title: Oregon's experiment in health care delivery and payment reform: coordinated care organizations replacing managed care.
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.
authors.affiliation: Saint Louis University.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Howard
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Bernell
authors.forename: Jangho
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Oregon State University.
authors.forename: Jeff
authors.initials: J
authors.lastname: Luck
authors.affiliation: Columbia Pacific Coordinated Care Organization.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Ranit
mesh_terms: D002204:Capitation Fee; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D003752:Dental Health Services / Q000458:organization & administration; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*; D008605:Mental Health Services / Q000458:organization & administration; D009922:Oregon; D010348:Patient Care Team; D018802:Patient-Centered Care / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D014481:United States
keywords: Medicaid; Oregon; coordinated care organizations; managed care; state health reform