Judy Mohr Peterson


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  • Sometimes public health can be siloed in their efforts (reflective of their varied funding streams). Use community assessments to help create a Systems-level approach.
  • Judy Mohr Peterson

    1. 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. 2. Oregon - Landscape <ul><li>Demographics: </li></ul><ul><ul><li>Population of 3.5 million – majority on I-5 corridor with wide expanses of rural to frontier areas </li></ul></ul><ul><ul><li>Well over 80% White </li></ul></ul><ul><ul><li>Hispanics largest & fastest growing racial-ethnic minority </li></ul></ul>
    3. 3. Medicaid: Oregon Health Plan <ul><li>In Oregon: </li></ul><ul><ul><li>650,000 people covered in a year </li></ul></ul><ul><ul><li>13% of population, including adults not traditionally covered by Medicaid programs </li></ul></ul><ul><ul><li>20% of children </li></ul></ul><ul><ul><li>38% of all births </li></ul></ul><ul><li>Oregon Health Plan: Prioritized list of health conditions and treatments with a priority and heavy focus on preventive services </li></ul><ul><li>Focus on managed care as delivery system </li></ul><ul><ul><li>Over 80% of all populations including disabled, seniors and special needs children are in managed care </li></ul></ul>
    4. 4. Oregonazation <ul><li>Both part of same agency, Department of Human Services </li></ul><ul><li>History of collaboration </li></ul><ul><li>Medicaid program has one staff person to promote prevention services; Public Health has staff person to work with “Health Systems” like managed care organizations. </li></ul>
    5. 5. Oregon Medicaid/Vital Statistics Connections <ul><li>Death certificate matching </li></ul><ul><ul><li>Remove from Medicaid rolls </li></ul></ul><ul><ul><li>Leading causes of mortality </li></ul></ul><ul><ul><li>Unintentional injuries for Medicaid population vs. general population </li></ul></ul>
    6. 6. Oregon Medicaid/Vital Statistics Connections <ul><li>Birth Certificate Data </li></ul><ul><ul><li>Performance measures </li></ul></ul><ul><ul><ul><li>Percent of births covered by the OHP vs. Self-pay </li></ul></ul></ul><ul><ul><ul><li>Receipt of prenatal care in 1st trimester </li></ul></ul></ul><ul><ul><ul><li>Smoking rates for pregnant women </li></ul></ul></ul>
    7. 7. Oregon Medicaid/Vital Statistics Connections <ul><li>Matching w/ Birth Certificate Data </li></ul><ul><ul><li>Birth Certificate data accuracy regarding Payer type (Medicaid) </li></ul></ul><ul><ul><li>Immunization Initiation </li></ul></ul><ul><ul><ul><li>Relationship between delayed immunization and insurance status of mother and/or child at birth </li></ul></ul></ul><ul><ul><ul><li>Looked for trends of OHP coverage or not by hospital </li></ul></ul></ul><ul><ul><ul><li>No trends by hospital found. Targeted interventions to caseworkers, outreach workers instead </li></ul></ul></ul>
    8. 8. Oregon Medicaid/Vital Statistics Connections <ul><li>Assessment of Prenatal care </li></ul><ul><ul><li>Prenatal care in Oregon for Undocumented women </li></ul></ul><ul><ul><ul><li>Labor and delivery covered, but prenatal care is not (Citizen Alien Waived Emergency Medical) </li></ul></ul></ul><ul><ul><ul><li>50% of foreign-born Mexican mothers did not receive adequate prenatal care regardless of whether with full Medicaid benefits or not (Kotelchuck measure) </li></ul></ul></ul><ul><ul><li>Adequacy of Prenatal Care </li></ul></ul><ul><ul><ul><li>Kotelchuck measure: Timeliness of initiation & #s of visits </li></ul></ul></ul><ul><ul><ul><li>Apply to managed care plans </li></ul></ul></ul><ul><ul><ul><li>Design interventions with each managed care plan based on assessing area of concern (too few visits or started too late into pregnancy) </li></ul></ul></ul>
    9. 9. Hints for Public Health Working with Medicaid <ul><li>Limited resources – focus on high prevalence and or high cost conditions that have clinical effective interventions </li></ul>
    10. 10. Contact Info <ul><li>Judy Mohr Peterson, Ph.D. </li></ul><ul><li>Manager, Analysis & Evaluation Unit </li></ul><ul><li>Office of Medical Assistance Programs </li></ul><ul><li>Dept. of Human Services </li></ul><ul><li>500 Summer St. NE; E-35 </li></ul><ul><li>Salem, OR 97371 </li></ul><ul><li>Ph: 503 945-6929 </li></ul><ul><li>Judy. mohr - peterson @state.or.us </li></ul>