Oregon price report explains payer exodus from some counties

A recent report that published rates Oregon hospitals charge commercial insurers for medical procedures could explain why some carriers have withdrawn from particular regional markets, reports The Bulletin.

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In 2017, central Oregon residents hoping to buy individual plans will have less insurers and health plans to choose from compared to residents in other parts of the state. Deschutes County residents in central Oregon, for instance, will only have two carriers to choose from, the fewest choices of any county in the state, according to the article.  

The Oregon Health Authority’s most recent report — the Oregon Hospital Payment Report 2014 — used insurers’ reported median costs of reimbursements to Oregon hospitals for 46 common medical procedures. The report shows St. Charles Bend, the largest healthcare provider in central Oregon, charged insurers more than the statewide median for 43 out of 46 common inpatient and outpatient procedures.

The hospital’s high prices and the region’s lack of competition could explain why many carriers have chosen not to offer products in the region, healthcare experts believe.

“When the price points are higher, it’s just harder to do business in that area,” Oregon State Public Interest Research Group policy director Jesse O’Brien told The Bulletin.

More articles on finance and payer issues: 

Anthem Blue Cross of Calif. to launch bundled payment program for cancer care
High-deductible health plans spike in Kentucky
Montana hospital pricing initiative could cause uptick in use of balance billing

 

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