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Healthc (Amst). 2014 Sep;2(3):163-167.

Oregon's Medicaid Transformation: An Innovative Approach To Holding A Health System Accountable For Spending Growth.

Author information

1
Center for Health Systems Effectiveness, Department of Emergency Medicine, Oregon Health & Science University.
2
Department of Emergency Medicine, Oregon Health & Science University.
3
Department of Family Medicine, Oregon Health & Science University.
4
Hatfield School of Government, Portland State University.
5
Department of Health Care Policy, Harvard University.
6
Center for Health Systems Effectiveness, Oregon Health & Science University.
7
Department of Public Health and Preventive Medicine, Oregon Health & Science University.
8
Department of Psychiatry, Oregon Health & Science University.
9
Providence Center for Outcomes Research and Education.
10
Office of Health Policy and Research, Oregon Health Authority.

Abstract

In 2012, Oregon initiated a significant transformation of its Medicaid program, catalyzed in part through an innovative arrangement with the Centers for Medicare and Medicaid Services (CMS), which provided an upfront investment of $1.9 billion to the state. In exchange, Oregon agreed to reduce the rate of Medicaid spending by 2 percentage points without degrading quality. A failure to meet these targets triggers penalties on the order of hundreds of millions of dollars from CMS. We describe the novel arrangement with CMS and how the CCO structure compares to Accountable Care Organizations (ACOs) and managed care organizations (MCOs).

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