OHA Report: Price Increases Drove Commercial Health Care Costs Between 2013-2019;

Posted on November 19, 2022

More Services Provided Drove Health Care Costs for Medicaid and Medicare Advantage.

PORTLAND, Ore. – According to a new Oregon Health Authority (OHA) report, the growth of health care costs in the commercial market in Oregon between 2013 and 2019 was largely due to price increases. In contrast, the growth of health care costs in Oregon’s Medicaid and Medicare Advantage markets was driven by increased utilization, or the number of services provided to patients. Commercial health care includes health benefits that Oregonians receive from their employer.

The full report is available here.

In addition to comparing commercial, Medicaid and Medicare Advantage data, the new report looks at five different service categories: inpatient care, outpatient care, professional services, emergency department services and prescription drugs.

Interim Health Policy and Analytics Director Ali Hassoun said, “Understanding what’s driving costs in our complex health care system is important because rising health costs affect all Oregon residents. As costs of housing, food and other basic necessities rise, it is important to understand what can be done to contain health costs for individuals and families.”

One way to analyze total health care costs is to look at the average price for a health care service and the number of times people received that service. Using data from Oregon’s All Payer All Claims database, OHA found stark differences between commercial, employer-sponsored insurance and publicly funded programs like Medicaid and Medicare Advantage.

For example, commercial prices for emergency department services, outpatient services, professional services and prescriptions grew while utilization was either flat or decreased from 2013 to 2019. The prices paid for Medicaid services, however, increased modestly while the number of services provided increased significantly.

Read the full report here.

The Health Care Cost Trends: Price and Utilization Report will be presented at the Sustainable Health Care Cost Growth Target Advisory Committee meeting on November 22 from 9:00 AM to 12:00 PM. Full details including how to join the meeting are here.

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