A Brief History of Health Services Prioritization in Oregon
Abstract
Aware of the need for accountable and effective funding of health care, Oregon established a set of policy objectives to guide the development of a methodology for setting health care priorities. In 1989, the Oregon Legislature created the Health Services Commission and directed it to develop a prioritized list of health services ranked in order of importance to the entire population to be covered. The Commission first tested a formulaic approach using a cost/utility analysis, but the results were unsatisfactory. Subsequent successful approaches rank- order general categories of health services (e.g., Maternity and newborn care; Comfort care) based on relative importance as gauged by public input and on Commissioner judgment. Within these general categories, individual condition/treatment pairs are prioritized according to impact on health, effectiveness and (as a tie-breaker) cost. The resulting prioritized list is used by the Legislature to allocate funding for Medicaid and SCHIP, but the Legislature cannot change the priorities set by the independent Commission. The benefits based on the prioritized list are administered primarily through managed care plans, and approximately 1.5 million Oregonians have gained health coverage due to the expanded access made possible by explicitly prioritizing health services.
Abolished Commission information
Requests for archived information from the Health Resources Commission and Health Services Commission should be sent to herc.info@dhsoha.state.or.us