 sponsors in the legislature from both sides of the political aisle. It is expected to get very little opposition as it makes its way through the legislative session.

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Hospital Rates More Transparent Under Proposed Bill

by KBNW Central Oregon

The Oregon Association of Hospitals and Health Systems (OAHHS) today announced that it has developed a new price transparency initiative.
This initiative has three key elements:

1-Senate Bill 900 calls for a new state-run website displaying median prices paid for procedures at hospitals; tools for hospitals to provide good-faith estimates to self-pay and out-of-network patients; and a pledge to work with insurers to help insured patients understand their out-of-pocket expenses for care.

2-The second element involves working hand-in-hand with insurers via the Oregon Health Leadership Council (OHLC) to help patients who have insurance to understand what their out-of-pocket expenses will be.

3-The last element of the OAHHS initiative is a commitment by Oregon’s hospitals to assist Oregonians who are paying for their own care (or for out-of-network services not covered by their health plan) in getting a good-faith estimate from any hospital for the cost of a scheduled procedure upon request.

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2 Oregon bills promote health care pricing transparency

by Lynne Terry, The Oregonian

Two bills before the Oregon Legislature aim to inform consumers about health care pricing.

One bill would require extensive pricing information while the other would provide patients with median prices that would not be insurance-specific.

The latter, Senate Bill 900, has 10 sponsors in the Legislature and the backing of the Oregon Association of Hospitals and Health Systems. It would require that the Oregon Health Authority post median prices for the 50 most common inpatient procedures and the 100 most common outpatient procedures for hospitals and hospital outpatient clinics.

Andy Davidson, president and CEO of the Oregon hospital association, said the bill would inform patients of the cost of procedures in advance.

"We want to make sure that hospitals' pricing data is accessible and easy to find," Davidson said. "We we know that our patients want more health care pricing information."

The organization said that as part of its backing for the bill its members would provide patients without insurance who asked an estimate of the cost of a scheduled procedure. Estimates on out-of-network costs would be provided to insured patients.

The other proposal, Senate Bill 891, would require hospitals and health care facilities to post prices for the 100 most common inpatient and the 100 most common outpatient services in Oregon. Sponsored by Sens. Elizabeth Steiner Hayward, a Beaverton Democrat, and Brian Boquist, a Dallas Republican, SB 891 would require facilities to list charges billed to insurance companies and uninsured patients and the amount allowed by various payers, including Medicare and coordinated care organizations.

OSPIRG Health Care Advocate Jesse O'Brien said the bill comes at a key time when Oregonians are having to dip into their pockets to pay for a greater cost for medical services. "We all know that health care still costs too much," O'Brien said. "The least we can do is make sure health care facilities post their prices, like any other business."

SB 891 would require that health care facilities respond to a patient inquiry about a billed charge in a timely manner and includes potential sanctions, including revoking a license, against facilities.

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Making the Cost of Medical Procedures More Transparent

by OBP's Think Out Loud

​Two bills before the legislature now would give consumers greater access to pricing information from hospitals and clinics. Senator Steiner Hayward is sponsoring SB 891, which would require hospitals and clinics to post the cost of all procedures both on location and online. SB 900, supported by the Oregon Association of Hospitals and Health Systems, requires hospitals to post the median cost for the most frequently used procedures online.

GUESTS: Elizabeth Steiner Hayward: Democratic state senator from NW Portland/Beaverton (District 17); Andy Davidson: President of the Oregon Association of Hospitals and Health Systems

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Oregon Hospitals Launch New Price Transparency Initiative

OAHHS Press Release

The Oregon Association of Hospitals and Health Systems (OAHHS), which represents all of Oregon’s community hospitals, today announced that it has developed a new price transparency initiative.

This initiative has three key elements, all of which focus on giving consumers pricing details in advance of a visit to a hospital for a procedure. These include legislation (SB 900) calling for a new state-run website displaying median prices paid for procedures at hospitals; tools for hospitals to provide good-faith estimates to self-pay and out-of-network patients; and a pledge to work with insurers to help insured patients understand their out-of-pocket expenses for care.

“Our transparency initiative aims to assist Oregonians in understanding hospital prices in advance of procedures,” said Andy Davidson, president and CEO of the Oregon Association of Hospitals and Health Systems. “We want to make sure that hospitals’ pricing data is accessible and easy to find. We know that our patients want more health care pricing information and with this initiative, Oregonians will be able to find the data on hospital prices that will help their decision making.”

The first element of the initiative entails legislation (SB 900), calling for a website, run by the Oregon Health Authority, that would use state-collected data from the state’s existing All Payer All Claims database to display median prices paid for common hospital inpatient and outpatient procedures. This website would give patients the ability to understand what the typical cost of a particular procedure would be, as paid by insurers. It would allow them the ability to compare the prices paid for the most common procedures across hospitals. It would not, however, show a consumer what his or her specific insurer would cover or not cover; or what their out of pocket costs would be based on the design of their health plan. For that information, they would have to check with their insurer.

