Oregon’s Coordinated Care Organizations and Their Effect on Prenatal Care Utilization Among Medicaid Enrollees

Lisa P. Oakley*, S. Marie Harvey, Jangho Yoon, Jeff Luck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Introduction Previous studies indicate that inadequate prenatal care is more common among women covered by Medicaid compared with private insurance. Increasing the proportion of pregnant women who receive early and adequate prenatal care is a Healthy People 2020 goal. We examined the impact of the implementation of Oregon’s accountable care organizations, Coordinated Care Organizations (CCOs), for Medicaid enrollees, on prenatal care utilization among Oregon women of reproductive age enrolled in Medicaid. Methods Using Medicaid eligibility data linked to unique birth records for 2011–2013, we used a pre-posttest treatment–control design that compared prenatal care utilization for women on Medicaid before and after CCO implementation to women never enrolled in Medicaid. Additional stratified analyses were conducted to explore differences in the effect of CCO implementation based on rurality, race, and ethnicity. Results After CCO implementation, mothers on Medicaid had a 13% increase in the odds of receiving first trimester care (OR 1.13, CI 1.04, 1.23). Non-Hispanic (OR 1.20, CI 1.09, 1.32), White (OR 1.20, CI 1.08, 1.33) and Asian (OR 2.03, CI 1.26, 3.27) women on Medicaid were more likely to receive initial prenatal care in the first trimester after CCO implementation and only Medicaid women in urban areas were more likely (OR 1.14, CI 1.05, 1.25) to initiate prenatal care in the first trimester. Conclusion Following Oregon’s implementation of an innovative Medicaid coordinated care model, we found that women on Medicaid experienced a significant increase in receiving timely prenatal care.

Original languageEnglish
Pages (from-to)1784-1789
Number of pages6
JournalMaternal and Child Health Journal
Issue number9
StatePublished - 1 Sep 2017
Externally publishedYes


  • Accountable care
  • Coordinated care
  • Health services
  • Medicaid
  • Prenatal care


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