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Oregon's Coordinated Care Organization Experiment

Are Members' Experiences of Care Actually Changing?

Wright, Bill J.; Royal, Natalie; Broffman, Lauren; Li, Hsin-Fang; Dulacki, Kristen

The Journal for Healthcare Quality (JHQ): July/August 2019 - Volume 41 - Issue 4 - p e38–e46
doi: 10.1097/JHQ.0000000000000178
Original Article

ABSTRACT In 2012, Oregon embarked on an ambitious plan to redesign financing and care delivery for Medicaid. Oregon's Coordinated Care Organizations (CCOs) are the first statewide effort to use accountable care principles to pay for Medicaid benefits. We surveyed 8,864 Medicaid-eligible participants approximately 1 year before and 12 months after CCO implementation to assess the impact of CCOs on member-reported outcomes. We compared changes in outcomes over time between Medicaid CCO members, Medicaid fee-for-service (FFS) members, and those who were uninsured. After 1 year, Medicaid beneficiaries enrolled in CCOs reported better access to care, better quality care, and better connections to primary care than Medicaid FFS or uninsured persons. We did not find early evidence of improvements in preventive care and screenings or in ED utilization. Although these are early indicators, results suggest that Oregon's delivery system transformation is having a positive impact on patient experience outcomes.

For more information on this article, contact Bill J. Wright at

The authors declare no conflicts of interest.

© 2019 National Association for Healthcare Quality
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