Oregon's health authorities called three medical institutions this week this week to unreasonably drive Oregon's medical expenses.
In 2021, the upper limit of the annual expenditure growth rate of the healthcare organization was set to 3.4 % per person. This is a part of a regulated bidding that suppresses the rise in medical expenses. Oregon Council Approved the program The law was updated in 2021 in 2019.
The Oregon Health Bureau on Wednesday has flagged three organizations by overshooting this restriction between 2021 and 2022 without justifying the increase. It contains Eugon -based Oregon Medical Group and two insurance companies, Moda Health and UnitedHealthcare, both of which manage the Medicare Advantage Plan.
Meanwhile, the states reported that the other 28 medical institutions over -shot the restrictions, but “there was a reasonable reason.”
The justification provided by the provider and insurance company deemed to be accepted by the state expands the health of behavior, staying in hospitals with limited skilled nursing abilities, registration of Medicade and increased usage. The service was included.
“Healthcare is becoming more and more expensive, and many labor families are out of reach of high -quality health care, and the budget of companies and government agencies paid for health insurance,” a statement said in a statement.
The state has discovered that the cost of care for individual insured patients in the Oregon's medical group, which owns a series of clinics in the Eugene area, has increased 6.5 % and has almost doubled the state growth rate. did. The Oregon Medical Group was quietly purchased by Optum in late 2020. After the purchase, more than 30 doctors left the group and were fired by many patients in Lane County.
The state health authorities also quoted UnitedHealthcare, the main insurance company owned by the same parent company as Optum. The state reported that UNITEDHEALTHCARE's Medicare Advantage Plan has risen 6.4 %.
The state also made a flag to Moda Health, a head -based insurance company -based insurance company, by increasing the Medicare Advantage plan by 11.6 %. However, MODA ended a plan in December 2024.
Moda Health's senior vice president and chief actuity, KRAIG Anderson, acknowledged that the company's Medicare Advantage Plan did not meet the state -of -the -art cost -growing value, but has conducted a commercial and medicade plan. 。
“The Medicare Advantage Plan in the industry has experienced unexpectedly high use from Cobid,” said Anderson. “This has contributed to the increase in presemiums that are more impressive than any other single factor. As a result, we left the Medicare Advantage Market in 2025.”
Optum and UnitedHealthCare did not respond immediately by email in comments.
State said that the warning would not lead to financial penalties.
However, from next year, organizations that increase costs for no good reason need to submit a performance improvement plan to detail how to reduce medical expenses. If companies continue to miss cost growth, the state will start issuing a fine next year.
-Kristine de Leon covers stories of consumer health, retail, small and medium -sized enterprises, and data enterprise. Please contact her at kdeleon@oregonian.com.
