|Title||Coordinated Care Organizations and mortality among low-income infants in Oregon.|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||Bui, LN, Yoon, J, Harvey, SM, Luck, J|
|Journal||Health Serv Res|
|Keywords||Accountable 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 Journal||Health Serv Res|
|PubMed Central ID||PMC6863224|
|Grant List||U01 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