Oregon's medicaid reform and transition to global budgets were associated with reductions in expenditures

K. John McConnell, Stephanie Renfro, Richard C. Lindrooth, Deborah J. Cohen, Neal T. Wallace, Michael E. Chernew

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


In 2012 Oregon initiated an ambitious delivery system reform, moving the majority of its Medicaid enrollees into sixteen coordinated care organizations, a type of Medicaid accountable care organization. Using claims data, we assessed measures of access, appropriateness of care, utilization, and expenditures for five service areas (evaluation and management, imaging, procedures, tests, and inpatient facility care), comparing Oregon to the neighboring state of Washington. Overall, the transformation into coordinated care organizations was associated with a 7 percent relative reduction in expenditures across the sum of these services, attributable primarily to reductions in inpatient utilization. The change to coordinated care organizations also demonstrated reductions in avoidable emergency department visits and improvements in some measures of appropriateness of care, but also exhibited reductions in primary care visits, a potential area of concern. Oregon's coordinated care organizations could provide lessons for controlling health care spending for other state Medicaid programs.

Original languageEnglish (US)
Pages (from-to)451-459
Number of pages9
JournalHealth Affairs
Issue number3
StatePublished - 2017

ASJC Scopus subject areas

  • Health Policy


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