September 18, 2024

Media Contact: Amy Bacher, amy.bacher2@oha.oregon.gov

New features on OHA hospital dashboard provide insight on commercial health insurer spending trends

SALEM, Ore. - Oregon Health Authority (OHA) released an updated interactive dashboard this month that shows how much commercial insurance companies paid Oregon hospitals for common procedures in 2022. This dashboard also shows how those payments differ within and among hospitals in Oregon.

OHA Director Dr. Sejal Hathi said, "Transparency is important to everyone involved in health care delivery. Providing information about cost differences is one way we can all move toward a more affordable health care system."

Updates to the dashboard include:

• New features to compare hospital spending by region and procedure. With the addition of median commercial payments by region and hospital type, the dashboard now allows for comparisons among hospitals by location and size. For example, the median commercial payment for a routine birth is lowest in Central Oregon ($9,145) and highest in the Northern Coast area ($13,313). A new map feature also offers more ways to understand how payments to hospitals in various geographic locations may differ for the same procedures. The size and composition of the population along with the provider density and competition in the area are among the factors that influence hospital payments.
• Data from emergency department settings. This new data show that in many cases, median insurance payments in emergency settings are higher than in other outpatient settings for the same procedure types. This is most notable among laboratory services such as blood panels and urinalyses, which are two to three times more costly on average in emergency settings compared with non-emergency outpatient settings.
• Medicare fee-for-service payment comparisons of commercial payments for the same procedures. The greatest statewide difference in payments is for CT scans of the arms and legs: the median commercial payment is more than 400% higher than the Medicare fee-for-service median payment ($695 vs. $127). The dashboard also calculates the potential savings of attaching commercial rates to Medicare payment rates, as Oregon does for its state employee health plans. For example, if all commercial payments were capped at 200% of the Medicare fee-for-service rate, statewide savings would have been over $400 million in 2022. Outpatient surgery has the highest potential savings of any category at $136 million. What commercial plans pay has varied widely both among different hospitals and within the same hospital for the same procedure. For instance, for physician evaluations, the highest paid hospital received 49 times the amount paid the lowest paid hospital ($535 vs. $11).

Nationwide, the United States spent $4.5 trillion on health care in 2022, an average of about $13,500 per person. Hospital care accounts for 30% of that spending.

For more information about OHA’s Hospital Reporting Program, visit the program’s webpage or contact hdd.admin@odhsoha.oregon.gov.