Health insurers must submit their first set of rate increases after the implementation of Cover Oregon to the Insurance Division by May 31, and this year’s filings will include a whole new set of measurements, forcing insurers to do some math about how they’re keeping costs under control.
The new measures, called “Cost and Quality Metrics” will not be used to approve or adjust rate hikes from the insurance companies. Instead, they’re likely to determine future rate increases by taking a snapshot of healthcare spending and cost controls in 2014. The Legislature and the Insurance Division could put some teeth into these metrics later and hold insurers accountable for avoiding big departures from those numbers in subsequent years.
The Oregon Health Policy Board made a baby-step Tuesday in its efforts to tackle rising healthcare costs -- approving a committee to set the groundwork for a legally allowable, sustainable rate of medical inflation for healthcare providers.
When the board finishes it work, it could recommend penalties and rewards to keep providers under a reasonable inflation rate, likely one similar to the rate imposed on the the coordinated care organizations -- 3.4 percent.
The Insurance Division may have had little choice but to let individuals and small businesses keep substandard policies, but the move means fewer customers for the exchange and a higher risk group for those who do shop on Cover Oregon. The Division is also charged with allowing inferior policies to be sold on Cover Oregon compared to outside the exchange.
July 29, 2013 -- The Oregon Insurance Division reduced insurance rates in the individual and small group markets by $69 million for 2014, but significant savings continued to be lost, as some insurers ignored slowing medical inflation and failed to factor reductions in uncompensated care as fewer people go without insurance under the Affordable Care Act.
May 9, 2013 – The Oregon Insurance Division today posted health insurers’ rate requests for small employer and individual health plans that start Jan. 1, 2014. The plans reflect new benefits and new rules under the federal Affordable Care Act.