Evolution of the Oregon Health Plan: ES-1. Executive Summary.

摘要

The Oregon Health Plan (OHP) is an innovative effort by the State of Oregon to extend health insurance coverage to uninsured State residents below poverty. The costs of expanded insurance coverage are financed through the use of a prioritized list of health care services (to determine the benefit package), increased enrollment in capitated managed care organizations (MCOs), as well as revenues generated by a cigarette tax earmarked for OHP. The Oregon Health Plan was implemented in February 1994 under a Section 1115 waiver from the Health Care Financing Administration (HCFA). As a Section 1115 demonstration program, the OHP is being evaluated through a HCFA-funded evaluation contract. The evaluation addresses both the implementation process and program impacts, using qualitative and quantitative approaches. This report is the First Interim Report produced by the evaluation. This report discusses how the Oregon Health Plan program has evolved since it was implemented in February 1994. The report is based on three site visits conducted in November 1994, October 1995, and June 1996, as well as analysis of secondary data maintained by the State. Data sources include the monthly enrollment and disenrollment reports, audited financial statements from managed care plans, and other administrative reports. Additional phone follow-up occurred on an as-needed basis.