MEDICAID - OPI COST COMPARISON

OPI is funded by the legislature with state General Funds. OPI services are modest; providing approximately 20 hours of in-home services per month. OPI consumers do not receive Oregon Health Plan (OHP) or Medicaid Long-Term Care benefits with the exception of SNAP (food stamps) and Supplemental Low Income Medicare Beneficiary Program benefits. More than 96% of all OPI consumers are at income levels that would qualify them for Medicaid services, which is at or below 200% of the Federal Poverty Level.

If an OPI consumer were to move into Medicaid, the costs to the state would immediately increase at a significant rate compared to protecting funding for the OPI program.

Only seniors with incomes of less than $1,823 per month are exempt from co-pays. People pay progressively higher co-pays as their income increases, until at $4,861 per month people pay the full amount.

A recent study conducted by an independent consulting agency titled “The Business Case for Oregon Project Independence” concluded that the benefits of OPI far outweigh the costs. In the report they examine the Social Return on Investment (SROI) for OPI, measuring “how much ‘good’ comes from a given effort.” The benefits totaled $49.4 million at a cost of only $13 million - a ratio of 3.8 to 1 SROI.

ADL: Activities of Daily Living

IADL: Instrumental Activities of Daily Living

SROI: Social Retunr on Investment

For more information on the graph to the left, this report, and the methodology used, please visit this site or find it under “Program Reports” on the State’s OPI page here.

*Expansion and changes for this program may be coming in 2023. At that time, criteria, services offered, and eligibility for the program will change.

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