Raising the Bar: Strategies to contain cost and improve quality in Oregon’s health insurance exchange

Oregon’s new health insurance exchange has the potential to rein in the rising cost of health insurance and the underlying cost of care, while improving quality and giving consumers better choices. With the purchasing power of hundreds of thousands of Oregonians behind it, the exchange has the power to build better value for consumers, but it can only live up to its promise if it works from the beginning to raise the bar for health insurance in Oregon.

Report

OSPIRG Foundation

A new OSPIRG Foundation report explores strategies that the Oregon health insurance exchange can implement to contain the rising cost of health insurance while improving the quality of care.

 

KEY FINDINGS

Oregon’s health insurance exchange could be genuinely transformative for individuals and small businesses struggling with the ever-rising cost of care, but only if it is done right. To fulfill its statutory mission to contain costs while improving quality, the exchange must:

•    Hold participating plans to high standards designed to bend the cost curve for quality care;
•    Hold participating plans accountable for adopting and successfully executing evidence-based strategies to improve quality and reduce the underlying cost of care;
•    Provide consumers with meaningful choice by ensuring that they can compare plans apples-to-apples;
•    Present total cost information transparently and in a user-friendly format; and
•    Rate and rank plans in a clearly-defined and clearly-presented fashion to provide consumers with the most detailed and accurate information available about quality and foster genuine competition between plans.

Adopting a strong framework at the outset will ensure that the exchange is in the best possible position going forward. Any standards that cannot be implemented immediately should be put on a clear, benchmarked timetable for future implementation to create certainty for consumers, insurers and providers.   

With the purchasing power of hundreds of thousands of Oregonians behind it, the exchange has the power to build better value for consumers, but it can only live up to its promise if it works from the beginning to raise the bar for health insurance in Oregon.