Broffman Lauren, Brown Kristin, Bayley Bruce K, Savitz Lucy, Rissi Jill
Lauren Broffman, associate research scientist, Providence Center for Outcomes Research and Education, Providence Health & Services, Portland, Oregon; Kristin Brown, administrator, Providence Center for Outcomes Research and Education, Providence Health & Services, Portland; K. Bruce Bayley, PhD, former director, Providence Center for Outcomes Research and Education, Providence Health & Services, Portland; Lucy Savitz, PhD, director of research and education, Intermountain Healthcare Institute for Health Care Delivery Research, Salt Lake City, Utah, and professor, Clinical Epidemiology, University of Utah School of Medicine, Salt Lake City; and Jill Rissi, PhD, associate professor, Division of Public Administration, Mark O. Hatfield School of Government, Portland State University, Oregon.
J Healthc Manag. 2016 Jul/Aug;61(4):291-302.
Oregon's coordinated care organizations (CCOs) are an integral part of a massive statewide reform that brings accountable care to Medicaid. CCOs are regional collaboratives among health plans, providers, county public health, and communitybased organizations that administer a single global budget covering physical, mental, and dental healthcare for low-income Oregonians. CCOs have been given freedom within the global budget to implement reforms that might capture efficiencies in cost and quality. For this study-fielded between 2012 and 2015-we traced the path of the global budget through the interior structures of two of Oregon's most promising CCOs. Using document review and in-depth qualitative interviews, we synthesized and summarized descriptive narrative data to produce case studies of the financial models in each CCO. We found that the CCOs feature substantially different market contexts, governance models, organizational structures, and financial systems.
俄勒冈州的协调护理组织（CCOs）是一项大规模全州范围改革的重要组成部分，该改革将可问责护理引入医疗补助计划。CCOs是健康计划、医疗服务提供者、县公共卫生部门和社区组织之间的区域合作组织，它们管理着一个单一的整体预算，涵盖俄勒冈州低收入人群的身体、心理和牙科医疗保健。CCOs在整体预算范围内被赋予了实施改革的自由，这些改革可能会在成本和质量方面提高效率。在2012年至2015年期间进行的这项研究中，我们追踪了整体预算在俄勒冈州两个最有前景的CCOs内部结构中的流向。通过文件审查和深入的定性访谈，我们综合并总结了描述性叙述数据，以生成每个CCO财务模型的案例研究。我们发现，这些CCOs具有截然不同的市场环境、治理模式、组织结构和财务系统。
