During 2014, in the months after Oregon expanded access to its Medicaid program to more than 380,000 additional people, anecdotes from members who had signed up but couldn’t get in to see doctors were commonplace.

Providers say they were deluged with a massive influx of patients who relied on Medicaid, known here as the Oregon Health Plan, and some had to close their doors to new patients. In extreme cases, a small number of providers even kicked existing patients out of their practices if they were on OHP.

The rush seems to have slowed down, but it’s still not altogether clear what kind of access OHP patients have to the medical system, whether that’s primary care visits, specialists, mental health or dental care.

To get a clearer picture, the health care providers and community leaders who oversee care for Central Oregon’s OHP population will pay an unidentified company up to $375,000 to study the access question from many perspectives: not just office visits, but phone calls. Not just members, but doctors, too.

Leslie Neugebauer, who heads the region’s coordinated care organization, the entity that doles out funding for OHP members’ care, said people’s stories don’t paint the full picture of access across Central Oregon.

“We’re trying to get away from anecdotes, and we want to have more standardized measures,” she said, “and we want to have something that’s going to be able to be reproduced year after year.”

The Central Oregon Health Council, a nonprofit group that governs the CCO, voted last month to move forward with one company’s proposal for undertaking the study, which will involve both quantitative and qualitative segments. The proposal was among three submitted, Neugebauer said.

Dan Stevens, the senior vice president of PacificSource Health Plans and a Health Council board member, wrote in an email he would not feel comfortable sharing the access study proposal that was selected because it is proprietary.

Neugebauer declined to identify the company selected to perform the study, because she said the contract with that company has not been finalized.

The main goal behind the study will be to determine what standardized methods OHP providers should use to measure access, Neugebauer said. Ultimately, though, this study will go beyond simply looking at numbers and comparing them to state and national averages, she said. It will study patient and provider experiences as well.

“The only way you can do that is to talk with them,” Neugebauer said, “having focus groups and in-depth interviews and things like that. This proposal had all of that involved.”

Neugebauer said she hopes to have a contract in place before the end of the year. The quantitative portion of the study will begin first and take three to six months to complete. The entire study will take nine to 12 months, she said.

When Health Council board members voted to approve the study, Megan Haase, chief executive officer of Mosaic Medical, a nonprofit community health center that treats many OHP patients, emphasized the study won’t just focus on office visits, but on less traditional ways to define access, such as phone calls or through electronic health monitoring.

Mosaic, for example, has a program in its Prineville clinic where patients measure their vital signs at home using pulse and blood pressure monitors that automatically transmit the data back to the clinic. A nurse calls them if their levels are concerning.

Access could also take the form of phone calls or using a provider’s electronic patient records portal to get questions answered faster than waiting for an office visit, said Ken House, Mosaic’s director of data and analytics.

“When you dig down into the primary care world, you see a lot of these face-to-face provider visits which probably could have been handled over the phone just fine and saved the patient some hassle from coming in,” he said. “So we’re trying to look at it a layer deeper and really understand what the needs of the community are and how we can meet those needs.”

Central Oregon’s CCO rounded out 2014 with a $6.6 million budget surplus, and its leaders weren’t sure why. One potential explanation: Members weren’t able to get in to doctors to get the care they needed.

Greg Hagfors, the CEO of Bend Memorial Clinic and a Health Council board member, said it’s unclear whether that was the case.

“The sad thing is we don’t know,” he said, “and again, that’s another good reason to have the study done.”

— Reporter: 541-383-0304,

tbannow@bendbulletin.com