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Evaluating Oregon's Health System Transformation
Evaluating Oregon's Health System Transformation

A new study from Portland State University researchers highlights $240M in health care savings over the first three years of the state’s Patient-Centered Primary Care Home (PCPCH) program. 

The PCPCH program was created by the Oregon Legislative Assembly in 2009 to achieve the “Triple Aim” of advancing public health, elevating the patient care experience, and reducing health care costs. To complete this task, the Oregon Health Authority, which oversees the PCPCH program, developed a standards-for-care model. Under the model, community-serving, patient-centered primary care clinics that provide accessible, comprehensive, and coordinated care are labeled Patient-Centered Primary Care Homes by the state. As of the release of the report, the state has recognized over 600 PCPCHs in rural and urban communities throughout Oregon.

The findings from the PSU report show that the state’s efforts to achieve the goals of the Triple Aim have produced positive results and have significantly transformed the health care system in Oregon. Clinics adopting the program assumed a “patient-centered lens” and shifted toward population-based strategies to improve health and health care delivery. In addition to the $240M saved, the study reports reductions in total health care expenditures of roughly $120 per person per year. The PCPCH program also resulted in savings in specialty, emergency department, and inpatient care.

Working in collaboration with the Oregon Health Authority, OHSU-PSU School of Public Health professor Dr. Sherril Gelmon and Dr. Billie Sandberg of PSU’s College of Urban and Public Affairs conducted qualitative evaluations of twenty “exemplary” PCPCH clinics around the state to better understand and report on the factors that promote successful implementation of the program. Using data provided by the state, School of Public Health professor Dr. Neal Wallace evaluated the impact of the program on health care expenditures and the use of insurance-covered services.

“PCPCH clinics serve a large portion of the state’s population, including people on Medicare, Medicaid, and state employees,” Dr. Wallace said. “And the evidence shows a correlation between the changes in primary care clinics and what people are spending on specialty care and trips to the emergency room. That suggests that the transformation of Oregon’s healthcare system really is resulting in improved health outcomes and reduced spending over time.”

“The PCPCH program is working,” said Dr. Gelmon. “It’s moving the state toward achieving the goals set up by the Triple Aim. Clinics are embracing the idea of patient-centered, coordinated care and the other standards set forth by the state. We’re hearing it from the people working at the clinics and we’re seeing it in the data we’ve analyzed.”

In 2009, the state set out to improve the health of all Oregonians and reduce costs associated with health care by transforming the state’s healthcare delivery system. The report from Drs. Gelmon, Wallace, and Sandberg shows how that transformation has succeeded and highlights the ways Oregon’s commitment to quality patient-centered, coordinated care at a large scale is producing positive results.

“Oregon’s health transformation efforts are making huge strides toward improving the health of Oregonians and controlling health care costs,” said Lynne Saxton, Oregon Health Authority director in a statement released by the agency. “[This report] demonstrates that a focus on integrated primary care can significantly save dollars for the state and provide the best health care possible for all Oregonians.”