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Health Aff (Millwood). 2018 Mar;37(3):386-393. doi: 10.1377/hlthaff.2017.1282.

Oregon's Emphasis On Equity Shows Signs Of Early Success For Black And American Indian Medicaid Enrollees.

Author information

1
K. John McConnell ( mcconnjo@ohsu.edu ) is a professor in the Department of Emergency Medicine and director of the Center for Health Systems Effectiveness, both at Oregon Health & Science University, in Portland.
2
Christina J. Charlesworth is a research associate at the Center for Health Systems Effectiveness, Oregon Health & Science University.
3
Thomas H. A. Meath is a research associate at the Center for Health Systems Effectiveness, Oregon Health & Science University.
4
Rani M. George is a research project manager at the Center for Health Systems Effectiveness, Oregon Health & Science University.
5
Hyunjee Kim is a research assistant professor at the Center for Health Systems Effectiveness and in the Department of Emergency Medicine, Oregon Health & Science University.

Abstract

In 2012 Oregon transformed its Medicaid program, providing coverage through sixteen coordinated care organizations (CCOs). The state identified the elimination of health disparities as a priority for the CCOs, implementing a multipronged approach that included strategic planning, community health workers, and Regional Health Equity Coalitions. We used claims-based measures of utilization, access, and quality to assess baseline disparities and test for changes over time. Prior to the CCO intervention there were significant white-black and white-American Indian/Alaska Native disparities in utilization measures and white-black disparities in quality measures. The CCOs' transformation and implementation of health equity policies was associated with reductions in disparities in primary care visits and white-black differences in access to care, but no change in emergency department use, with higher visit rates persisting among black and American Indian/Alaska Native enrollees, compared to whites. States that encourage payers and systems to prioritize health equity could reduce racial and ethnic disparities for some measures in their Medicaid populations.

KEYWORDS:

Disparities; Health Reform; Medicaid; State/Local Issues

PMID:
29505371
PMCID:
PMC5899901
DOI:
10.1377/hlthaff.2017.1282
[Indexed for MEDLINE]
Free PMC Article

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