Case Study of Health Care

Health Share of Oregon

A Community Oriented Approach to Accountable Care for Medicaid Beneficiaries

What is an accountable care organization (ACOs)?

The accountable care organizational model resulted in an effort that tried to focus on improving the quality of care available to patients while also focusing on cost restraints in the Medicaid system. An ACO is an organization that is accountable to Medicaid and the guidelines they have set which are relatively strict.

What makes Oregon unique in its approach to Coordinated Care Organization?

The policy makers in Oregon based the design of this program on the idea that consumers can play a critical role in improving their own health outcomes. The Oregon approach places consumers directly in an advisory role position with consumers serving as member of a community advisory council. This integrative perspective on healthcare design and community assessment has shown promise.

Why are states experimenting with different models of integrated care?

Models of integrated care represent the frontlines of improvement areas for the entire healthcare system in the United States. This approach takes a more comprehensive view of a patient's health outcomes and uses a variety of different perspectives.

Are ACOs a viable model to reduce the rate of growth in per-capita Medicaid spending? Why or why not?

I believe that the ACO is definitely a viable model that can reduce the growth in per-capita healthcare spending. One of the best features of the design of the program is its flexibility. For example, the funds from the Medicare accounts can be used to address non-medical needs that can actually have a huge impact on health outcomes. For example, the case mentions spending on homelessness which can have a huge impact on someone's health. Another example that is provided deals with buying a patient an air conditioner for their home which could directly result in preventing exacerbations of chronic conditions leading to hospitalization. This flexibility, coupled with the idea bringing the patient onboard the planning stages and on councils, can result in creative solutions to problems that can have a big impact on health outcomes.