Oregon Medicaid enrollees are less likely to make unscheduled trips to the hospital following the implementation of the state’s accountable-care model, new research by Oregon State University shows.
The study suggests the Oregon system of coordinated care organizations, or CCOs, which have been serving Medicaid enrollees since 2012, can provide lessons to other states regarding the three-pronged pursuit of better health, better care and lower cost.
Health economist and health policy researcher Dr. Jangho Yoon of the Oregon State University College of Public Health and Human Sciences led the study.
Among all types of patients, privately and publicly insured as well as the uninsured, hospitalizations account for nearly one-third of U.S. health expenditures, so reducing them in ways that don’t compromise care is an important goal.
“Between 2003 and 2009, elective hospital admissions remained stable, but non-elective admissions grew from 25.3 million to 26.7 million,” Dr. Yoon says. “And hospitals’ emergency departments have become the primary gateway to inpatient care.”
Oregon’s 15 CCOs emphasize primary care, disease prevention and population health measurements, not just individual outcomes. They work with Medicaid patients under a lump sum payment system that rewards the CCOs for hitting certain quality standards, including efficient use of hospital emergency rooms.
Oregon is one of 13 states with an accountable-care system for Medicaid patients and is considered to have implemented the most progressive model of accountable care.Friday Letter Submission, Publish on October 18