Welcome
We report race, ethnicity, language and disability (REALD) data as proxies to exposure to systemic racism, linguistic marginalization, ableism and disablism. Our goal is to identify inequities in quality of and access to health care services provided by CCOs.
The CCO Metrics program worked closely with OHA’s
Equity and Inclusion Division on REALD reporting in this dashboard. E&I works with diverse communities to eliminate health gaps and promote optimal health in Oregon. We aim to create and foster the conditions for communities most impacted by health inequities to do
data justice.
Methodology
Frequently Asked Questions
Definitions
Download Data
Accessibility
For viewing the data as text, we recommended going to Download Data. You can get data from this display in other languages, large print, braille or another format for free. Please contact us at Metrics.Questions@odhsoha.oregon.gov or 503-201-1949. We accept all relay calls.
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Please remember that
people are not numbers. Relying on quantitative data alone can have negative impacts.
CCO Metrics: Demographic Disparities
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Frequently Asked Questions
CCO metrics come from multiple data sources. Most metrics come from administrative (billing) claims. Claims are primarily used for health care payments. We link claims data with eligibility records, which include patient information (ex: name, date of birth, member ID) that can be linked to the REALD and SOGI Repository. For more information about the Repository, please visit Methodology.
We also report metrics from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. This annual survey collects data on patient experiences with health care. CAHPS began asking REALD questions in 2019. Two CAHPS surveys are conducted annually: Adult and Child. In 2024, the response rate was 14.8% for the Adult survey and 11.8% for the Child survey.
Demographic data for administrative and CAHPS metrics come from different sources and are collected using different methods. Therefore, demographic reporting for administrative and CAHPS metrics are not comparable.
Lastly, CCOs report a handful of metrics using electronic health records (EHR) data. CCOs do not report member-level data for these metrics. At this time, we cannot report demographic data for EHR metrics.
For more information, please visit Methodology.
Unlike race or ethnicity, language and disability subgroups do not have parent categories. For example, Vietnamese, Chinese and Japanese are subgroups in the Asian parent category. We use parent categories to show average CCO service rates across all subgroups.
For race or ethnicity, we have an additional chart in the Service gaps tab. This chart allows for comparison across parent categories. For example, on average, how did CCO services rates for Asian members compare to American Indian and Alaska Native members? It also allows for comparison within groups. For example, how did CCO service rates compare within Asian communities (e.g., Vietnamese members compared to Korean members)?
To protect member confidentiality, we suppress data for
some groups. To report as much as possible, we provide two levels of detail for race/ethnicity and disability data: Granular (most detail) and aggregate (least detail).
Aggregate data can mask inequities. We always recommend using granular data when they are available.
Most CCO metrics use full population data. This means that we know the service rate for all eligible members. However, for some measures only a small number of members may be served in a year.
For metrics with small eligible populations, changes year-over-year can fluctuate dramatically. These fluctuations may be based on a handful of members or changes to the population, rather than a change in health care services. As such, year-over-year comparisons need to be interpreted with caution.
We add this warning to groups when:
- Administrative (billing) claims: Fewer than 12 members were served or 60 inpatient visits occurred (numerator).
- Inpatient visits are only used for All-Cause Readmission and Ambulatory metrics.
- CAHPS survey: The relative standard error (RSE) was less than 50%.
We report the most detailed demographic data whenever possible. However, service rates are not displayed when groups are so small that individuals may be able to be identified.
We suppress data for groups with:
- Administrative (billing) claims
- Metrics with percent rates
- Fewer than 30 eligible members (denominator) or
- Fewer than 5 members served (numerator).
- All-Cause Readmission metrics
- Fewer than 150 inpatient eligible visits (denominator) or
- Fewer than 25 inpatient visits occurred (numerator).
- Ambulatory metrics
- Fewer than 360 eligible member months (MM) (denominator) or
- Fewer than 25 emergency department visits occurred (numerator).
- CAHPS survey
- Fewer than 30 members responded to the question (denominator);
- Fewer than 3 members agreed (numerator);
- All or no members agreed (rate 100% or 0%); or
- The relative standard error (RSE) was greater than or equal to 50%.
For administrative metrics, we use the National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set (HEDIS) guidelines on suppressing denominator sizes. NCQA suppresses groups with fewer than 30 members from health plan-level and stratified reporting. CMS also suppresses rates with a denominator less than 30 due to reliability concerns.
