Value Judgment in the Oregon Medicaid Experiment

Datos Bibliográficos

ID9104559
AutoresRobert M Kaplan (0000-0003-0229-0200)
Año1994
Volumen32
Número10
Páginas975-988
Fecha de publicación1994-10-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199410000-00001
PMID7934274
OpenAlexW2047362348
IdiomaEN
Citas recibidas8
Referencias citadas7

Oregon proposed a unique social experiment in which combinations of medical conditions and treatments were prioritized. Under the proposed program, providers would not be reimbursed for services relevant to 17% of the condition-treatment pairs. The program was designed to expand access and allow significantly more residents to qualify for Medicaid. The original Oregon proposal used four levels of human judgment: community values assessed in town meetings; ratings of the desirability of health states; medical judgment of treatment efficacy; and subjective reordering of the list by Oregon Health Services Commissioners. In August 1992, the Department of Health and Human Services rejected Oregon's application to proceed with the experiment, objecting to the use of one of the four types of subjective data: ratings of the desirability of health states. A revised application that eliminated this one subjective component was approved in March 1993. This paper demonstrates that among the four levels of judgment, the ratings of health states were supported by the most evidence of reliability and validity. Implications for future prioritization experiments are discussed

Actuarial science · Business · Economics · Family medicine · Health care · Human services · Management science · Medicaid · Political science · Prioritization · Reliability (semiconductor) · Statistics · Value (mathematics) · Applied Psychology · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Law · Mathematics · Medicine · Patient Satisfaction in Healthcare · Psychology · Gerontology