Examining the Effect of Medicaid Expansion on Women and Infants in Oregon: Collaboration between Academic Public Health and the Practice Community

Oregon has recently undertaken a transformation of its health care system, to realize the Triple Aim of quality improvement, cost reduction, and better population health. In 2012 the state began delivering Medicaid services through Coordinated Care Organizations (CCOs), 15 geographically-focused networks of insurers and providers who receive a global budget to provide coordinated medical, dental, and mental health care through patient-centered primary care homes.  Oregon is also among 26 states that are expanding Medicaid eligibility under the ACA.  Proponents anticipate that the CCO model and Medicaid expansion together will improve access to care for newly eligible individuals while reducing per-enrollee costs for the state. There exists, however, no comprehensive surveillance system to demonstrate these effects.  In October 2013, researchers from the College of Public Health and Human Sciences at Oregon State University (OSU) and Oregon Health Authority (OHA) were awarded funding from the CDC to study the use of health services and health outcomes among women of reproductive age (15-44 years) and their infants, before and after Medicaid expansion. The research creates an integrated data system that links Oregon Medicaid data with other independently-maintained data sources: vital records, hospital discharge, Pregnancy Risk Assessment Monitoring System, and CCO Metrics (quality and performance measures at the enrollee level).  The research agenda is being developed through collaboration with OSU, OHA and groups of stakeholders. We describe strategies to build partnerships between OSU and OHA and activities to link data sources and bring together people across institutions to assess the impact of Medicaid expansion.