The Oregon Association of Hospitals and Health Systems (OAHHS) www.oahhs.org representing all of Oregon’s community hospitals has developed a new price transparency initiative giving Oregon consumers pricing details in advance of a visit to a hospital for a procedure.
State legislation (SB 900) calls for a new state-run website displaying median prices that are paying for common procedures at hospitals collected from information on the state’s existing All Payer All Claims database. The website would enable patients to understand what the typical cost of a particular procedure will be as paid by insurers.
The legislation would allow patients to compare the prices paid for the most common procedures across hospitals. However, it would not show a consumer what their 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 would entail working with insurers via the Oregon Health Leadership Council (OHLC) www.orhealthleadershipcouncil.org 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.
The third element of the OAHHS initiative is a commitment by Oregon’s hospitals to assist state residents who are paying for their own care or for out-of-network services not covered by their healthcare to get a good-faith estimate from any hospital for the cost of a scheduled procedure when requested.
Committee meetings and work sessions were held on SB 900 in March and April 2015. For more information go to http://gov.oregonlive.com/bill/2015/SB900.