Health Policy Commons^™

The Impact Of Program Changes On Enrollment, Access, And Utilization In The Oregon Health Plan Standard Population, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

In February 2003, in an effort to expand Medicaid coverage within tight fiscal constraints, the Oregon Health Plan (OHP) underwent a significant redesign of benefits, cost-sharing and premium structure. The OHP2 redesign resulted in two tiers of coverage, OHP Plus and OHP Standard, and a premium subsidy program. The OHP Plus benefit package and cost sharing structure is similar to the original OHP and serves the federally-mandated Medicaid populations: children and pregnant women, low-income elderly and individuals meeting the SSI definition of disability. OHP Standard, designed for Oregon’s expansion population,1 includes a reduced benefit package, expanded co-pays and increased premiums. …

The Impact Of Program Changes On Health Care For The Ohp Standard Population: Early Results From A Prospective Cohort Study, Matthew J. Carlson, Bill J. Wright, Charles Gallia

Sociology Faculty Publications and Presentations

The purpose of this study is to assess the impact of benefit changes on the Oregon Health Plan (OHP) Standard Population across three domains: Enrollment; Access to care; Utilization

Cost-Benefit Analysis Of Physician Assistants, Roderick Stanton Hooker

Dissertations and Theses

This study examined if physician assistants (PAs) are cost-beneficial to employers. In an era of cost accountability, questions arise about whether a visit to a PA for an episode of care differs from a visit to a physician, and if PAs erode their cost-effectiveness by the manner in which they manage patients.

Four common acute medical conditions seen by PAs and physicians within a large health maintenance organization were identified to study. An episode approach was undertaken to identify all laboratory, imaging, medication and provider costs for these diagnoses. Over 12,700 medical office visits were analyzed and assigned to each …

Physical And Environmental Features That Contribute To Satisfaction With Hospice Facilities, Arezu Movahed

Dissertations and Theses

Improving the quality of remaining life for individuals who are terminally ill and their families is an issue that has become increasingly important in recent years. This issue has evolved from perceived deficiencies of conventional health care institutions in meeting the needs of people who are in the final stages of their life, when curative measures are no longer deemed appropriate. In response to deficiencies in care of the terminally ill and their families, there has been a movement toward humanizing conventional health care and making it more holistic. Hospice care, which is consistent with this movement, has evolved as …

A Case Study Of The Development Of Oregon's 1985 Public Policy In Youth Substance Abuse, Sonja Carol Grove

Dissertations and Theses

Youth substance abuse in Oregon reached epidemic proportions in the early 1980s. A response to this social issue from the Governor's Office, the state legislature, and the Office of Alcohol and Drug Programs during 1983-1985 is the foundation of this case study. Oregon, a small state of three million, was faced with a growing problem of youth and adult substance abuse. Legislative leaders, agency staff, and Governor Atiyeh recognized an opportunity to create public policy to solve problems of substance abuse including crime. The focus on substance abuse included streamlining several budgets with substance abuse monies in various state agencies. …

Behavioral And Community Impacts Of The Portland Needle Exchange Program, Kathleen Joan Oliver

Dissertations and Theses

Research questions were: 1: Will Drug Injectors Use An Exchange In A StateWhere Syringes Are Legal? 2: Will Drug Injectors Using An Exchange Decrease Risky Behavior? 3: Will Frequent Clients Change Risk Behaviors More Than Infrequent Clients? 4: Will Drug Injectors Using An Exchange Change Risk Behaviors More Than A Comparison Group Not Using An Exchange? 5: Does An Exchange Have An Impact On The Number Of Discarded Syringes On The Streets? 6: Is There A Difference In The Rate Of Spread Of HIV Infection Among Users And Non-Users Of The Exchange. Drug injectors will use needle exchange programs, even …

Oregon Primary Care Physicians' Support For Health Care Reform, Timothy Alan Baker

Dissertations and Theses

This dissertation studies Oregon primary care physicians' attitudes toward health care reform. Two models of reform are examined: one, health care rationing such as that proposed by the Oregon Health Plan (OHP); and, two, support for national health insurance (NHI).

This work examines the necessity for changing the present health care system, traced from the early origins of the medical profession to the present day health care "crisis." The high cost of health care is examined and an overview of the OHP is provided, including citations from John Kitzhaber, M.D., author of the plan.

