title: Physicians' early perspectives on Oregon's Coordinated Care Organizations.
abstract: BACKGROUND
  Through development of Coordinated Care Organizations (CCOs), Oregon's version of the Accountable Care Organization (ACO) for Medicaid beneficiaries, Oregon is redesigning the healthcare system delivering care to some of its most vulnerable citizens. While clinicians are central to healthcare transformation, little is known about the impact on their role. The aim of this study was to understand the current and perceived effect CCO-related changes have on Oregon physicians' professional and personal lives.
  
  
  METHODS
  This qualitative observational study involved semi-structured interviews, conducted between March and October, 2013, of twenty-two purposively selected physicians who varied in years of practice, gender, employment status, specialty, and geographic location from three different CCOs. A grounded theory approach was used to analyze data.
  
  
  RESULTS
  Physicians expressed uncertainty and ambiguity about the CCO model, reporting minor financial changes in the first year, but anticipating future reimbursement changes; new team-based care roles and responsibilities, accountability for quality incentive measures; and effects of CCO implementation on their personal lives. To meet CCO model changes and requirements, physicians requested collegial networking, team-based care training, and data system and information technology support for undergoing health system transformation.
  
  
  CONCLUSIONS
  Although perhaps not immediate, healthcare reform can have a real and perceived impact on physicians' professional and personal lives.
  
  
  CONCLUSIONS
  Attention to the impact of healthcare reform on physicians' personal and professional lives is important to ensure strategies are implemented to maintain a viable workforce, professional satisfaction, financial sustainability, and quality of care.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA; The Foundation for Medical Excellence, Portland, OR, USA. Electronic address: stockr@ohsu.edu.
authors.forename: Ronald
authors.initials: R
authors.lastname: Stock
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hall
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Anna Marie
authors.initials: AM
authors.lastname: Chang
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Cohen
mesh_terms: D060866:Accountable Care Organizations / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008484:Medicaid; D009922:Oregon; D018802:Patient-Centered Care / Q000458:organization & administration*; D010549:Personal Satisfaction; D010820:Physicians / Q000191:economics / Q000706:statistics & numerical data*; D036301:Qualitative Research; D014481:United States
keywords: Accountable Care Organization; Coordinated Care Organization; Healthcare reform; Physician well-being