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Oregon’s big disparities in reimbursement rates

Here are four findings summarized by Becker’s Hospital Review showing how Oregon’s commercial insurance companies pay sharply different rates for the medical procedures.

1. “For 46 common procedures, median prices insurers paid hospitals could more than triple, depending upon which hospital administered treatment.”

2. “In 2014, gallbladder surgery was the most expensive common outpatient procedure, with an overall median reimbursement rate of $9,029.”

3. “Heart valve surgeries were the most expensive inpatient hospital procedures, at a median rate of $74,205 per operation. procedures.”

4. Oregon Health Authority communications director Robb Cowie told the (Salem, Ore.) Statesman Journal, as paraphrased by Becker’s, that “reimbursement disparities can reflect how many specific procedures hospital staff have overseen, the extent of care each patient requires and whether a hospital-payer contract exists.”

For the Becker’s Hospital Review article, please hit this link.

For the Statesman Journal story, please hit this link.

 

 


Deconstructing Oregon Medicaid reform

This JAMA article looks at successes and challenges in Oregon’s three-year-old and nationally watched effort, through Coordinated Care Organizations, to reform its Medicaid program to improve healthcare access and population health while slowing increases in spending.


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