Site visits such as this one represent an important opportunity to guide HHS efforts to maximize benefits from use of IS in primary health care settings. Oregon presents a particularly interesting setting for our first site visit due to the State’s history of progressive thinking and organization around health care and public health issues. The State Primary Care Office and the Office of Medical Assistance Programs have worked closely with the consolidated health centers and the Oregon Primary Care Association (OPCA) to address issues of health care access, cost and quality of care for Oregon’s safety net community. The formation of CareOregon, the State’s largest Medicaid managed care provider, in the 1990’s represents a recent example of safety net stakeholders working together in Oregon. CareOregon, formed through a cooperative venture involving safety net providers in the State, has assisted consolidated health centers work with the State’s Office of Medical Assistance Programs (OMAP) to continue serving low-income populations following adoption of Medicaid managed care. More recently a range of senior State health officials have shown strong interest and involvement both in OCHIN and in other infrastructure-related initiatives affecting the State’s consolidated health centers. CareOregon has also played an important role in the early development of OCHIN by serving as the consortium’s first organizational home.
Safety net providers and the populations they serve in Oregon. The 30-plus consolidated health centers comprise the major portion of safety net providers in Oregon. These include community health centers, health care for the homeless centers, Indian/tribal health centers, rural health centers and school-based health centers. While many of consolidated health centers are located along the Western edge of the State, a number of consolidated health centers are located in rural parts of the state south and east of Portland. The populations served by these health centers differ substantially in terms of insurance status, demographics and chronic disease prevalence. The consolidated health centers also vary significantly by number of sites, dedicated clinical and administrative staff, total clients and total encounters per year.
Oregon’s consolidated health centers and their associated networks fulfill their mission by serving the State’s uninsured, underinsured, Medicaid beneficiaries and other vulnerable populations. In 2002, approximately 14 percent or nearly one half million Oregonians were without health insurance. According to a 2002 OPCA report on safety net gaps, primary care safety net clinics in Oregon serve 27 percent of the uninsured population and 15 percent of the Medicaid population over the course of a year. Over 60 percent of Oregon’s Medicaid population are enrolled in one of the state’s 14 fully capitated managed care plans.