In all other cases, we follow guidelines on small number reporting from OHA's Office of Health Policy and Analytics (HPA).
In 2020, the CAHPS survey began asking respondents to identify their primary race or ethnicity. For 2019, we assigned respondents with multiple race or ethnic identities to the least common group they
selected. For all other years, we assign respondents to the primary race or
ethnic identity they selected.
Also in 2020, CAHPS stopped sampling children with chronic conditions separately from the general population. With these changes, survey results prior to 2020 cannot be compared to later years.
Lastly, 2019 and 2020 survey results in this dashboard include the oversample of target race and ethnicity groups. In the CCO Metrics: Overall Population dashboard, we do not include the oversample in 2019 and 2020 results. As such, results here may differ compared to other reporting.
REALD data standards allow members to select multiple races or ethnicities. They also ask members to identify the race or ethnicity they primarily identify with.
For CCO metrics, we report members' primary race or ethnic identity. If a member selected more than one race or ethnicity and did not select a primary, we use the least common group they selected.
For more information, please visit Methodology.
Not everyone who speaks English less than "very well" will ask for or receive an interpreter. A person’s willingness to ask for an interpreter may be influenced by a variety of factors, including but not limited to:
- geography
- availability of interpreters in their preferred language
- trust in sharing personal matters with an interpreter who may be a member of the same small community.
People who self-report speaking English less than "very well" may perceive asking for an interpreter as an additional barrier to services. These barriers may include more time to set up services or fear of being seen as a nuisance by providers.
People with disabilities may be more likely to access health care services. However, they are less likely to receive preventive health care services, such as cancer screenings, and more likely to experience health inequities.1 Frequent health care does not mean quality or equitable health care.
_________________
1Horner-Johnson, Dobbertin, Lee, & Andresen, 2014; Krahn et al., 2015; Wisdom et al., 2010).
In chart titles, we describe the change over time. Descriptions are based on percent change, or the relative rate of change. For example, a 100% increase means the rate doubled from one year to the next.
For consistency, we use the following descriptions for ranges in percent change:
- Improved: 10% or more
- Slightly improved: 3.01% to 9.99%
- Held steady: -3% to 3%
- Slightly worsened: -3.01% to -9.99%
- Worsened: -10% or less
Definitions
Ppt stands for percentage points. This is the absolute difference between two groups. For example, the absolute difference between 20% and 15% is 5 percentage points (ppt).
REALD is a set of standardized questions and data about a person's race, ethnicity, language and disability. REALD offers more detailed demographic data than other data sources, which helps us unmask inequities.
Race means physical traits, like skin color, that people and societies see as important. Ethnicity means the culture people share, like their language, traditions, family history and beliefs.
In 2024, we report CCO service rates by:
- Administrative (billing) claims: Up to 40 granular and 9 aggregate categories.
- CAHPS survey: Up to 71 granular and 10 aggregate categories.
We report the race or ethnicity members said they primarily identify with. We assign each member to a single race or ethnic category. This allows for easier comparisons w hen looking at the population as a whole.
A single race category does not represent an individual’s racial identity, which may be
multiracial, complex and intersectional. For this reason, a single race category is not
reported at a member level. A person’s full racial identity must be valued and honored
when seeking care.
For more information, please visit Methodology.
The language members want to be communicated with in person, on the phone or video remote. We report CCO service rates by:
- Administrative (billing) claims: Up to 79 preferred spoken languages.
- CAHPS survey: English, Spanish and Another language. We roll up all other languages besides English and Spanish to protect member confidentiality.
Minors largely depend on a parent or guardian to access health care services. For this reason, we report guardians' language preferences for:
- Administrative (billing claims): All members under age 15.
- CAHPS survey: All members under age 18 (survey completed by guardian).
Note: We report the language preferences members reported during enrollment or when surveyed. The data here may not reflect requests made during a health care visit.
For members who reported using a language other than English during enrollment, we report three categories:
- Bi-/Multilingual: Members who speak more than one language, but prefer to communicate in English and speak English "very well." These members may prefer to have written materials in a language other than English.
- May need interpreter: Members who did not report needing or wanting an interpreter but prefer to communicate in a language other than English or speak English less than “very well.”
- Interpreter requested: Members who reported needing or wanting an interpreter, or preferring a specific type of interpreter.
