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Medicaid Enrollment Report

Welcome to OHA's Medicaid Enrollment dashboard

The Medicaid Enrollment Report is an interactive dashboard that allows users to explore data about who is enrolled in Oregon's Medicaid program, which is known as the Oregon Health Plan (OHP). The dashboard is updated each month (typically by the tenth) with current data from the prior month.

Important! Significant updates were made to this dashboard with the February 2024 release. The previous version of the dashboard can be still accessed here until May 2024. If there is something you rely on in the previous version that is not available in the updated version (below), please email HPA.IDEA.Team@odhsoha.oregon.gov by April 15, 2024.

Dashboard Filters and Terminology About the Data General Information

Questions about the dashboard? Email OHA.HealthAnalyticsRequest@odhsoha.oregon.gov

Help us improve! Please complete a short survey about your experience using this dashboard.

The Dashboard

Please allow a few moments for the dashboard to load.
Use the dropdown filters to modify the data. Learn what the filter options mean under "Filters and Terminology" below.
To view in full screen mode, click the expand icon  in the bottom right corner.


 

 

Filters and Terminology

​T​his filter allows you to view the data for an individual health plan, as described below. In this dashboard, people are assigned to the CCO or FFS counts based on where they receive physical health coverage.

  • ​​Each of Oregon’s 16 Coordinated Care Organizations​ (CCOs)
    A CCO is a network of all types of health care providers (physical health, dental health, and behavioral health care) who work together to serve OHP members in their local communities. CCOs have one budget to cover all types of care, and are accountable for health outcomes of the population they serve.​​​Learn more about the Coordinated Care Model.
  • ​Fee-for-Service (FFS)
    Fee-for-Service means the OHP member’s physical health care is covered by the Oregon Health Authority (OHA) rather than a CCO. Some members can choose to receive FFS benefits, such as American Indian or Alaska Native people. Fee-for-Service is also referred to as “Open Card.”​​
  • PACE (combined)
    PACE organizations​ are managed care organizations that provide both Medicaid and Medicare services for people with chronic care needs who are 55 years or older. PACE stands for Program of All Inclusive Care for the Elderly​As of January 2024, there are two PACE organizations ​​in Oregon covering members in only a few counties (outlined below). The dashboard shows a single count for all PACE enrollees combined.
    • Providence ElderPlace serves all of Multnomah and Clatsop counties, as well as parts of Washington, Tillamook, and Clackamas counties.
    • AllCare PACE serves parts of Jackson and Josephine counties through a health center in the city of Grants Pass​.
​​

OHP stands for Oregon Health Plan, which is the name of Oregon’s Medicaid program. This filter allows you to view data by:

  • ​OHP: HOP​
    A subset of OHP, this option filters the data to only those enrolled in the Healthier Oregon Program (HOP), which expands OHP coverage to people who would otherwise be ineligible due to their immigration status
  • OHP: Bridge
    A subset of OHP, this option filters the data to only those enrolled in Oregon’s Bridge Program​, which opens OHP to people who earn up to 200% of the federal poverty level. Note: The Bridge Program is expected to fully launch in July 2024. Until then, people who were receiving OHP coverage during the COVID-19 Public Health Emergency (PHE) and are found to be eligible for the OHP Bridge during redeterminations are being enrolled through a category called “Adult Temporary Plan."
  • ​​​OHP: All other​
    This category includes all other OHP members (i.e., those who are not part of either the HOP nor Bridge programs).​
“Dual eligible” means the OHP member also receives Medicare benefits. I.e., they are eligible for and enrolled in both Medicaid (OHP) and Medicare. Options in this filter are:
  • Yes (the OHP member also receives Medicare benefits)
  • No (the OHP member does not receive Medicare benefits)​
Note: This dashboard only includes those who are "fully" dual eligible, which means the individual receives Medicare and OHP-covered services. This dashboard does NOT include people who are enrolled in a Medicare Savings Program, also known as "partially dual eli​gible." Learn more under Who is counted in the dashboard? ​below. 
The "Age" tab of the dashboard allows users to view the data by different age groupings. The significance of the groupings is described in the bullets below. Please note that the data are inclusive of ​the upper range. For example, ages "0-18" includes people who are 18 years old (up until their 19th birthday). 
  • ​0-5, 6-18, 19-64, 65+ ​is a general grouping with children stratified to reflect a ​new policy (effective January 2023)​​​, which keep children in OHP continuously enrolled until they turn six. 
  • 0-18, 19-64, 65+ is a general grouping (children, adults, and older adults)​.
  • 0-5, 6-10, 11-17, 18-25, 26+. The middle three ranges (bolded) are commonly used to define "children, adolescents, and young adults" (respectively) in child and family behavioral health.
  • 0-20 ​is the age range that receives EPDST benefits. EPDST stands for Early and Periodic Screening, Diagnostic, and Treatment. ​​
​ ​Note: The "Geography" tab of this dashboard also allows users to view enrollment as a percent of the population for children (ages 0-17) and adults (18 and older). These are the age groups used by the PSU Population Research Center. which is the data source used for the denominator (i.e., county populations). 
Eligibility groups are based on “PERCs” which stands for program eligibility resource codes. People are assigned PERCs based on the reason(s) they are eligible for OHP, such as age, income, pregnancy, disability status, etc.  ​See how PERCs have been categorized​ into the eligibilty groups desribed below. ​

