The Politics of Creating the Coordinated Care Organizations

The creation of the Oregon's Coordinated Care Organizations (CCOs) required navigating two discrete sets of politics: the politics of the Oregon state legislature and the politics of Washington, DC. The first set of politics involved the passage of the legislation that established the CCOs; while the second involved gaining federal approval of the Medicaid Section 1115 waivers necessary to implement the care model. This chapter tells the story of the politics of Oregon's recent health reforms with reflections on the lessons learned from decades in public service. Those lessons include: the importance of leadership and building a good team, the need to create the imperative for change and the fact that all productive politics are personal.