National Academy of Medicine

Case Study: Medicaid and Public Health Collaboration in Oregon

By Jennie Bonney and Debbie I. Chang
April 24, 2017 | Discussion Paper

Oregon is one of the leading states engaged in innovative health care delivery system reform that includes population health as a central component. Collaboration among key agencies and stakeholders is an important feature of Oregon’s reform efforts, and it occurs at many levels. This case study will highlight the state’s efforts to link the Medicaid delivery system and public health system to support prevention initiatives. Oregon’s experience may be helpful to other states as they consider reforms under Medicaid to advance population health and other prevention strategies.

In Oregon, both the state Medicaid office and state Public Health Division are housed within the Oregon Health Authority (OHA). This agency encompasses all public health care purchasing programs along with health policy and public health. Under a single agency, Medicaid and public health have shared goals and many opportunities to collaborate as partners on a population health strategy designed to improve health outcomes for a geographically defined population. In the road map referenced above, we refer to this type of prevention strategy as population level 2 or PL-2. While other case studies have focused on how Oregon is aligning its health care and early learning systems, this case study focuses on collaboration between Medicaid and public health in Oregon to improve health outcomes for a geographically defined population. Read more >>

The Robert Wood Johnson Foundation awarded the Nemours Foundation a 1-year grant to explore and promote the use of existing Medicaid authority to support prevention. The initiatives described in the companion documents are intended to sustain approaches that link the clinic to community prevention efforts addressing chronic disease, including childhood obesity. This case study is part of a practical resource that will include two additional case studies, a roadmap and other tools for states, and a white paper. Together, these resources bring to light how states have successfully created sustainable financing through Medicaid and the Children’s Health Insurance Program for preventing chronic diseases at both the individual and population levels. The toolkit can help states get started or continue their prevention efforts. These additional documents can be found at http://movinghealthcareupstream.org/innovations/pathways-through-medicaid-to-prevention.  

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Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.