Overall, Oregon primary care physicians overwhelmingly …

Alzheimer's Disease Caregivers: The Transition From Home Care To Formal Care, Marie Theresa Duncan

Dissertations and Theses

Elderly people with irreversible cognitive declines such as Alzheimer's Disease (AD) make many demands on those who must care for them, whether those caregivers are family members or the paid staff of nursing homes. When family members no longer have the capacity to meet these demands, a move to a nursing home or other formal care facility becomes the only solution. Such a shift does not, however, mean the end of family caregiving. Instead, the family's caregiving activities must be integrated with the ongoing efforts of the formal care staff. Currently, relatively little is known about 1) what families experience …

A Preliminary Report On The Implementation Of Health Care Rationing In Oregon, Theresa Julnes, Tom Lee Mason

Center for Urban Studies Publications and Reports

Oregon is now in the process of implementing a first of its kind health care rationing plan. The intent of this new legislation is to expand Medicaid coverage to all citizens at or below the Federal poverty level. Under the proposed system, health care services will be prioritized and will be available only to the extent they can be paid for by presently appropriated funds. This rationing program is an extension of a policy adopted in 1987 whereby Oregon ended public expenditures for organ transplants. The following preliminary report examines the background of the policy, the national significance of the …

Caregiving For Parents And Caregiving For Children: The Differential Effects On Job Stress And Absenteeism, Linda Boise

Dissertations and Theses

An important area of contemporary research is the impact of family responsibilities on the workplace. Historically, caregiving responsibilities have been predominantly for minor children. Increasingly, caregiving involves caring for parents or other elderly or disabled adults.

The study reported in this dissertation compares the effects of caregiving on job stress and absenteeism for two groups of employees, one caring for parents and the other caring for children. It utilizes data from the "Work and Elder Care Project" conducted by the Regional Research Institute for Human Services and the Institute on Aging at Portland State University. Of the 9,573 employees who …

A Preliminary Analysis Of Beneficiary Discharge Status And Post-Hospital Placement Before And After The Implementation Of Medicare's Prospective Payment System, Anne Marguerite Wilkinson

Dissertations and Theses

In recognition of the inherently inflationary nature of retrospective reimbursement, the Reagan Administration enacted legislation that substantially changed Medicare's hospital reimbursement system. The Prospective Payment System (PPS) mandated paying hospitals a fixed payment, set in advance, based on the patient's diagnosis rather than retrospectively paying for all services delivered to a patient. Critics contend that PPS introduces incentives for hospitals to conserve resources during the hospital stay and to shift care to less costly settings, both potentially affecting quality of care to the elderly. The question addressed by this dissertation is whether there were changes in the discharge health status …

Hospital Responses To A Nursing Shortage : Policy Issues And Professional Implications, Marlene Lobracco Smith

Dissertations and Theses

This study addresses three policy issues found in the literature: How can hospitals best manage the problem of shortages of the nursing home resource, how have federal policy makers responded to the mounting shortages, and how has the unique character of nursing influenced policy.

An analysis of existing hospital policy making is presented. An analysis of the class conflict within nursing is also presented. Data have been generated from a case sample of six urban hospitals in the Pacific Northwest to assess their management of the nursing resource during the critical shortages of the late 1970s.

Three response patterns have …

Residential Care Facilities: Resident Characteristics And Public Policy, Sharon Anice Baggett

Dissertations and Theses

Residential care is a rapidly growing form of housing and service provision for older adults. Residential care policy is defined by historical and cultural influences in social welfare and by the history of policy development and regulation in long term care, specifically for nursing homes. These influences have played a large role in the growing regulatory environment for residential care.

This study examines the characteristics of elderly residential care facility (RCF) residents and examines these through the lens of current state and federal regulations concerning the type of care given in these facilities. It is hypothesized that the lack of …

Social Structure, Health Orientation And Health Behavior, Khalifa Ali Baej

Dissertations and Theses

An attempt has been made to examine the relationship between social structure and medical factors in a framework which links cosmopolitanism to health orientation and behavior. Specifically, this study has attempted to investigate the variations in health knowledge, beliefs, attitudes and behavior among individuals whose social structure varies in terms of cosmopolitanism.