Oregon’s Priority List

Oregon ranked 709 medical services, in a priority list, classifying them into 17 categories. Items in categories 1 through 9 were deemed “essential to basic care,” items in categories 10 through 13 were “very important” and services in categories 14 through 17 were considered “valuable to individuals but of minimal gain and-or high cost.”

Oregon’s 1991 budget for Medicaid funded most items on the priority list. This included 98% of the services in the first group of categories, 82% of services in the second and 7% in the last. Rank, Category of Treatment: Example 1. Prevents death with full recovery: Appendectomy 2. Maternity and newborn care: Childbirth 3. Prevents death with residual problems: Serious head injury 4. Preventive care for children: Immunizations 5. Extends life, improves quality of life: Diabetes treatment 6. Reproductive services: Contraceptives, sterilization 7. Comfort care: Painkillers for terminally ill 8. Preventive dental care: Exam, cleaning of teeth 9. Adult preventive care: Mammograms, blood-pressure tests 10. Acute condition: full cure: Treatment of vaginitis 11. Chronic condition: single treatment: Hip replacement 12. Acute condition: partial recovery: Aarthroscopic knee surgery 13. Chronic condition: repeated treatments: Sinusitis, migraines 14. Acute, self-limiting condition: Diaper rash, conjunctivitis 15. Infertility treatments: Artificial insemination 16. Adult preventive care: Sigmoidoscopy for colon problems 17. Minimal improvement in quality of life: Treatment of viral warts SOURCE: “Rationing America’s Medical Care,” Brookings Institution, adapted from Oregon Health Services Commission report on “Prioritization of Health Services”