P oint-C ounterpoint M o r e o n O r e g o n 's C o o r d i n a t e d C a r e O r g a n iz a t io n s Harold A. Pollack University of Chicago

This Point-Counterpoint completes our discussion of Oregon’s coordi­ nated care organizations (CCOs), one of the nation’s most innovative and challenging models of Medicaid service provision. In the Point essay, Steven W. Howard and colleagues present fur­ ther information about how CCOs will actually work. Arguing that the CCOs resemble managed care by another name, Howard et al. point out the daunting challenges CCOs face, such as collaboration requirements and global budget constraints. In the Counterpoint, Anna Marie Chang and colleagues respond to the implementation challenges raised by the Point essay and provide further observations based on their own implementation research. They argue that though challenges remain in the search for alternative payment models for specialty care and in the integration of behavioral health care, CCOs have made clear progress in many areas and should be considered if not yet successful then at least viable as a health care innovation. Every state faces increasing pressure to improve the quality and econ­ omy of Medicaid services. The Affordable Care Act (ACA) heightens this pressure. The ACA’s Medicaid expansion dramatically increases the program’s market share. Other ACA provisions seek to support diverse coordinated care models. These delivery-reform aspects of the ACA attract less attention than the polarized disputes over expanded coverage. They are no less important. Once again, Oregon will serve as either a role model or a cautionary example in this difficult area. Journal o f Health Politics, Policy and Law, Vol. 40, No. 1, February 2015 DOI 10.1215/03616878-2854891 © 2015 by Duke University Press

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Harold A. Pollack is Helen Ross Professor o f Social Service Administration at the University of Chicago. He has been appointed to three expert committees o f the National Academies of Sciences and is president of the American Political Science Association's organized section on health care politics and policy. His research has been published in the American Journal o f Public Health, JAMA, Health Eco­ nomics, and other peer-reviewed publications. His journalism has appeared in the Washington Post, American Prospect, and other publications. In 2009 and 2010, he was a special correspondent fo r the Mew Republic's Treatment section, covering the health reform debate. He is the section editor fo r Point-Counterpoint.

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