Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon
In 2012, Oregon’s Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. E...
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| Veröffentlicht in: | Medical care research and review 2019-10, Vol.76 (5), p.627-642 |
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| creator | Harvey, S. Marie Oakley, Lisa P. Yoon, Jangho Luck, Jeff |
| description | In 2012, Oregon’s Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model. |
| doi_str_mv | 10.1177/1077558717741980 |
| format | Article |
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Marie ; Oakley, Lisa P. ; Yoon, Jangho ; Luck, Jeff</creator><creatorcontrib>Harvey, S. Marie ; Oakley, Lisa P. ; Yoon, Jangho ; Luck, Jeff</creatorcontrib><description>In 2012, Oregon’s Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model.</description><identifier>ISSN: 1077-5587</identifier><identifier>EISSN: 1552-6801</identifier><identifier>DOI: 10.1177/1077558717741980</identifier><identifier>PMID: 29161977</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Accountable Care Organizations - economics ; Accountable Care Organizations - statistics & numerical data ; Acute services ; Adult ; Apgar score ; Babies ; Birth weight ; Births ; Childbirth & labor ; Clinical outcomes ; Congenital anomalies ; Congenital defects ; Ethnicity ; Female ; Government programs ; Health care expenditures ; Health status ; Humans ; Infant ; Infant mortality ; Infant Mortality - trends ; Infant, Low Birth Weight - physiology ; Infant, Newborn ; Infants ; Low birth weight ; Maternal-Child Health Services ; Medicaid ; Medicaid - economics ; Medicaid - statistics & numerical data ; Minority & ethnic groups ; Neonates ; Newborn babies ; Oregon ; Organizations ; Rural areas ; United States ; Weight ; Young Adult</subject><ispartof>Medical care research and review, 2019-10, Vol.76 (5), p.627-642</ispartof><rights>The Author(s) 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-31212ad8946a8c66d3523076c5a69d188b15570df187985b1e818cf0e35e631e3</citedby><cites>FETCH-LOGICAL-c365t-31212ad8946a8c66d3523076c5a69d188b15570df187985b1e818cf0e35e631e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1077558717741980$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1077558717741980$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21800,27903,27904,30978,43600,43601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29161977$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harvey, S. Marie</creatorcontrib><creatorcontrib>Oakley, Lisa P.</creatorcontrib><creatorcontrib>Yoon, Jangho</creatorcontrib><creatorcontrib>Luck, Jeff</creatorcontrib><title>Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon</title><title>Medical care research and review</title><addtitle>Med Care Res Rev</addtitle><description>In 2012, Oregon’s Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model.</description><subject>Accountable Care Organizations - economics</subject><subject>Accountable Care Organizations - statistics & numerical data</subject><subject>Acute services</subject><subject>Adult</subject><subject>Apgar score</subject><subject>Babies</subject><subject>Birth weight</subject><subject>Births</subject><subject>Childbirth & labor</subject><subject>Clinical outcomes</subject><subject>Congenital anomalies</subject><subject>Congenital defects</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Government programs</subject><subject>Health care expenditures</subject><subject>Health status</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant mortality</subject><subject>Infant Mortality - trends</subject><subject>Infant, Low Birth Weight - physiology</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Low birth weight</subject><subject>Maternal-Child Health Services</subject><subject>Medicaid</subject><subject>Medicaid - economics</subject><subject>Medicaid - statistics & numerical data</subject><subject>Minority & ethnic groups</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Oregon</subject><subject>Organizations</subject><subject>Rural areas</subject><subject>United States</subject><subject>Weight</subject><subject>Young Adult</subject><issn>1077-5587</issn><issn>1552-6801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kM1LAzEQxYMoVqt3T7LgxctqJtl8eZPFaqHYi56XdJMtW7ZJTXYP-teb0qpQ8DQD7zdvHg-hK8B3AELcAxaCMSnSXoCS-AidAWMk5xLDcdqTnG_1ETqPcYUxLoikp2hEFHBQQpyhSel9MK3TvTVZqYPN5mGpXful-9a7-JC9Wp9E3WXamWzqGu36bD70tV_bmLUu4Xbp3QU6aXQX7eV-jtH75OmtfMln8-dp-TjLa8pZn1MgQLSRquBa1pwbygjFgtdMc2VAykWKL7BpQAol2QKsBFk32FJmOQVLx-h257sJ_mOwsa_Wbaxt12ln_RArUFwUnFChEnpzgK78EFxKVxGSbCGxJFF4R9XBxxhsU21Cu9bhswJcbTuuDjtOJ9d742Gxtub34KfUBOQ7IOql_fv6r-E30FWAug</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Harvey, S. 