This Point-Counterpoint completes our discussion of Oregon's coordinated 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 further 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...

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