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Insurance Division Prepares for Rate Increases in 2015 Using Cost and Quality Metrics

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The information-only data will give the state a baseline to track efforts that health insurance companies are making to temper the cost of healthcare while maintaining a level of quality. Rate requests for 2015 will be released in June, posing the possibility of a high rate increase from Moda, which has dominated plans sold on Cover Oregon.

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.

Policy Board Moves Ahead at Setting Sustainable Growth Rate

A task force will take a measure of overall healthcare spending and the costs for each provider. The state will then use that information to set a benchmark for medical inflation, both in the public and private sectors.

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.

Cali Decision to Extend Old Policies Means More Trouble for Cover Oregon

The Lund Report
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.
Editor's Note: An earlier version incorrectly stated that the state's two insurance co-operatives are available only on Cover Oregon. Health Republic and Oregon's Health Co-op also sell policies directly from their web sites.
 

Insurers Extend Deadline for Ending Current Plans

Consumers have a choice: Keep current plans a little longer or shop for more comprehensive plans and financial assistance through Cover Oregon
Today, nine insurance companies notified the Oregon Insurance Division that they will offer theoption to renew current individual health plans that are not compliant with the federal Affordable Care Act. 
 

Insurance Division Knocks off $69 Million in Rate Review

The Lund Report
Despite the significant cuts in waste, OSPIRG Foundation’s report found ways that insurers are not passing along additional savings to consumers, and Gov. Kitzhaber has responded to liberal Democrats’ concerns to further strengthen the system.

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.

Oregon Insurers Propose Rates for 2014 Health Plans

The Lund Report
Charts show sample rate requests for Oregon counties

 

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.

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