How does Oregon pay for better healthcare outcomes, and what happens when that system is put at risk?In this episode of the Salem Business Journal Podcast, host Jesse Pion sits down with Sheamus, CEO of Yamhill Community Care, to break down Oregon’s Coordinated Care Organizations (CCOs) and the Quality Incentive Program (QIP).They unpack how the program works, why it rewards outcomes instead of volume, how millions of dollars are reinvested back into local communities, and why proposed budget cuts could threaten access to care across Oregon. This conversation connects policy, data, and real-world impact, including how incentives can save lives.🎙️ Sponsored by Compass Visuals and Hotel Salem00:00 – Introduction & episode setup00:12 – Meet Sheamus, CEO of Yamhill Community Care01:06 – What is a Coordinated Care Organization (CCO)?01:53 – How global budgets shift risk from the state to local systems02:36 – What is the Quality Incentive Program (QIP)?03:05 – How incentive payments and performance withholds work03:38 – Real-world example: statewide payouts and challenge pools04:22 – YCCCO’s incentive earnings and reinvestment into the community04:49 – Why not just raise provider rates instead?05:24 – Paying for outcomes vs volume in healthcare06:01 – Community reinvestment: housing, childcare, and prevention06:46 – Continuous improvement and rising benchmarks07:19 – Incentives gone wrong: the Wells Fargo comparison08:39 – Limits of benchmarks and vaccine saturation09:02 – How incentives directly improve vaccination rates and save lives09:51 – Are Oregonians better off because of this program?10:26 – YCCCO’s 12-year perfect record explained11:03 – The “secret sauce”: community-led governance11:59 – Why smaller, local systems can outperform larger ones12:19 – The future of the Quality Incentive Program12:56 – Proposed budget cuts and what they mean for providers13:10 – Message to lawmakers: access, value-based care, and risk14:22 – Why cutting QIP undermines Medicaid reform14:49 – Legislative outlook and concerns15:09 – Final thoughts on why the program matters16:03 – Closing remarks & sponsor thanks