Study critical of state health care

Future staked in Oregon Health Plan


Published May 9, 2013 at 05:00AM / Updated Nov 19, 2013 at 12:31AM

SALEM — A national study showing that newly insured low-income Oregonians saw no improvement in their physical health has thrust the state into the spotlight at a time Oregon is betting it can improve health care for the same population.

The study, recently published in The New England Journal of Medicine, tracked those newly insured on the Oregon Health Plan, the state’s version of Medicaid, between 2008 and 2010. The study showed the coverage did help decrease depression and financial hardships, but physical health did not improve.

Mike Bonetto, the governor’s health care adviser, said it’s important to note the study tracked people before the state set out to overhaul its health care system.

If anything, he maintained, the study reinforces the state’s current efforts.

“We feel like our reform efforts are getting at the heart of getting better value and better outcomes at lower costs,” he said.

He also noted that Oregon’s system, under the coordinated care model, will have accountability measures to ensure targets are being met.

“There is a need for us to hold organizations and contracts accountable for actually improving health,” Bonetto said.

And he said, two of the big takeaways from the study are positive, showing that coverage does decrease the level of financial insecurity in people and helps with mental health. The research has been used to fuel the national debate when millions more will be covered under President Barack Obama’s health-care plan.

Katherine Baicker, a professor at the Harvard School of Public Health and lead researcher on the project, said the study is nuanced.

“We’ve given policy makers and researchers a lot more information about the multifaceted effects in Oregon,” she said.

In 2008, Oregon expanded its Medicaid coverage. It offered a rare opportunity to compare those who were newly covered to those who remain uninsured. Research compiled from 6,387 adults randomly selected and covered by Medicaid was compared to 5,842 adults who weren’t covered.

Researchers looked at blood pressure, cholesterol and glycated hemoglobin levels. They also screened for depression.

There were substantial reductions in the rate of depression but no measurable improvements in high blood pressure. The study also showed costs increased with a rise in the use of services.

Rep. Jason Conger, R-Bend, who sits on the House Health Care committee, said the study does send “mixed messages.”

“But it certainly undermines the argument for expanding Medicaid without more reforms,” he said.