Oregon’s Medicaid Coordinated Care Organizations

Seq ID: 401
DocID: OR20
Authors: McConnell, KJ
Year: 2016
State: OR
Website link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939819/pdf/nihms799531.pdf
Publicly Available: Yes
Billing and Reimbursement:
Certification:
Evidence Generation:
Policy: MCO contract language and reimbursement models
Sustainable Financing:
Workforce Development:

In 2012, the state of Oregon transformed its Medicaid program by establishing 16“coordinated care organizations,” or CCOs, to provide comprehensive care for its Medicaid population. Coordinated care organization scan be considered a type of accountable care organization (ACO): they are locally governed; are accountable for access, quality, and health spending; and emphasize primary care medical homes. However, CCOs differ from most Medicare and commercial ACOs in their acceptance of full financial risk in the form of a global budget. Coordinated care organizations are also required to integrate financing and delivery systems for a broad scope of services, including mental health, addiction, and dental services. Approximately 90% of the state’s 1.1 million Medicaid enrollees now receive care through CCOs that take a variety of forms that reflect the local context.





Download Document