• K John McConnell, Christina J Charlesworth, MeathThomas H ATHAThomas H. A. Meath is a research associate at the Center for Health Systems Effectiveness, Oregon Health & Science University., Rani M George, and Hyunjee Kim.
• K. John McConnell ( mcconnjo@ohsu.edu ) is a professor in the Department of Emergency Medicine and director of the Center for Health Systems Effectiveness, both at Oregon Health & Science University, in Portland.
• Health Aff (Millwood). 2018 Mar 1; 37 (3): 386-393.

AbstractIn 2012 Oregon transformed its Medicaid program, providing coverage through sixteen coordinated care organizations (CCOs). The state identified the elimination of health disparities as a priority for the CCOs, implementing a multipronged approach that included strategic planning, community health workers, and Regional Health Equity Coalitions. We used claims-based measures of utilization, access, and quality to assess baseline disparities and test for changes over time. Prior to the CCO intervention there were significant white-black and white-American Indian/Alaska Native disparities in utilization measures and white-black disparities in quality measures. The CCOs' transformation and implementation of health equity policies was associated with reductions in disparities in primary care visits and white-black differences in access to care, but no change in emergency department use, with higher visit rates persisting among black and American Indian/Alaska Native enrollees, compared to whites. States that encourage payers and systems to prioritize health equity could reduce racial and ethnic disparities for some measures in their Medicaid populations.

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