OHSU

Health Systems Research in Oregon

What is health systems research?

Health systems, or health services research, studies the factors that figure in health care today, including costs, healthcare processes, medical technologies, social factors, individual behaviors, and lifestyle choices. It considers the quality of care and how changes in health services affect patient outcomes and our communities.

The Center for Health Systems Effectiveness considers how our health care systems interact. Our research encompasses patients, providers, insurers -- everyone who plays a role in shaping our health care.

Health services research includes comparative effectiveness research, patient-centered research, and healthcare quality improvement research. Our research is focused on identifying effective approaches to delivering, funding, and shaping high-quality health care.  

Health services researchers include medical doctors, nurses, pharmacists, dentists, economists, epidemiologists, social scientists, public health experts, policy makers, and community leaders.

Oregon CCO Background

Oregon, like every other state in the union, has struggled to provide high-quality care to its Medicaid population in a cost-effective manner. In response, the State of Oregon has undertaken an innovative and substantial restructuring of its Medicaid program in its initiation of Coordinated Care Organizations (CCOs), regionally-based healthcare delivery groups comprised of multiple health service organizations. CCOs face global budgets with a fixed rate of increase, which, if successful, will save more than $1 billion in federal and state dollars within three years and more than $3.1 billion over the next five years..

Oregon's CCOs make an excellent platform for study and for testing the effectiveness  of new concepts in health care delivery design.

  • Oregon is the first state to explicitly tackle the health care cost challenge with a global budget that caps the total amount that can be spent caring for a population.
  • Oregon's CCOs will be held accountable to performance and quality metrics designed to insure that cost reductions are achieved through better, more efficient care – not simply by restricting access to providers.
  • Oregon has created an All Payer All Claims database, allowing for  a comprehensive assessment of the cost and quality of care over time.

CHSE  has received NIH, foundation, and philanthropic funding  to identify the impact of the CCO transformation on cost and quality, to identify what works within the Oregon experiment, and to disseminate these findings locally and nationally.