Abstract
The development of methods for public health surveillance in Medicaid populations is an important goal for public health practice. In Oregon, we developed approaches to case finding using claims and self-reported data obtained from the Medicaid beneficiary population. Disease rosters, derived from claims data, form the basis for analyses pertaining to particular health conditions. Self-reported information obtained through a telephone survey forms the basis for analyses pertaining to behavioral risk factors, disease history, and other information not available in claims data. We also describe some projects in which we plan to use combined claims and survey data. We describe our experiences with using these techniques and provide examples from projects in progress or planned. Our initial experiences suggest that these approaches enhance our ability to conduct public health surveillance in Oregon's Medicaid population.
EACH YEAR IN Oregon approximately 550,000 residents-or about 18 percent of the population-receive medical services through Medicaid. Low income is a requirement for Medicaid eligibility, and poverty is associated with a variety of poor health outcomes and their risk factors. Medicaid populations are an important focus for public health interventions, which can have a substantial impact on reducing the burden of disease in this population. Public health surveillance provides the foundation for the development, implementation, and evaluation of such interventions. However, it has been difficult to obtain in a systematic manner the necessary information for surveillance in this population. Therefore, in Oregon developing methods for public health surveillance of the Medicaid population is an important goal for state public health practice.
To facilitate the availability and use of Medicaid data for public health surveillance in Oregon, the Public Health Medicaid Assessment Initiative (PHMAI) was established in 1997. The PHMAI is a partnership between the Oregon Office of Medical Assistance Programs (OMAP), the state Medicaid agency, and the Oregon Health Division (OHD), the state public health agency. In this article, we present some of our initial experiences with public health surveillance of the Oregon Medicaid population. We describe three approaches: developing disease rosters using Medicaid claims data, collecting survey data, and linking survey and claims data. For each activity, we provide some technical details and give examples from projects in progress or planned. We ask readers to understand that lack of data is not an oversight. Instead, we made a purposeful decision to describe the processes we developed, the reasons behind them, and our plans for using the resulting data. Our aim is to generate ideas for enhancing public health surveillance among Medicaid populations.