Descriptions of major categories:​​
  • ABAD (Aid to the Blind/​Disabled) includes people with disabilities who meet federal criteria. Some of these individuals are also covered by Medicare.​
  • Adult Temporary Plan​ are members who will transition to the OHP Bridge program​ when it launches in July 2024.​
  • Breast and Cervical Cancer is a program that includes people who have been diagnosed and do not have access to other health insurance.​
  • CHIP (Children's Health Insurance Program) provides coverage to children in families whose income is above the usual Medicaid eligibility limit (up to 300% of the federal poverty level) but have no other health insurance. 
  • "CHIP to Medicaid" are children ​whose families earn above the Medicaid income limit that was in place before the Affordable Care Act expanded Medicaid eligibility (133% of the federal poverty level).​
  • HOP (Healthier Oregon Program) expanded OHP coverage to people who were otherwise ineligible due to their immigration status.​ (Note: "HOP other" includes individuals who are assigned outdated PERCs such as CWM or CAK for various administrative reasons. These members are assumed to be in the HOP program currently and are included in HOP counts throughout this dashboard).
  • MAGI (Modified Adjusted Gross Income) is a method for calculating income that was established by the 2010 Affordable Care Act. "MAGI Adults" have a household income up to 133% of the federal poverty level and are sometimes referred to as the ACA Expansion population. "MAGI Child" is a category for those live in a household with income up to 133% of the federal poverty level. 
  • TANF (Temporary Assistance for Needy Families) is a cash assistance program for low-income families. Families who receive TANF are automatically also eligible to receive OHP benefits. "TANF Extended" means the person is no longer in the TANF program but is receiving up to one additional year​ of OHP.​
  • Other: This category includes people who have not yet been assigned PERCs or are assigned PERCs that relate to outdated programs. 

What about Veteran Dental​ and COFA Dental eligibility groups? This dashboard page only includes people who have their physical health care covered through OHP. Thus, people who are enrolled in a dental-only program are excluded. As of January 2024, there were around 2,180 people enrolled in Oregon’s Veteran Dental program and 12 people enrolled in COFA Dental. To request a recent count, please use the Health Analytics General Request Form​.
Throughout other parts of this dashboard, the CCO counts that are shown include people who have their physical health care covered by a CCO (learn more under “Who is counted in the dashboard” above). While most OHP members enrolled in a CCO have all types of their health care (physical, dental, and behavioral) covered by their CCO, some members have CCO coverage for behavioral and/or dental care only. This page shows those additional counts of people who are enrolled in a CCO for care other than physical care. 

From this page, you can also access a separate "FFS Supplement" page which shows the same type of information (i.e., enrollment by delivery type) for the fee-for-service population. 

