We report geographic data as proxies to the boundaries that impact opportunities for health, which begin where we live, learn, work and play. These boundaries may be physical (for example, mountain ranges) or social and political (for example, segregation). Our goal is to identify inequities in quality of and access to health care services provided by CCOs.
We use Oregon Health Science University (OHSU)
Oregon Office of Rural Health's designations for geographic boundaries, including Primary Care Service Areas. Smaller geographic boundaries allow us to see inequities that would otherwise be masked by larger groupings, such as urban or rural only.
Frequently Asked Questions
Definitions
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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: Geographic Disparities
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Frequently Asked Questions
CCO metrics come from multiple data sources. Most metrics come from administrative (billing) claims data. Claims are primarily used for health care payments. We link claims data with eligibility records which include members' ZIP code.
Using ZIP code, we can assign members to a Primary Care Service Area, County and Urban/Rural/Frontier designation. In this dashboard, we use OHSU Oregon Office of Rural Health's designations. For more information, please see Definitions below.
- Note: We use the most recent ZIP code on file for members. The data here may not reflect members' residence when the health care visit occurred.
Other CCO metrics come from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and electronic health records (EHR). At this time, we do not report geographic data for these metrics.
To protect member confidentiality, we suppress data for places with small eligible populations. To report as much as possible, we provide three breakouts: Primary Care Service Area, County and Frontier/Rural/Urban. For more information, please see Definitions below.
Primary Care Service Areas provides the most detail, since it uses the smallest geographic boundaries. Frontier/Rural/Urban is an aggregate roll-up and provides the least amount of detail.
Aggregate data can mask inequities. We always recommend using Primary Care Service Area or County 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 intrepreted with caution.
We report the most detailed geographic data whenever possible. However, service rates are not displayed in places with eligible populations so small that individuals may be able to be identified.
We suppress data for places where there were:
- Metrics with percent rates
- Fewer than 30 eligible members (denominator) or
- Fewer than 5 members were 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).
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.
For numerator sizes, we follow guidelines on small number reporting from OHA's Office of Health Policy and Analytics (HPA).
Some CCO members reside outside of their CCO's service area. For example, a member may attend college away from where they lived when they enrolled for the Oregon Health Plan. In this dashboard, we show all reportable service rates in Oregon based on the members' most recent ZIP code, regardless if it is within the CCO's service area. A very small number of CCO members reside out of state. In this dashboard, we only show service rates for places in Oregon.
Census tracts are geographic areas that generally have between 2,500 and 8,000 residents. In urban areas, census tracts can be very small and may compromise confidentiality. In frontier and rural areas, census tracts can be quite large and may not meaningfully show how residents access health care.
In this dashboard, we prioritize Primary Care Service Areas, which more accurately represent community use of health care services. For more information, please see Definitions below.
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
Primary Care Service Areas are geographic areas that more accurately represent community use of health care services. There are 128 Primary Care Service Areas in Oregon. These are areas that:
- Have health resources generally located within 30 to 40 minutes travel time;
- Are not smaller than ZIP Code(s);
- Are geographically contiguous and/or follow main roads;
- Contain a population of at least 800 to 1,000 or more people;
- Constitute a "rational" medical trade or market area considering topography, social and political boundaries, and travel patterns;
- Additional considerations are boundaries that:
- Are congruent with existing special taxing districts (e.g., health or hospital districts);
- Include a population which has a local perception that it constitutes a "community of need" for primary health care services, or demonstrates demographic or socioeconomic homogeneity. The population should be large enough (800-1000 or more) to be financially capable of supporting at least a single midlevel health care provider.
Oregon has 36 counties which vary greatly in size, geography and population. A CCO's service area may cover multiple counties, and some do not follow county boundaries.
For this breakout, we use OHSU Oregon Office of Rural Health's designations:
- Frontier: County with six or fewer people per square mile. In 2024, Oregon had ten frontier counties:
- Baker
- Gilliam
- Grant
- Harney
- Lake
- Malheur
- Morrow
- Sherman
- Wallowa
- Wheeler
- Rural: Geographic area ten or more miles from a population center of 40,000 or more people.
- Urban: Geographic area less than ten miles from a population center of 40,000 or more people. In 2024, Oregon had 14 urban areas:
- Albany
- Beaverton
- Bend
- Corvallis
- Eugene
- Grants Pass
- Gresham
- Hillsboro
- Lake Oswego
- Medford
- Portland
- Salem
- Springfield
- Tigard
General Information
Release 2025.1 (published November 25, 2025)
First publication of CCO metrics stratified by geography.