What is driving the cost of health care?

| Print |  Email
Articles - May 2013
Monday, April 29, 2013

Reform

The Affordable Care Act gets underway in earnest starting next January, and Oregon is leaping ahead of most states to comply. The federal government granted the state $226 million to set up Cover Oregon, a health insurance exchange that will initially serve only the individual and small group markets. It intends to enable small companies to offer employees various levels of choice to shop for the plan they prefer. Cover Oregon will coordinate payment of premiums between the employer and the mix of plans selected. In April the Obama administration announced that states could delay the rollout of small-employer exchanges until 2015, but Oregon’s exchange will be implemented as planned next year, according to Lisa Morawski, Cover Oregon’s communications manager.

Oregon has also moved swiftly to approve 15 coordinated care organizations (CCOs) to serve Oregon Health Plan and Healthy Kids plan members in 90% of the state. CCOs are networks of doctors, therapists, dentists and other professionals who have banded together to ensure local at-risk patients get effective treatment for chronic illnesses, receive preventative care and avoid the emergency room.

Although CCOs are designed to reduce costs, other ACA provisions could initially raise prices in the individual insurance market. That’s because the law will remove pre-existing conditions as a reason for denying coverage and mandate expansion of benefits, such as covering prescription drugs, and mental health services, and providing preventive care without a copay or deductible. Premiums for older plan members must be no more than three times those of younger members, lowering costs for the old but probably raising them for the young. Federal premium tax credits will offset some of the cost increases.

Even as state and national reforms move forward, it’s impossible to say whether these changes will meet their dual goals of delivering quality care to everyone while controlling costs. More than most states, Oregon is on a path to do just that. But for now, cost shifting, expensive technologies and the demands of an aging population continue to place an untenable burden on the state’s health care system.

0513 Data Graph 06

SOURCE: U.S. BUREAU OF LABOR STATISTICS

0513 Data Graph 07

 SOURCE: THE KAISER FAMILY FOUNDATION; CENTERS FOR MEDICARE & MEDICAID SERVICES

Brandon Sawyer is research editor for Oregon Business. You may reach him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 



 

More Articles

Ranking the airlines that fly PDX

The Latest
Friday, August 14, 2015
airlinesthumbBY JACOB PALMER | DIGITAL NEWS EDITOR

17 airlines make stops at Portland International Airport, but not all are created equal when it comes to customer service.


Read more...

Downtime with Jill Nelson

September 2015
Wednesday, August 19, 2015
BY JACOB PALMER

Live, Work, Play wit the CEO of Ruby Receptionists.


Read more...

The Cover Story

Linda Baker
Thursday, August 27, 2015
01-cover-0915-thumbBY LINDA BAKER

How do you put a baby on the cover of a business magazine without it looking too cutesy?


Read more...

Inside the Box

September 2015
Wednesday, August 19, 2015
BY GINA BINOLE

Screening for “culture fit” has become an essential part of the hiring process. But do like-minded employees actually build strong companies — or merely breed consensus culture?


Read more...

Store Bought

July/August 2015
Friday, July 10, 2015
BY LINDA BAKER

Market of Choice is on a tear. In 2012 the 35-year-old Eugene-based grocery chain opened a central kitchen/distribution center in its hometown. The market opened a third Portland store in the Cedar Mill neighborhood this year; a Bend outpost broke ground in March. A fourth Portland location is slated for the inner southeast “LOCA” development, a mixed-use project featuring condos and retail. Revenues in 2014 were $175 million, a double-digit increase over 2013. CEO Rick Wright discusses growth, market trends and how he keeps new “foodie” grocery clerks happy.


Read more...

Aim High

September 2015
Thursday, August 20, 2015
BY JOE CORTRIGHT

We get the education we deserve.


Read more...

Preserving the Legacy

July/August 2015
Monday, July 13, 2015
BY KIM MOORE | PHOTOS BY JASON E. KAPLAN

A New York floral and gift business takes on the iconic Harry & David brand.


Read more...
Oregon Business magazinetitle-sponsored-links-02
SPONSORED LINKS