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Coordinated Care Organizations and mortality among low-income infants in Oregon.
- Source :
-
Health Services Research . Dec2019, Vol. 54 Issue 6, p1193-1202. 10p. 4 Charts. - Publication Year :
- 2019
-
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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00179124
- Volume :
- 54
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Health Services Research
- Publication Type :
- Academic Journal
- Accession number :
- 139743235
- Full Text :
- https://doi.org/10.1111/1475-6773.13228