The second element entails working hand-in-hand with insurers via the Oregon Health Leadership Council (OHLC) to help patients who have insurance to understand what their out-of-pocket expenses will be. This information would be based on their insurer’s contract with a particular hospital or provider, along with information from the patient’s insurer as it pertains to their particular insurance coverage. It is clear that patients want to know what portion of charges they will be responsible for in advance, and Oregon hospitals and the OHLC will work to ensure that is achievable.

“The Oregon Health Leadership Council is committed to helping patients understand health care pricing—and is eager to work with our members to achieve that goal,” said Greg Van Pelt, president of the OHLC. “We know that people want health care providers and insurers to work together to ensure a patient-friendly experience. This is precisely what we intend to do.”

The last element of the OAHHS initiative is a commitment by Oregon’s hospitals to assist Oregonians who are paying for their own care (or for out-of-network services not covered by their health plan) in getting a good-faith estimate from any hospital for the cost of a scheduled procedure upon request.

“Oregon hospitals put the health care needs of their patients first every day. Oregonians know they can count on their community hospital for quality care, 24/7/365, and now they can count on us to be even better partners in informed decision making,” added Davidson.

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Legislature 2015: Hospital transparency bills could target high-priced procedures

by Elizabeth Hayes, Portland Business Journal

Two bills introduced in the Legislature take on the opaque and often puzzling world of hospital pricing.

While one of the bills goes much further than the other, they both attempt to give consumers greater access to pricing data from Oregon hospitals and clinics.

SB 891, sponsored by Sens. Elizabeth Steiner Hayward, a Beaverton Democrat, and Brian Boquist, a Dallas Republican, requires prices to be listed at clinic locations and online, along requiring with real-time price estimates, upon request.
"Just having the information out there will transform the way health care works in the state," said OSPIRG Health Care Advocate Jesse O'Brien. "It's a way to create a more level playing field, so consumers can shop around and providers can compete on price."

SB 900, which has seven sponsors in the House and Senate and is supported by the Oregon Association of Hospitals and Health Systems, requires less detailed price data to be posted on the Oregon Health Authority's site.
"The key message here is everyone acknowledges that driving improvements in price transparency is critical," said Robin Moody, the association's vice president of public policy. "Consumers want it and it's necessary for a healthy marketplace."
Oregon once had such a website, from 2007 to 2010, but the state mothballed it during the Recession, Moody said.

SB 900 would revive the site, culling price data on common inpatient and outpatient procedures from the All Payers All Claims database, "an underused asset," Moody said. The median price for all health plans would be posted.
Under the OSPIRG bill, clinics would post all negotiated prices with everyone from Medicare and Medicaid to the largest insurance plans. In addition, facilities would post additional fees, such as out-of-network fees.

Tom Holt, director of government affairs for Cambia Health Solutions (parent company of Regence Blue Cross Blue Shield of Oregon), said he doesn't support the bill because it's not user friendly.

"In order to derive anything useful, you would have to know (medical) codes," he said. "It would impose a significant administrative burden on physicians and hospitals, that's going to get reflected in the costs we and consumers get charged."
Such exhaustive price data would take up "a large spreadsheet," but O'Brien said he would expect that with such a huge appetite for the data, web and app developers would likely be eager to create consumer tools for easily accessing the data.

Holt said he supports the hospital association bill, even though the information isn't customized for each consumer and their particular situation and health plan (which is something that Cambia's HealthSparq tool does).

"It's useful for a back-of-the-envelope look at what something is going to cost," Holt said. "It doesn't get to the level of detail consumers might demand. It's a great start."

With more Oregonians picking up a greater portion of their own health care costs in the form of high-deductible plans, it's more important than ever for consumers to be armed with this information, O'Brien said.

A lack of public information about the price of health care hampers competition and contributes to excessive spending, he said. The Institute of Medicine found that lack of competition and excessive price variation leads to $105 billion in waste in health care spending each year.

Either bill would be an improvement from today. Oregon has received an "F" for transparency from Catalyst for Payment Reform, a respected arbiter of price transparency in health care.
Said Moody: "By taking this action, we'd be able to move to an A."

O'Brien said the OSPIRG bill would mean that "Oregon would have the most across the board price transparency in the country."

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Media Contact Info

Philip Schmidt
Associate Vice President for Public Affairs
Direct: (503) 479-6020
pschmidt@oahhs.org

Andy Van Pelt
Executive Vice President
Direct: (503) 479-6018
avanpelt@oahhs.org