Mission, Vision, Values and History

The Center for Outcomes Research and Education (CORE) was founded in 1986 at Providence Health System in Portland, Oregon with the goal of using data and research to make health care better. In CORE’s early days, we focused on evaluating promising medical treatments and programs. However, as we looked deeper into the factors that shape health, it became clear that many of them operate through systems and policies outside of what most people consider health care. To make a bigger impact, we needed to move upstream and look at how these larger forces interact with health care to shape health outcomes and health equity.

Oregon has long been a health policy pioneer, and a series of changes to its Medicaid program in the early 2000s provided the perfect platform for CORE’s shift upstream. During this period, our research helped the state identify what was working and uncover what was not – including evidence that cost-sharing structures were inadvertently causing many people to lose coverage. The state responded by changing its cost-sharing rules, and for the first time we could draw a direct line from our work to real policy and systems change. CORE’s work in this area continued through our most well-known study, the Oregon Health Insurance Experiment, which drew significant national attention and contributed to the evolution of the Affordable Care Act (ACA), a major shift in the U.S. health care system that resulted in millions of people gaining health insurance coverage.

Over time, our work in Medicaid and health policy—in Oregon and around the U.S.—led us to new questions about the root causes of poor health, how different historical and community factors intersect with health care to shape health, and how we could elevate our data and scientific work to address these complex and interconnected drivers. CORE is perhaps best known in this area for our housing is health work, which examines the foundational role stable housing plays in driving health and health care outcomes. Our work has also explored how food security, life experiences like trauma or economic deprivation, and stigma or discrimination shape health, while also examining emerging approaches for health systems and communities to address those intersectional challenges.

Our journey has both informed our scientific approach to understanding health and taught us important lessons about the limits of that approach for understanding health equity. There are many types of knowledge and expertise, and many types of evidence that should inform systems change. When we have worked in partnership with community members—especially those with lived experiences in the systems we are studying—we have ended up asking better questions, deploying richer methodologies, and developing better evidence and recommendations as a result.

Our work with communities impacted by health inequities has also taught us that evidence and ideas mean little if they aren’t accessible and useful for those who could benefit from them. That’s why, as our research practice has grown, we’ve also expanded our ability to help communities and stakeholders communicate and translate that research into lasting, positive change. Today, we help our partners bridge that gap between research and practice to both inform and inspire their work.

As CORE’s vision has evolved, so has our team. What started as a small local research shop is now a multidisciplinary team of researchers, scientists, and data experts working with a wide range of cross-sector partners to take on today’s biggest barriers to better health. Through this work, we build evidence that creates a meaningful impact on health and health equity and deliver insights that help shape and sustain healthier systems, policies, programs, and communities.

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