Oregon's medicaid ranking and cost-effectiveness: Is there any relationship?

Tammy O. Tengs, Gregg Meyer, Joanna E. Siegel, Joseph S. Pliskin, John D. Graham, Milton C. Weinstein

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

The authors examine whether Oregon's 1990, 1991, 1992, and 1993 prioritized lists were ranked in a manner consistent with cost- effectiveness. Two sets of cost-effectiveness data are used: data from economic analyses and Oregon's own cost-effectiveness data. Comparing the ranks of Oregon's lists with the ranks of cost-effectiveness estimates from the literature reveals Spearman correlations of -0.08 for the 1990 list, +0.39 for the 1991 list, +0.25 for the 1992 list, and +0.24 for the 1993 list. Comparing Oregon's lists with Oregon's own cost-effectiveness data reveals rank correlations of +0.99 for the 1990 list, +0.06 for the 1991 list, -0.05 for the 1992 list, and -0.03 for the 1993 list. Thus, there appear to be essentially no relationship between the 1990 list and cost- effectiveness estimates from the economic literature and modest positive relationships between the 1991-93 lists and the literature. In addition, there is virtually no relationship between the 1991-93 lists and Oregon's own cost-effectiveness data. Further, the correlations are very different from +1.0, suggesting that other factors are at play. For example, the 1993 list that is currently being implemented was ranked primarily by improvement in five-year survival and human judgment, not cost-effectiveness.

Original languageEnglish
Pages (from-to)99-107
Number of pages9
JournalMedical Decision Making
Volume16
Issue number2
DOIs
StatePublished - 22 Apr 1996

Keywords

  • Medicaid
  • Oregon
  • cost-effectiveness
  • rationing
  • resource allocation

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