At first, we were so pleased the other day at the progress the state announced on its Medicaid reform.

The news release announced: It’s working. The reform is lowering costs and hitting key performance measures.

“Emergency department visits and spending are decreasing under the coordinated care model,” said Tina Edlund, acting Oregon Health Authority director. Measurements indicate Oregon’s CCOs are lowering unnecessary hospitalizations for conditions that can better be treated elsewhere, the release said. “There are also reductions in hospital readmissions, largely due to community efforts to achieve the highest quality care and to keep people at their healthiest.”

The release goes on to highlight some of the progress in primary care, adoption of electronic health records and more.

There are no qualifiers, asterisks or words of caution about how well it’s all working.

But dig deeper and look at the actual report, and there’s quite a bit of bad news. Emergency room visits will have to drop another 16 percent if the state is going to pass in the category. Many other benchmarks are like that. There are others where the state doesn’t have data yet.

Does that mean Oregon’s Medicaid reform is working?

Of course, it doesn’t. It means in some areas the reforms are moving in the right direction. In some areas, Oregon has a lot of work to do. And in some areas, the state doesn’t know if it’s working.

What’s worse is that if Oregon doesn’t meet some of the benchmarks by 2015 it could start facing penalties from the federal government.

In the worst-case scenario, it could face up to $190 million in penalties over the next few years if it doesn’t end up reducing costs by a 2 percent reduction in the rate of growth in per capita Medicaid spending. The state could face up to $35.2 million in penalties over the next few years for not meeting health quality benchmarks.

When a car is working, you can count on it to get you where you need to go.

When health care reform is working, it’s saving money or improving health.

When a state government is working, it doesn’t put out a press release announcing health reform is working, when it’s not clear if it’s working.