- These data come from the Decision Support/Surveillance and Utilization Review System (DSSURS), which most closely match the data CCOs use for language services.
For this demographic, we link administrative (billing) claims data with enrollment data. We do not report language access needs for CAHPS survey metrics at this time.
We report granular disability categories based on limitations to daily living, also known as functional limitations. These vary slightly by data source (administrative or CAHPS).
Administrative (billing) claims
2+ limitations
Members who reported having more than one of the following functional limitations, excluding Independent living/Self-Care+.
Blind/Low vision only
Members who only reported being blind or having serious difficulty seeing, even when wearing glasses (all ages).
Communication only
Members who only reported having serious difficulty communicating (understanding or being understood by others) using their usual (customary) language (ages 5 and older).
Deaf/Hard of hearing only
Members who only reported being deaf or having serious difficulty hearing (all ages).
Independent living/Self-care+
Members who reported having:
- Difficulty doing errands alone such as visiting a doctor’s office or shopping because of a physical, mental or emotional condition (ages 15 and older), and/or
- Difficulty bathing or dressing (ages 5 and older).
Members who did not respond to REALD disability questions but were identified as receiving:
- Permanent Disability or
- Long-term care (LTC) services.
Learning/Cognitive/Mental health onlyMembers who only reported having any of the following:
- Learning: Serious difficulty learning how to do things most people their age can learn (ages 5 and older).
- Cognitive: Serious difficulty remembering, concentrating or making decisions because of a physical, mental or emotional condition (ages 5 and older).
- Mental health: Serious difficulty with mood, intense feelings, controlling their behavior, or experiencing delusions or hallucinations (ages 15 and older).
Mobility/Physical only
Members who only reported having serious difficulty walking or climbing stairs (ages 5 and older).
Non-disabled
Members who answered one or more of the REALD disability questions but did not report any functional limitation and were not identified as eligible for Permanent Disability or LTC services.
CAHPS Survey
In 2024, the CAHPS survey differed with two categories:
Independent living/Self-care
Members who only reported having:
- Difficulty doing errands alone such as visiting a doctor’s office or shopping because of a physical, mental or emotional condition (ages 15 and older), and/or
- Difficulty bathing or dressing (ages 5 and older).
Self-ID only
- Members who identified as disabled or as having a condition in their own words. These members did not answer "yes" to function limitation questions. This option was added to the CAHPS survey in 2024.
For CAHPS metrics, we do
not identify members who received Permanent Disability or long-term care (LTC) services.
In this dashboard, we assign each person to a single disability category. This allows for easier comparisons when looking at the population as a whole. However, no single disability group can adequately capture a person’s health trajectory or exclusion from full participation in their community.
We also report a disability aggregate roll-up of number and type of functional limitation(s):
- 1 limitation: Members who reported having one functional limitation, excluding Independent living/Self-care+ (Administrative) or Independent living/Self-care only (CAHPS).
- 2+ limitations: Members who reported having two or more functional limitations, excluding Independent living/Self-care+ (Administrative) or Independent living/Self-care only (CAHPS).
- Any disability: Members with any reported or identified disability. We only report this category if all other categories are suppressed.
- Independent living/Self-care+ (Administrative): Members who either:
- Reported having:
- Difficulty doing errands alone such as visiting a doctor’s office or shopping because of a physical, mental or emotional condition (ages 15 and older),
- Difficulty bathing or dressing (ages 5 and older), and/or
- Did not respond to REALD disability questions but were identified as receiving Permanent Disability or Long-term care (LTC) services.
- Independent living/Self-care (CAHPS): Members who only reported having:
- Difficulty doing errands alone such as visiting a doctor’s office or shopping because of a physical, mental or emotional condition (ages 15 and older), and/or
- Difficulty bathing or dressing (ages 5 and older).
- Self-ID only (CAHPS): Members who identified as disabled or as having a condition in their own words. These members did not answer "yes" to function limitation questions. This option was added to the CAHPS survey in 2024.
In this dashboard, we assign each person to a single disability category. This allows for easier comparisons when looking at the population as a whole. However, no single disability group can adequately capture a person’s health trajectory or exclusion from full participation in their community.
Among members who self-identified as having a functional limitation, we report their:
- Current age and
- Age acquired, or the earliest age when the limitation(s) began.
For people with more than one functional limitation, we report the age when they acquired their first functional limitation.
