Oregon Rate Review Grants Award List

Cycle I Grant Application Summary

Oregon Grantee: Oregon Department of Consumer and Business Services

Award Date: August 16, 2010

Award Amount: $1,000,000

• Expand the Scope of the Review Process: Oregon intends to expand review to include large group unreasonable health insurance premium increases.
• Improve the Review Process: Currently, Oregon reviews all individual and small group health insurance premiums to determine whether increases are justified and in compliance with the community rating law. Grant funds will be used to develop and implement a large group market health insurance premium review process.
• Increase Transparency and Accessibility: Oregon has a robust consumer transparency program including posting of information, public comment, and consumer email notification. Grant funds will be used to move stakeholder engagement to the next level by developing administrative rules and publicly disclosing more meaningfully information. In addition, Oregon will fund a consumer advocacy organization to collect comments on health insurance premium filings.
• Develop and Upgrade Technology: Oregon will collect, organize, and report in-depth information to HHS and consumers.

Cycle II Grant Application Summary

Oregon Grantee: Oregon Department of Consumer and Business Services

Award Date: September 20, 2011

Total Award: $4,040,777

Baseline Award: $3,000,000

Workload Award Amount: $440,777

Performance Award Amount: $600,000

• Improve rate filing requirements: Oregon plans to adopt the use of the federal disclosure form (Consumer Disclosure about Proposed Health Insurance Rate Increases) to use with all individual and small group rate filings.
• Improve transparency and consumer interfaces: Oregon plans to start hosting additional hearings for individual and small group rate requests. Oregon will also create and publish a rate review booklet or consumer guide to provide consumers with a plain language explanation of the filing process and a guide to understanding rate filings.
• Hire new staff: Oregon will create 4 new positions with Cycle II grant funding; these positions are in addition to the 4 positions created with Cycle I resources.
• Improve IT: Oregon will develop an improved data process that will effectively organize rate information and allow for the posting of rate schedules used to compare rates between insurers on the Department of Insurance website.

Cycle III Grant Application Summary

Oregon Grantee: Oregon Department of Consumer and Business Services

Award Date: September 23, 2013

Total Award: $3,594,809

Baseline Award Amount: $2,000,000

Workload Award Amount: $1,194,809

Performance Award Amount: $400,000

• Enhance Data Center: The Oregon Department of Consumer and Business Services will invest Cycle III funds in an All Payer Claims Database with the goal of enhancing data quality, expanding data analysis, and making data more accessible.
• Improve Health Pricing Transparency: Oregon will use and display recognized metrics that standardize comparisons of provider pricing and efficiency. In 2013 and 2014, Oregon will implement HealthPartners Total Cost of Care and Total Resource Use Measures.
• Enhance Accessibility of Health Pricing Data: Oregon plans to enhance the online display of health data through optimization for mobile devices, new search and mapping functions, and the development of customizable search and reporting functions.
• Integrate Quality and Price Information: Oregon plans to integrate claims and clinical data in order to permit integrated reporting on price and quality.
• Enhance Consumer Engagement with Rate Review: Oregon will use Cycle III funds to support the in-depth analysis of rate filings by a consumer organization.

Cycle IV Grant Application Summary

Oregon Grantee: Oregon Department of Consumer and Business Services
Award Date: September 19, 2014
Total Award: $1,179,000

• Data Dissemination and Transparency: The Oregon Department of Consumer and Business Services will use grant funds to augment an existing Data Center with the goal of enhancing data quality, expanding data analysis, and making data more accessible.  
• Improve the Quality/Efficiency of Rate Review: Oregon will continue to build on its existing process by adopting rate review best practices, including the use of market conduct authority to confirm rates are implemented as filed.  Oregon will also ensure information in rate filing submissions is consistent with audited financial data.
• Health Pricing Transparency Activities Integrated into Rate Review:  Oregon will use funds to continue to improve rate review through the continued intake, analysis, and publication of health pricing data.  Oregon intends to further incorporate health care pricing and performance data into rate review and make this information readily available to the public.

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