TitleOregon's experiment in health care delivery and payment reform: coordinated care organizations replacing managed care.
Publication TypeJournal Article
Year of Publication2015
AuthorsHoward, SW, Bernell, S, Yoon, J, Luck, J, Ranit, CM
JournalJ Health Polit Policy Law
Volume40
Issue1
Pagination245-55
Date Published02/2015
ISSN1527-1927
KeywordsCapitation Fee, Delivery of Health Care, Dental Health Services, Humans, Insurance, Health, Reimbursement, Managed Care Programs, Medicaid, Mental Health Services, Oregon, Patient Care Team, Patient-Centered Care, Primary Health Care, United States
Abstract

To control Medicaid costs, improve quality, and drive community engagement, the Oregon Health Authority introduced a new system of coordinated care organizations (CCOs). While CCOs resemble traditional Medicaid managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted payments rewarding outcomes and evidence-based practice; increased transparency; and greater community engagement. The CCO model faces several implementation challenges. If successful, it will provide improved health care delivery, better health outcomes, and overall savings.

DOI10.1215/03616878-2854919
Alternate JournalJ Health Polit Policy Law
PubMed ID25480844