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Hospitals and insurers urge pause on cost'growth penalties as OHA begins first PIPs; lawmakers signal bills to revisit rules
Summary
Oregon Health Authority explained the cost growth target program, its reasonableness review, and the start of performance improvement plans; Providence and Regence told lawmakers they seek a moratorium on financial penalties, arguing the program is backward'looking and risks passing costs to consumers.
Oregon Health Authority staff briefed the Interim Committee on Health Care on the statewide cost growth target program and the initial determinations that will trigger performance improvement plans (PIPs) this year; industry witnesses testified they want a pause on the program's financial penalties.
Claire Pierce Grobel described the program's intent to limit total health care spending growth to an annual target (set at 3.4% for an initial five'year period) using a total cost'of'care methodology across Medicaid, Medicare and commercial markets. OHA compiles and validates payer and provider data annually, applies statistical scrubs to identify organizations that exceeded the target with confidence, and then determines whether…
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