Enrolling Elderly and Disabled Beneficiaries in Medicaid Managed Care: Lessons Learned from the Oregon Health Plan
Oregon launched the Oregon Health Plan (OHP) in February 1994, enrolling both its traditional AFDC and new expansion populations into managed care. Exactly one year later, the State began enrolling its elderly and disabled beneficiaries, including those dually eligible for both Medicare and Medicaid. By the end of 1995, the majority of the elderly and disabled were enrolled in Fully Capitated Health Plans. By early 1998, this figure had climbed to 75 percent, with an additional 6 percent enrolled with a primary care case manager. The remaining beneficiaries remain in fee-for-service, many of them specifically exempted because of a third-party resource (such as supplemental Medi-Gap insurance). Oregon’s experience with elderly and disabled beneficiaries provides some valuable lessons for other states that may be considering enrolling this population into managed care.