Age plays a pivotal role in disability experience. Health trajectories are affected at
certain times in life. For example, those who are born with or acquire a disability at a
young age will likely experience more discrimination and greater environmental barriers than
those who acquire a disability later in life.
In this dashboard, we do not include members whose demographic data were missing, unknown or declined.
- Missing: Member does not have a recorded response to demographic questions.
- Unknown: Member responded "Don't know" to demographic questions.
- Declined: Member responded "Don't want to answer" to demographic questions.
To see the percent of demographic data that were missing, unknown or declined, go to the Data tables tab.
General Information
Data file released December 2, 2025:
Release 2025.2 (published December 2, 2025)
General updates:
- 2024 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data added in Release 2025.2.
- Starting with Release 2025.1, we now report groups whose service rates were suppressed to protect member confidentiality.
Changes to disability data:
- All 2023 disability data refreshed using 2024 demographic data from the REALD & SOGI Repository. In the 2024.1 Release, many members who declined, did not know or did not respond to disability questions were likely assigned as non-disabled for administrative metrics. For disability, 2024 missing, unknown and declined rates also apply to 2023.
- Starting in measurement year 2024, Independent living/Self-care+ no longer includes members who only qualify for Supplemental Securinty Income (SSI). Use caution when comparing 2024 data with prior years.
Starting in measurement year 2024, we added the following measures to our reporting. These measures come from the Centers for Medicare & Medicaid Services (CMS) Core Sets:
- Ambulatory Care Sensitive Emergency Department Visits for Non-Traumatic Dental Conditions in Adults (EDV-AD)
- Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB)
- CAHPS: Rating of Health Plan - Adults (CPA-AD)
- CAHPS: Rating of Health Plan - Children (CPA-CH)
- Concurrent Use of Opioids and Benzodiazepines (COB-AD)
- Oral Evaluation During Pregnancy (OEVP)
Measurement year 2024 was the first year of quantitative data reporting for the following Upstream metric:
- Young Children Receiving Social-Emotional Issue-Focused Intervention/Treatment Services
Starting in measurement year 2024, we no longer report the following measures. With Senate Bill 966, these measures are no longer eligible for the CCO Quality Incentive Program:
- Ambulatory Care: Emergency Department Utilization
- Any Dental Service
Starting in measurement year 2024, we updated metric names and abbreviations to align with the CMS Core Sets and measure stewards. For most metrics, this was a minor update. The following metrics had more substantial name changes:
Previous
name
| Updated name
|
| CAHPS:
Access to Care | CAHPS: Getting Care Quickly (CPA) |
| CAHPS:
Access to Dental Care | CAHPS: Regular Dentist (CPA) |
| CAHPS: Overall Rating of
Health Care | CAHPS: Rating of All Health Care (CPA) |
| CAHPS:
Satisfaction with Care | CAHPS: Customer Service (CPA) |
| Health
Equity: Meaningful Language Access | Meaningful Language Access (Health Equity) |
| Oral
Evaluation for Adults with Diabetes | Adults with Diabetes - Oral Evaluation
|
Additionally, we have updated filters to align with metric names and abbreviations. Please note the following when searching for metrics:
| Previous
filter name | Updated filter name |
| ADHD Medication (Initiation) | Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Initiation Phase
(ADD-CH) |
| ADHD Medication
(Continuation) | Follow-Up Care for Children Prescribed
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication: Continuation and
Maintenance Phase (ADD-CH) |
| Adolescent Immunization:
Combo 2 | Immunizations for Adolescents: Combo 2 (IMA-CH) |
Dental Sealant at Least One First Molar
| Sealant Receipt on Permanent First Molars: Rate 1 - At Least
One Sealant (SFM-CH) |
Dental Sealant All First Molars
| Sealant Receipt on Permanent First Molars: Rate 2 - All Four
Molars Sealed (SFM-CH) |
| Pharmacotherapy
for Opioid Use Disorder | Use of Pharmacotherapy for Opioid Use Disorder (OUD-AD) |
| Psychosocial
Care for Children on Antipsychotics | Use of First-Line Psychosocial Care for Children and
Adolescents on Antipsychotics (APP-CH) |
| Substance
Use Treatment: Engage | Initiation and Engagement of Substance Use Disorder Treatment:
Engagement (IET) |
| Substance
Use Treatment: Initiate | Initiation and Engagement of Substance Use Disorder Treatment:
Initiation (IET)
|