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Why the Oregon CCO experiment could founder

Eric C Stecker1

  • 1Oregon Health and Science University.

Journal of Health Politics, Policy and Law
|May 21, 2014
PubMed

Insights

Oregon's Medicaid experiment uses global payments and coordinated care organizations (CCOs) to control health care spending. However, successful cost containment requires effective execution beyond just insightful design.

Area of Science:

  • Health Services Research
  • Health Economics
  • Public Health Policy

Background:

  • Oregon implemented a Medicaid waiver, representing a significant effort to control healthcare expenditures.
  • The initiative involves global payments with shared financial risk at both the state and coordinated care organization (CCO) levels.

Purpose of the Study:

  • To evaluate the design and execution challenges of Oregon's innovative Medicaid experiment aimed at cost containment.
  • To analyze the mandated integration of medical, behavioral, and dental healthcare services within the CCO model.

Main Methods:

  • The study examines Oregon's Medicaid waiver, focusing on the implementation of global payments and two-sided risk structures.
  • Analysis includes the mandated comprehensive coverage and the focus on CCO-level innovation and quality metrics.

Main Results:

  • The Oregon experiment represents a bold attempt to limit healthcare spending through a novel payment and delivery model.
  • The design incorporates coordinated care organizations (CCOs) with financial accountability for quality outcomes.

Conclusions:

  • While the design is innovative, the success of Oregon's Medicaid experiment in achieving cost containment hinges on effective execution.
  • Challenges in implementation may hinder the achievement of the envisioned cost containment goals within the projected timeframe.

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