Comparing Quality

The Department of Consumer and Business Services (DCBS) received funding from federal rate review grants to improve transparency and consumer engagement in the health insurance rate review process. DCBS worked with the Oregon Health Care Quality Corporation (Q Corp) to develop cost and quality comparison reports for consumer use.

The reports disclose cost and quality information for Oregon’s largest insurance companies.

Some companies were not able to provide all of the necessary data. In those cases, N/A appears in the measurement field of the report.

What period of time does the report cover?

This report uses 2014 data.

What does N/A mean?

For purposes of these reports, N/A means that the data needed was not available.

Why is data missing?

In some cases, there were issues with the quality of the data that prevented its use. In other cases, insurers were unable to provide the necessary data or to provide the data within the timeframe needed to accommodate this grant work.

Why isn’t my insurance company included in the report?

Data used for these reports were taken from Oregon’s All Payer All Claims (APAC) database. Not all insurance companies are required to submit data to the APAC. Insurance companies with more than 5,000 covered commercial market lives in Oregon were required to submit data.

If your insurance company is not included in the report, it was not required to submit data.

Which members are represented by these scores?

The quality scores are for each carrier’s entire membership.

The “Use insurance dollars wisely” scores represent individual, small group, and large group plans.

What do the scores Better, Average, and Below mean?

Better means the company scored well above the average for insurance companies in the report.

Average means the company scored in the middle among insurance companies in the report.

Below means the company scored well below the average for insurance companies in the report.

Where do the scores come from?

Q Corp used data from Oregon’s All Payer All Claims Database, the National Committee for Quality Assurance’s Quality Compass, and HealthPartners’ Total Cost of Care measure.

More information about the development of these reports can be found at http://dfr.oregon.gov/healthrates/Documents/cycle3-consumer-testing.pdf

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