Oregon Healthcare Analytics

Healthcare Analytics for Oregon Hospitals and Clinics

Oregon's coordinated care organization model is the most ambitious Medicaid accountable care experiment in the United States — and it reduced Medicaid spending growth by 30% over five years. Oregon's CCOs hold full financial risk for their attributed populations' total cost of care, community benefit spending, and quality performance. Health systems contracting with CCOs need analytics infrastructure built for Oregon's unique model, not adapted from fee-for-service tools designed for other states.

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30%Reduction in Oregon Medicaid spending growth achieved through the CCO coordinated care organization model over 5 years
Oregon Healthcare Landscape

Oregon's Healthcare Data Challenge

Oregon operates approximately 65 acute care hospitals — a relatively small number for a state of its geographic size, reflecting a healthcare market where delivery is concentrated in the Portland metro and a handful of regional centers. OHSU — Oregon Health & Science University — anchors the Portland academic medical center market, serving as the state's primary Level I trauma center and research institution. Providence Health Oregon, part of Providence Health & Services, operates more than 10 hospitals across the state. Legacy Health's six Portland-area hospitals provide the primary independent system alternative in the metro market. PeaceHealth serves Eugene/Springfield and Oregon's southern coast. Samaritan Health Services provides the primary system for the coastal and mid-Willamette Valley communities from its Corvallis base.

Oregon Health Plan (OHP), the state's Medicaid program, is unique in American healthcare. Oregon implemented coordinated care organizations (CCOs) in 2012 — regional entities that hold full financial risk for the total cost of care for their attributed Medicaid population, including physical health, behavioral health, and oral health. CCOs including Health Share of Oregon (Portland metro), PacificSource Community Solutions, Trillium Community Health Plan, and AllCare Health are required to demonstrate community benefit investment, social determinants of health intervention, and quality measure performance alongside financial accountability. This creates an analytics environment where hospital systems contracting with CCOs must report against community-level quality metrics and per-capita cost-of-care benchmarks that have no equivalent in most state Medicaid programs. Portland's documented houseless population health crisis — the city has the highest per-capita unsheltered population on the West Coast — creates a unique population health analytics challenge around ED utilization, behavioral health, and social determinants.

~65
Acute care hospitals across Oregon
1.4M+
Oregon Health Plan enrollees in the CCO model
30%
Reduction in Medicaid spending growth through CCO model over 5 years
CCO
Oregon's unique coordinated care org model — unlike any other state's Medicaid
How Vizier Helps

Oregon-Specific Analytics Solutions

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CCO Total Cost of Care Analytics
Oregon's CCO model requires health systems to manage their attributed population's total cost of care per member — a fundamentally different analytics model than fee-for-service quality reporting. Vizier tracks per-capita spending trends, community benefit investment metrics, and quality measure performance against CCO incentive measure benchmarks for Health Share, PacificSource, Trillium, AllCare, and other CCO contracts simultaneously.
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Social Determinants & Houselessness Analytics
Oregon's housing crisis — particularly in Portland, where the unsheltered population is the highest per-capita on the West Coast — creates ED utilization patterns that no standard readmission risk model was built to predict. Vizier integrates ICD-10 social determinant codes, housing instability flags, and ED utilization patterns to identify high-cost, high-need patients whose care requires social intervention alongside clinical management.
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Rural Southern & Eastern Oregon Viability
Southern and Eastern Oregon communities face high poverty rates, limited hospital capacity, and wildfire health impacts that create financial sustainability challenges for regional health systems. Vizier models critical access hospital financial trajectories, patient migration to urban centers for specialty care, and service line contribution margins for Oregon rural facilities operating under tight margins without urban cross-subsidy.
Oregon Health Systems

Organizations Like These Face Oregon's Analytics Challenges

Oregon health systems operate in the most analytically demanding Medicaid environment in the country, where CCO contracts require per-capita cost of care reporting, community benefit investment metrics, and quality performance accountability that extend far beyond standard fee-for-service quality reporting. Systems that cannot demonstrate CCO performance risk losing market access in Oregon's highly managed Medicaid market.

OHSU Health
Providence Health Oregon
Legacy Health
PeaceHealth Oregon
Samaritan Health Services
Asante Health System
Regulatory Context

Oregon Compliance and Reporting Requirements

Oregon Health Plan is administered by the Oregon Health Authority (OHA) through coordinated care organizations that hold global budgets for their attributed Medicaid populations. CCOs must demonstrate performance against OHA's incentive measure set — a portfolio of quality measures tied to per-member-per-month payment adjustments. Hospitals contracting with CCOs must align their quality reporting to CCO incentive measure requirements, including behavioral health integration metrics added following Oregon's landmark Measure 110 drug policy reform and subsequent addiction treatment expansion.

Oregon's progressive policy environment has created additional reporting requirements including CCO community benefit investment reporting, social determinants of health screening requirements tied to OHP payment, and health equity reporting with race and ethnicity stratification. MIPS quality reporting applies to Oregon physician practices, and OHSU's academic status creates research reporting obligations. OHP's comprehensive behavioral health integration mandate following the 2020 carve-in of behavioral health into CCO global budgets added significant new analytics requirements for providers.

Medicaid Program
Oregon Health Plan (OHP) — CCO coordinated care organization model
Managed Care
Health Share, PacificSource, Trillium Community, AllCare Health, Columbia Pacific
Key Reporting
OHA CCO incentive measures, total cost of care, SDOH screening, MIPS
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