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Oregon Medicaid

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Oregon Office of Medical Assistance Programs. Conference for Community Health Assessment ... Office of Medical Assistance Programs. Dept. of Human Services ... – PowerPoint PPT presentation

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Title: Oregon Medicaid


1
Oregon Medicaid Vital Records
  • Session 10
  • Judy Mohr Peterson
  • Oregon Office of Medical Assistance Programs
  • Conference for Community Health Assessment
  • Seattle, WA Sept. 20-22, 2006

2
Oregon - Landscape
  • Demographics
  • Population of 3.5 million majority on I-5
    corridor with wide expanses of rural to frontier
    areas
  • Well over 80 White
  • Hispanics largest fastest growing racial-ethnic
    minority

3
Medicaid Oregon Health Plan
  • In Oregon
  • 650,000 people covered in a year
  • 13 of population, including adults not
    traditionally covered by Medicaid programs
  • 20 of children
  • 38 of all births
  • Oregon Health Plan Prioritized list of health
    conditions and treatments with a priority and
    heavy focus on preventive services
  • Focus on managed care as delivery system
  • Over 80 of all populations including disabled,
    seniors and special needs children are in managed
    care

4
Oregonazation
  • Both part of same agency, Department of Human
    Services
  • History of collaboration
  • Medicaid program has one staff person to promote
    prevention services Public Health has staff
    person to work with Health Systems like managed
    care organizations.

5
Oregon Medicaid/Vital Statistics Connections
  • Death certificate matching
  • Remove from Medicaid rolls
  • Leading causes of mortality
  • Unintentional injuries for Medicaid population
    vs. general population

6
Oregon Medicaid/Vital Statistics Connections
  • Birth Certificate Data
  • Performance measures
  • Percent of births covered by the OHP vs. Self-pay
  • Receipt of prenatal care in 1st trimester
  • Smoking rates for pregnant women

7
Oregon Medicaid/Vital Statistics Connections
  • Matching w/ Birth Certificate Data
  • Birth Certificate data accuracy regarding Payer
    type (Medicaid)
  • Immunization Initiation
  • Relationship between delayed immunization and
    insurance status of mother and/or child at birth
  • Looked for trends of OHP coverage or not by
    hospital
  • No trends by hospital found. Targeted
    interventions to caseworkers, outreach workers
    instead

8
Oregon Medicaid/Vital Statistics Connections
  • Assessment of Prenatal care
  • Prenatal care in Oregon for Undocumented women
  • Labor and delivery covered, but prenatal care is
    not (Citizen Alien Waived Emergency Medical)
  • 50 of foreign-born Mexican mothers did not
    receive adequate prenatal care regardless of
    whether with full Medicaid benefits or not
    (Kotelchuck measure)
  • Adequacy of Prenatal Care
  • Kotelchuck measure Timeliness of initiation s
    of visits
  • Apply to managed care plans
  • Design interventions with each managed care plan
    based on assessing area of concern (too few
    visits or started too late into pregnancy)

9
Hints for Public Health Working with Medicaid
  • Limited resources focus on high prevalence and
    or high cost conditions that have clinical
    effective interventions

10
Contact Info
  • Judy Mohr Peterson, Ph.D.
  • Manager, Analysis Evaluation Unit
  • Office of Medical Assistance Programs
  • Dept. of Human Services
  • 500 Summer St. NE E-35
  • Salem, OR 97371
  • Ph 503 945-6929
  • Judy.mohr-peterson_at_state.or.us
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