After expanding Medicaid, residents of Oregon are largely able to find a doctor and have dropped ER visits, despite a more than 50% increase in the number of people using the program, according to a new analysis by the state.
The report (PDF) is on the state's Coordinated Care Organization (CCO) program, which manages care for a majority of Medicaid beneficiaries. The program was established under a 2012 Medicaid waiver. There are 16 of the organizations throughout the state.
Each year, the state withholds a portion of total monthly payments given to CCOs and they only receive the withheld funds if they meet 17 different measures, such as access to care and visits to the emergency room use.
For 2015, CCOs received a combined total of $168 million in incentive payments, up from $128 million in 2014.
Key findings of the report include:
- 83.8% of Medicaid beneficiaries were able to receive appointments and care when they needed it, up slightly from 83% in 2014.
- 43.1 enrollees visited an emergency department per 1,000 member months compared with 47.3 in 2014.
- 8.6% of adult Medicaid beneficiaries were readmitted to a hospital within 30 days of discharge, down from 11.4%.
Lori Coyner, the state's Medicaid director says the financial incentive strategy that CCOs operate under is responsible for their success.
“Putting dollars at risk does lead to improved and better quality care,” Coyner said.
The waiver that established the CCOs is set to expire in June 2017. A renewal request is currently in the works and the state plans to submit it sometime this year.
More than 450,000 people have joined Medicaid since the state expanded eligibility for the program in 2014. Today, around 1.1 million Oregonians rely on the program, which is more than one-quarter of the state's population.