CCO Evaluation Project

Major Research Questions
How do CCO's vary in terms of governance, organization, finance, and operations?

What are the impacts of different types of CCOs on health, health behaviors, health care utilization, and costs over time?
Jeanene Smith, Ph.D., Office for Oregon Health Policy and Research
Jill Rissi, Ph.D., Portland State University
Matthew Carlson, Ph.D., Portland State University
Neal Wallace, Ph.D., Portland State University
John McConnell, Ph.D., Oregon Health and Science University
Project Timeline
Jan 2012 - Jan 2015
When can we expect to see results?
Results will be published in Spring of 2015

Additional Information

What is the CCO Evaluation Project?
Many experts agree that the ACO and CCO models have the capacity to lower costs and improve care. However, there is some concern that CCOs could increase concentration of power, that cost savings and health improvements might not show up, or that rewards for better care coordination and shared savings may not allow providers to profit the way they did under the fee-for-service model.

In order to know if CCOs will truly allow states to increase coverage without becoming overburdened by healthcare costs, states need to know what CCO implementation looks like, what effects CCOs have on patient health, and how the CCO model shifts costs and utilization patterns.

This multi-disciplinary, mixed-methods research study takes advantage of a natural experiment in Oregon. We’ll use qualitative document analysis to create the first-ever typology of CCOs, and we will use that typology to assess what CCOs in Oregon actually do, how they impact health care outcomes, and how each CCO’s outcomes are associated with its individual design.

Study design
This study builds off of the Oregon Health Study, which collected health care and health outcomes data from 70,000 low-income Oregonians.

We already have years of baseline health data for these individuals; we will compare their outcomes before assignment to a CCO to outcomes after assignment to a CCO, and we will evaluate how those outcomes change over time for patients in different CCOs.

The study will evaluate the following outcomes:

  • Health care access and quality
  • Patient engagement
  • Health behaviors
  • Health outcomes
  • Health care utilization patterns
  • Per-member costs
  • Per-user costs
The study will use patient surveys, document analysis, and claims data analysis to assess the outcomes above.

For more information about the CCO Evaluation Project, contact us.