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As part of an eventual statewide set of health insurance reform measures, the State of Oregon has proposed implementing a demonstration program, with Federal cofunding, that would change the State's existing Medicaid program in three fundamental ways. It would: 1) expand coverage to include all persons with incomes up to 100 percent of the Federal poverty level; 2) enroll all covered persons in some form of managed care, such as with a health maintenance organization or a "gatekeeper"primary care physician; and 3) determine acute and primary health care benefits according to a ranked list of services, with actual benefits dependent on the level of program funding. [Foreword, p. III]
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
The controversial Oregon proposed managed health care delivery system serving more than 220,000 Medicaid clients statewide is examined in detail. Reviews issues of access, quality of care, and financial oversight. Also includes 3Factors to Consider in Managed Care Programs2. Charts and tables.