title: Oregon's Medicaid Transformation: An Innovative Approach To Holding A Health System Accountable For Spending Growth.
abstract: In 2012, Oregon initiated a significant transformation of its Medicaid program, catalyzed in part through an innovative arrangement with the Centers for Medicare and Medicaid Services (CMS), which provided an upfront investment of $1.9 billion to the state. In exchange, Oregon agreed to reduce the rate of Medicaid spending by 2 percentage points without degrading quality. A failure to meet these targets triggers penalties on the order of hundreds of millions of dollars from CMS. We describe the novel arrangement with CMS and how the CCO structure compares to Accountable Care Organizations (ACOs) and managed care organizations (MCOs).
authors.affiliation: Center for Health Systems Effectiveness, Department of Emergency Medicine, Oregon Health & Science University.
authors.forename: K John
authors.initials: KJ
authors.lastname: McConnell
authors.affiliation: Department of Emergency Medicine, Oregon Health & Science University.
authors.forename: Anna Marie
authors.initials: AM
authors.lastname: Chang
authors.affiliation: Department of Family Medicine, Oregon Health & Science University.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cohen
authors.affiliation: Hatfield School of Government, Portland State University.
authors.forename: Neal
authors.initials: N
authors.lastname: Wallace
authors.affiliation: Department of Health Care Policy, Harvard University.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Chernew
authors.affiliation: Center for Health Systems Effectiveness, Oregon Health & Science University.
authors.forename: Glenn
authors.initials: G
authors.lastname: Kautz
authors.affiliation: Department of Public Health and Preventive Medicine, Oregon Health & Science University.
authors.forename: Dennis
authors.initials: D
authors.lastname: McCarty
authors.affiliation: Department of Psychiatry, Oregon Health & Science University.
authors.forename: Bentson
authors.initials: B
authors.lastname: McFarland
authors.affiliation: Providence Center for Outcomes Research and Education.
authors.forename: Bill
authors.initials: B
authors.lastname: Wright
authors.affiliation: Office of Health Policy and Research, Oregon Health Authority.
authors.forename: Jeanene
authors.initials: J
authors.lastname: Smith