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States face three fundamental challenges in administering their Medicaid programs. In developing its Coordinated Care Organization (CCO) model—including specifications for the governance of the risk-bearing entity, the granting in most cases of geographic exclusivity and the adoption of a collaborative, transparent model for performance improvement—Oregon has deepened the scope of earlier global waiver proposals seeking financial sustainability and improved population health. Although state health policies must be tailored to their particular political and environmental characteristics, Oregon CCO model offers five valuable lessons for states as they address these challenges. |
