The Oregon legislature established in 2019 the Sustainable Health Care Cost Growth Target (CGT) Program. The CGT program sets a statewide target for the annual per-person growth rate of total healthcare spending in the state. The CGT has been designed to align healthcare cost growth with wages, inflation, and other economic indicators to continue to promote consumer affordability and high-quality care. The program is the culmination of years of collaboration with multiple health system partners and legislators to address the rising cost of healthcare.
St. Charles Health System Inc., a nonprofit health system providing medical services to patients in Central Oregon, recently commissioned Milliman to evaluate its cost target methodology with respect to the state program. St. Charles serves more than 150,000 hospital patients annually, and more than 100,000 individuals receive care from a provider in their clinics annually. We were asked to conduct two main tasks. One was to review whether the cost target methodology for the organization's report for 2022-2023 – published in 2025 – aligns with the approach described by official guidance. We also validated specific numbers in St. Charles's reporting.
Key sections in the report include:
- Program considerations: Attribution, diagnosis-based risk adjustment, and high-cost claimants
- Data reconciliation: Insurer trends and covered population
- Oregon Health Authority methodology review: Background, data collection, and 2022-2023 results
This report was commissioned by St. Charles Health System, Inc.