Note: CCO Plan Types A and B (which cover physical health) are the CCO counts shown throughout the rest of the dashboard. ​

 

 

About the Data

Main data source: Medicaid Management Information System (MMIS), Decision Support and Surveillance Utilization Review System (DSSURS). 
​Learn more about MMIS.

Maps that show enrollment as a percent of the population also use: Population Research Center. Population estimates and reports: certified population estimates, July of each year [internet]. Portland, OR: Portland State University; 202# [accessed MM/DD/YYYY]. Available from: https://www.pdx.edu/population-research/population-estimate-reports​​

The dashboard shows the cumulative count of people who are eligible or enrolled* for/in​ Medicaid on the 15th day of each month. That means if a person loses coverage on the 14th, or becomes enrolled on the 16th, they won’t be counted in that specific month.

Throughout most of the dashboard, counts are shown for those with OHP coverage for physical health care. As a result, people enrolled in dental-only only programs are generally excluded. However, some dental-only program members are counted in the “CCO Plan Type" page if they receive dental care through a CCO (i.e., CCOF). ​​

The dashboard does not count people who are enrolled in a Medicare Savings Program (MSP). MSP means people receive Medicare benefits, but Medicaid helps pay their cost-sharing (such as premiums and deductibles). There around 55,000 people in Oregon who are enrolled in a Medicare Savings Program. People receiving MSP benefits are sometimes also referred to as "partially dual eligible" for Medicaid.

*What does “eligible or enrolled” mean? 
People sign up for Medicaid using one of Oregon’s eligibility systems, such as ONE​. These systems determine if a person is eligible for Medicaid. If they are, then the person’s information is transferred to MMIS, which is the system used to administer Oregon’s Medicaid program (and the data source for this dashboard). Once a person’s information is transferred to MMIS, the system will enroll them in the Medicaid program. It can take a few days or more for MMIS to complete a person’s initial enrollment. Since the data in this dashboard are from a snapshot in time, some people may be found eligible for Medicaid, but still be in the process of becoming enrolled. Therefore, the data include people who are “eligible or enrolled” in Oregon’s Medicaid program. ​​

Cells with an asterisk (*) indicate number <10 (inclusive of zero). These numbers are suppressed because they may be statistically unreliable. As a result, totals may not reflect the sum of numbers shown across a row or column.

Users should not "backwards calculate" to deduce suppressed values, as they may be statistically unreliable.

Are these numbers final?
Counts from the most recent few months might change slightly when the dashboard is refreshed in each month. That’s because sometimes people are retroactively enrolled or disenrolled and the data are updated to reflect those changes.

What are "other or unknown" counties?
Individuals who cannot be categorized in the reporting database for various reasons, such as spelling errors or other admnistrative issues.

Are the demographic data REALD?
REALD is an effort to increase and standardize Race, Ethnicity, Language, and Disability (REALD) data collection across the Oregon Department of Human Services (ODHS) and the Oregon Health Authority (OHA). ​Learn more about REALD​.

​Because not all of the data in MMIS is collected according to REALD standards (learn more in the MMIS data profile), this dashboard currently includes only the racial and ethnic group​s in accordance with guidelines set by the US Office of Management and Budget. Data at this level may not capture racial and ethnic identity adequately to understand who is enrolled in Medicaid in Oregon.

We are currently developing a separate dashboard using data from OHA's REALD data repository which will report Medicaid population demographics with more granularity. The dashboard is expected to publish in spring 2024. ​​

 

 

General Information

​You can get data from this display in other languages, large print, braille, or a format you prefer. Email OHA.HealthAnalyticsRequest@odhsoha.oregon.gov​​.​

Oregon’s Monthly Medicaid Enrollment Dashboard (2024). Interactive display accessed [MM/DD/YYYY]. Salem, OR: Oregon Health Authority.
https://www.oregon.gov/oha/HPA/ANALYTICS/Pages/Medicaid-Data-Dashboards.aspx 

If you need additional data or analysis than what's presented in this dashboard, visit the Health Analytics Data Request​ page. 

You can also explore other dashboards​ produced by the Office of Health Analytics