Impact of Oregon's pioneering health insurance program: 03/21/2016
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Three years after starting a pioneering health insurance system for Medicaid recipients, Oregon has reduced some expenses and boosted some areas of preventive care, finds a recent viewpoint in theJournal of the American Medical Association.
In contrast with the fee-for-service Medicaid funding in other states, since 2011 Oregon has received an overall, upfront budget with incentives paid for improvements in care quality as well as specific areas of clinical prevention (with financial penalties for increases in health spending).
The JAMA viewpoint reports per-member, per-month spending for inpatient care decreased by 14.8 percent in the past three years. The viewpoint adds per-member, per-month spending on outpatient care also declined 2.4 percent in 2014.
In what the viewpoint suggests is an encouraging development, spending on primary care services increased by 19.2 percent in 2014. To backup, one of the goals of Oregon's Medicaid experiment is to increase the use of primary versus emergency medical services. Hence, one of the likely measures of the program's success is an increase in spending for patient primary care.
Regarding specific preventive care measures, the screening for alcohol and substance use among 200,000 Oregon Medicaid participants jumped from one tenth of one percent in 2011 to 7.3 percent in 2014.
The viewpoint adds the percentage of Medicaid participants in patient-centered primary care homes increased from a state-wide average of about 52 percent in 2011 to 81 percent in 2014.
In addition, the viewpoint reports there were increases from 2011-2014 within some health prevention areas where no incentives were provided, including immunization for children and teens as well as tobacco cessation. However, the viewpoint notes not all health prevention areas improved without incentives. For example, the viewpoint notes screening for chlamydia and cervical cancer, as well as well-child visits declined in the pioneering program's first 15 months.
The viewpoint notes (and we quote): 'Overall, lessons from Oregon will provide important evidence about the extent to which new (health insurance) models can provide adequate access, improve population health, and slow the growth of health care spending' (end of quote).
The viewpoint concludes Oregon's pioneering efforts (and we quote) ' could serve as a template for Medicaid reform' (end of quote).
Meanwhile, MedlinePlus.gov's Medicaid health topic page explains Medicaid is state and federal government health insurance program that helps some low-income U.S. citizens pay their medical bills.
Information about Medicaid eligibility and benefits are provided by the Centers for Medicare & Medicaid Services (in two different websites) within the 'resources' section of MedlinePlus.gov's Medicaid health topic page.
A primer about health coverage for low income Americans (from the Henry J. Kaiser Family Foundation) also is available in the 'resources' section of MedlinePlus.gov's Medicaid health topic page.
MedlinePlus.gov's Medicaid health topic page also provides links to the latest pertinent journal research articles, which are available in the 'journal articles' section. You can sign up to receive updates about Medicaid as they become available on MedlinePlus.gov.
To find MedlinePlus.gov's Medicaid health topic page, please type 'Medicaid' in the search box on MedlinePlus.gov's home page, then, click on 'Medicaid (National Library of Medicine).' MedlinePlus also has a health topic page devoted to Medicare.
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