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OHA released its annual report on cost growth trends for health insurance plans and large provider organizations across the state. The report provides insight into health care spending in the Commercial, Medicaid, and Medicare markets statewide, and for 30 health plans and 53 provider organizations; more than half of plans and provider organizations met the cost growth target.
The report shows that between 2021-2022 health care costs in Oregon grew 3.6%, slightly above the cost growth target of 3.4%. Cost growth was driven by increases in hospital outpatient services, behavioral health services, and changes in how providers were paid, with more providers receiving prospective payments, quality payments, and other value-based arrangements.
“It’s important to continue to shine a light on health care spending in Oregon. This report allows health insurers and large providers to see where they stand in comparison to others and help focus their efforts on containing health care costs,” said David Baden, Oregon Health Authority Deputy Director for Policy and Programs.
Key trends from the 2021-2022 report include:
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Overall cost growth was greatest in the Medicare market. Statewide, total health care expenditures grew 2.2% in the Medicare market, compared to 1.5% in the Commercial market, and 1.2% in the Medicaid market. Even though health care cost growth in Oregon was below the target for this measurement period, cumulatively, health care costs in Oregon have grown 12.4% between 2018-2022.
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More than half of health plans and provider organizations met the target in at least one market. Health plans were more likely to meet the cost growth target for their Medicaid and Commercial lines of business; only 3 Medicare Advantage health plans met the target. Provider organizations were more likely to meet the target for Medicaid.
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Primary cost drivers include an increase in hospital outpatient services, behavioral health services, and non-claims payments. Medicare Advantage non-claims spending increased substantially, largely due to prospective payments. Medicaid, Medicare Advantage and Commercial markets also saw more performance incentive dollars.
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Retail pharmacy spending continued to grow across the state, even after more than $1.2 billion in pharmacy rebates were taken into account. Retail pharmacy spending grew 2.9% in the Commercial and Medicaid markets, and 2.6% in the Medicare Advantage market.
Oregon’s annual public hearing on health care cost growth trends and cost drivers in the state, as well as strategies to slow the rate of growth, will be held Tuesday, June 4, hosted by the Oregon Health Policy Board at their monthly meeting.
The 2024 public hearing will be held from 9:00 AM – noon (Pacific time), in-person at 800 NE Oregon Street, Portland, and virtually by Zoom.
More information about the 2024 public hearing is available in the draft agenda. This year’s public hearing focuses on health care cost growth in Oregon between 2021-2022 and includes:
- Welcome and Opening Remarks
- Panel #1: Cost Growth in the Commercial Market
- Panel #2: Strategies to Control Health Care Cost Growth
- Public Comment*
- Closing Remarks
* Members of the public are invited to share personal stories about the high cost of health care. To provide public comment in writing or during the hearing, please email OHA staff at HealthCare.CostTarget@oha.oregon.gov or submit your request online.
For more information and meeting materials, please visit the OHPB meeting webpage.
For more information about the Cost Growth Target Program and Public Hearings, please visit the CGT website.
Member Handbook
In Lieu of Services updates
For previous guidance, please see the CCO Contract Forms page.
- 10 a.m. to 12 p.m., June 12, 2024 - Community Engagement
- 10 a.m. to 12 p.m., June 20, 2024 - Community Engagement
- 2 to 4 p.m., June 3, 2024 - Community Engagement
- 3 to 5 p.m., June 4, 2024 - Community Engagement
- 10 a.m. to 12 p.m., June 10, 2024 - Community Engagement
- 10 a.m. to 12 p.m., June 17, 2024 - Community Engagement
- 2 to 4 p.m., June 10, 2024 - Community Engagement
- 9 to 11 a.m., June 11, 2024 - Community Engagement
- 2 to 4 p.m., June 12, 2024 - Community Engagement
- 9 to 11 a.m., June 13, 2024 - Community Engagement
- 10 a.m. to 12 p.m., June 17, 2024 - Community Engagement
- 2 to 4 p.m., June 17, 2024 - Community Engagement
- 1 to 2 p.m., June 3, 2024
- 1 to 3 p.m., June 4, 2024
- 1 to 3 p.m., June 5, 2024
- 1 to 4 p.m., June 14, 2024
Learn more about these RACs and the rulemaking process.
Temporary rules, effective June 1, 2024 to November 27, 2024
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944-010 - Establishing Behavioral Health Resource Networks standards.
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944-020 - Drug Treatment and Recovery Services Fund Grants
- Process for application, denials, general criteria; requirements for Drug Treatment and Recovery Services Fund grants.
Learn more about Behavioral Health and temporary Medicaid rules.
June 4, 2024
June 6, 2024
Please visit the committee and workgroup links below for more information about meetings. You can also view the OHA Public Meeting calendar.
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