TitleCoordinated Care Organizations and mortality among low-income infants in Oregon.
Publication TypeJournal Article
Year of Publication2019
AuthorsBui, LN, Yoon, J, Harvey, SM, Luck, J
JournalHealth Serv Res
Date Published12/2019
KeywordsAccountable Care Organizations, Adult, Cohort Studies, Female, Humans, Infant, Infant Mortality, Infant, Newborn, Infant, Premature, Insurance Coverage, Male, Managed Care Programs, Medicaid, Oregon, Poverty, United States

OBJECTIVE: To examine the impact of Oregon's Coordinated Care Organizations (CCOs), an accountable care model for Oregon Medicaid enrollees implemented in 2012, on neonatal and infant mortality.

DATA SOURCES: Oregon birth certificates linked with death certificates, and Medicaid/CCO enrollment files for years 2008-2016.

STUDY DESIGN: The sample consisted of the pre-CCO birth cohort of 135 753 infants (August 2008-July 2011) and the post-CCO birth cohort of 148 650 infants (August 2012-December 2015). We used a difference-in-differences probit model to estimate the difference in mortality between infants enrolled in Medicaid and infants who were not enrolled. We examined heterogeneous effects of CCOs for preterm and full-term infants and the impact of CCOs over the implementation timeline. All models were adjusted for maternal and infant characteristics and secular time trends.

PRINCIPAL FINDINGS: The CCO model was associated with a 56 percent reduction in infant mortality compared to the pre-CCO level (-0.20 percentage points [95% CI: -0.35; -0.05]), and also with a greater reduction in infant mortality among preterm infants compared to full-term infants. The impact on mortality grew in magnitude over the postimplementation timeline.

CONCLUSIONS: The CCO model contributed to a reduction in mortality within the first year of birth among infants enrolled in Medicaid.

Alternate JournalHealth Serv Res
PubMed ID31657003
PubMed Central IDPMC6863224
Grant ListU01 DP004783 / DP / NCCDPHP CDC HHS / United States
1U01DP004783-01 / / National Center for Chronic Disease Prevention and Health Promotion (NCCDPP) of the Centers for Disease Control and Prevention / International