Portland, Ore.
Research to examine the effects on health care access
The Office for Oregon Health Policy & Research (OHPR) has been awarded a $260,000 grant from the Robert Wood Johnson Foundation, through its Changes in Health Care Financing and Organization national initiative, to study the impacts of the benefit reductions and changes to the Oregon Health Plan (OHP).
Beginning in February, 2003, changes and benefit reductions to the OHP -- Oregon's Medicaid program -- have included the elimination of outpatient behavioral health and chemical dependency coverage, temporary loss of prescription drug coverage and an increase in patients' out-of-pocket expenses for premiums and co-payments. OHPR will work with investigators from Portland State University (PSU) and the Oregon Health & Science University (OHSU) over the next two years to develop a better understanding of these impacts on access to health care in the state.
"We believe this proposal will provide findings that are beneficial to Oregon and other states understanding of the complex interactions of health care access, coverage and financial stability in these tough economic times," said Dr. Jeanene Smith, Deputy Administrator of OHPR and director of this project.
Dr. Neal Wallace from PSU's Mark O. Hatfield School of Government and Dr. John McConnell from OHSU's Center for Policy and Research in Emergency Medicine (CPR-EM) will examine cost shifts within OHP that might result from increases in patient cost-sharing or the loss of some benefits - such as increased hospital and pharmacy costs due to the elimination of outpatient mental health coverage for OHP beneficiaries.
Dr. Robert Lowe and Dr. McConnell, both from OHSU's CPR-EM, will examine changes in Emergency Department utilization throughout the state -- comparing use before and after the Oregon Health Plan changes occurred -- as a measure of access to primary care for low-income Oregonians. A preliminary study suggested that the number of uninsured patients seeking care at hospital emergency departments increased substantially after the February, 2003 changes to OHP went into effect.
Findings of the research will be disseminated to state and federal policy-makers through the Oregon Health Research and Evaluation Collaborative (OHREC), a statewide organization of health services researchers from Oregon's universities and state and local agencies formed to study the impact cutbacks have on low-income Oregonians' access to health care.
BACKGROUND: OFFICE FOR OREGON HEALTH POLICY & RESEARCH (OHPR) --
This state office is responsible for the development and analysis of health policy in Oregon and serves as the policymaking body for the Oregon Health Plan, Oregon's Medicaid program. The Office provides analysis, technical, and policy support to assist the Governor and the Legislature in setting health policy. It carries out specific tasks assigned by the Legislature and the Governor, provides reports and conducts analyses relating to health care costs, utilization, quality, and access. The office provides staff support to statutorily-established advisory bodies responsible for health care policy recommendations including: the Oregon Health Policy Commission, the Health Services Commission, the Health Resources Commission, the Racial and Ethnic Health Task Force, the Advisory Committee on Physician Credentialing, the Medicaid Advisory Committee and coordinates the work of the Oregon Health Research and Evaluation Collaborative. http://www.ohpr.state.or.us/
OREGON HEALTH RESEARCH & EVALUATION COLLABORATIVE (OHREC) --
This unique collaborative of Oregon health services researchers, state agencies, stakeholders and advocates was formed to share information and to study the impact of changes to the Oregon Health Plan. OHREC is designed to facilitate communication of research findings to policymakers, both statewide and nationally. Initial funding for the formation of the collaborative has been through Oregon's Robert Wood Johnson State Coverage Initiatives Grant through the Office of Oregon Health Policy and Research.
OHSU'S CENTER FOR POLICY AND RESEARCH IN EMERGENCY MEDICINE --
This unique center was formally established in April 2003 to coordinate emergency medicine research projects that can help guide health care policy. It is the only one of its kind in an academic Department of Emergency Medicine. It features four full-time faculty members with diverse backgrounds in medicine, public health, epidemiology, economics and statistics. The center also is part of the Oregon Health Policy Institute which includes faculty from OHSU, Portland State University and Oregon State University. OHSU's Center for Policy and Research in Emergency Medicine currently has 15 studies underway looking at ways to improve the way we deliver emergency care.
THE ROBERT WOOD JOHNSON FOUNDATION --
This foundation, based in Princeton, NJ, is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse -- tobacco, alcohol and illicit drugs.
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