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- Title
Coordinated Care Organizations and mortality among low-income infants in Oregon.
- Authors
Bui, Linh N.; Yoon, Jangho; Harvey, S. Marie; Luck, Jeff
- Abstract
<bold>Objective: </bold>To examine the impact of Oregon's Coordinated Care Organizations (CCOs), an accountable care model for Oregon Medicaid enrollees implemented in 2012, on neonatal and infant mortality.<bold>Data Sources: </bold>Oregon birth certificates linked with death certificates, and Medicaid/CCO enrollment files for years 2008-2016.<bold>Study Design: </bold>The sample consisted of the pre-CCO birth cohort of 135 753 infants (August 2008-July 2011) and the post-CCO birth cohort of 148 650 infants (August 2012-December 2015). We used a difference-in-differences probit model to estimate the difference in mortality between infants enrolled in Medicaid and infants who were not enrolled. We examined heterogeneous effects of CCOs for preterm and full-term infants and the impact of CCOs over the implementation timeline. All models were adjusted for maternal and infant characteristics and secular time trends.<bold>Principal Findings: </bold>The CCO model was associated with a 56 percent reduction in infant mortality compared to the pre-CCO level (-0.20 percentage points [95% CI: -0.35; -0.05]), and also with a greater reduction in infant mortality among preterm infants compared to full-term infants. The impact on mortality grew in magnitude over the postimplementation timeline.<bold>Conclusions: </bold>The CCO model contributed to a reduction in mortality within the first year of birth among infants enrolled in Medicaid.
- Subjects
OREGON; UNITED States; NEONATAL mortality; BIRTH certificates; INFANTS; INFANT mortality; PREMATURE infants; DEATH certificates; MORTALITY; INSURANCE statistics; MANAGED care plan statistics; MEDICAID statistics; LONGITUDINAL method; POVERTY; QUESTIONNAIRES; RESEARCH funding; ACCOUNTABLE care organizations
- Publication
Health Services Research, 2019, Vol 54, Issue 6, p1193
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13228