Oregon officials weigh cap on commercial payments to hospitals

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Oregon health officials are weighing a potential cap on commercial health insurance payments to hospitals in an effort to address rising costs, the Oregonian reported July 15.

According to the report, the state’s Committee on Health Care Affordability has been tasked with recommending strategies to slow rising healthcare costs, including examining a cap on commercial insurance payments to hospitals. Such a cap would require approval by the state legislature.

Oregon already caps hospital payments under its public employee health plans, limiting rates to 200% of Medicare for in-network facilities and 185% for nonparticipants, while also capping annual premium growth at 3.4%. The cap only applies to the state’s 24 largest hospitals.

On July 9, the Oregon Health Authority released data showing that the average statewide payment for an inpatient procedure was $38,208 in 2023, a 23.4% increase since 2019, or 5.3% after adjusting for inflation. Despite rising payments, the number of common inpatient procedures for commercially insured patients declined by 17.7% over the same period.

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