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Medicaid, Health care reform -- Oregon, Managed care plans (Medical care), Integrated delivery of health care, Medicaid beneficiaries -- Services for -- Oregon


In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization. The change to coordinated care organizations also demonstrated reductions in avoidable emergency department visits and improvements in some measures of appropriateness of care, but also exhibited reductions in primary care visits, a potential area of concern. Oregon’s coordinated care organizations could provide lessons for controlling health care spending for other state Medicaid programs.


This is the author manuscript archived with permission. Published in final edited form as: Health Aff (Millwood). 2017 March 01; 36(3): 451–459. doi:10.1377/hlthaff.2016.1298.



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