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Marie ; Oakley, Lisa P. ; Yoon, Jangho ; Luck, Jeff</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-31212ad8946a8c66d3523076c5a69d188b15570df187985b1e818cf0e35e631e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Accountable Care Organizations - economics</topic><topic>Accountable Care Organizations - statistics & numerical data</topic><topic>Acute services</topic><topic>Adult</topic><topic>Apgar score</topic><topic>Babies</topic><topic>Birth weight</topic><topic>Births</topic><topic>Childbirth & labor</topic><topic>Clinical outcomes</topic><topic>Congenital anomalies</topic><topic>Congenital defects</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Government programs</topic><topic>Health care expenditures</topic><topic>Health status</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant mortality</topic><topic>Infant Mortality - trends</topic><topic>Infant, Low Birth Weight - physiology</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Low birth weight</topic><topic>Maternal-Child Health Services</topic><topic>Medicaid</topic><topic>Medicaid - economics</topic><topic>Medicaid - statistics & numerical data</topic><topic>Minority & ethnic groups</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Oregon</topic><topic>Organizations</topic><topic>Rural areas</topic><topic>United States</topic><topic>Weight</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harvey, S. 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Marie</au><au>Oakley, Lisa P.</au><au>Yoon, Jangho</au><au>Luck, Jeff</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon</atitle><jtitle>Medical care research and review</jtitle><addtitle>Med Care Res Rev</addtitle><date>2019-10</date><risdate>2019</risdate><volume>76</volume><issue>5</issue><spage>627</spage><epage>642</epage><pages>627-642</pages><issn>1077-5587</issn><eissn>1552-6801</eissn><abstract>In 2012, Oregon’s Medicaid program implemented a comprehensive accountable care model delivered through coordinated care organizations (CCOs). Because CCOs are expected to improve utilization of services and health outcomes, neonatal and infant outcomes may be important indicators of their impact. Estimating difference-in-differences models, we compared prepost CCO changes in outcomes (e.g., low birth weight, abnormal conditions, 5-minute Apgar score, congenital anomalies, and infant mortality) between Medicaid and non-Medicaid births among 99,924 infants born in Oregon during 2011 and 2013. We further examined differences in the impact of CCOs by ethnicity and rurality. Following CCO implementation the likelihood of low birth weight and abnormal conditions decreased by 0.95% and 1.08%, a reduction of 13.4% and 10.4% compared with the pre-CCO level for Medicaid enrollees, respectively. These reductions could be predictive of lifelong health benefits for infants and lower costs for acute care and are, therefore, important markers of success for the CCO model.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>29161977</pmid><doi>10.1177/1077558717741980</doi><tpages>16</tpages></addata></record> |
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| subjects | Accountable Care Organizations - economics Accountable Care Organizations - statistics & numerical data Acute services Adult Apgar score Babies Birth weight Births Childbirth & labor Clinical outcomes Congenital anomalies Congenital defects Ethnicity Female Government programs Health care expenditures Health status Humans Infant Infant mortality Infant Mortality - trends Infant, Low Birth Weight - physiology Infant, Newborn Infants Low birth weight Maternal-Child Health Services Medicaid Medicaid - economics Medicaid - statistics & numerical data Minority & ethnic groups Neonates Newborn babies Oregon Organizations Rural areas United States Weight Young Adult |
| title | Coordinated Care Organizations: Neonatal and Infant Outcomes in Oregon |
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