Oregon is pursuing an innovative transformation of its statewide health care delivery system to provide care through locally accountable coordinated care organizations (CCOs). To help Oregon policymakers address critical program design consideration, Carolyn Ingram, CHCS senior vice president, presented Potential Risk-Sharing Between the State and CCOs to the Oregon Health Policy Board's Global Budget Methodology Workgroup on September 20, 2011. Her presentation, created by CHCS for the Robert Wood Johnson Foundation's State Health Reform Assistance Network, outlines a range of approaches for sharing risk between the state and Coordinated Care Organizations. It explores key considerations and trade-offs in each, as well as the cost savings that comprehensive care coordination can produce. Ms. Ingram also shared an overview that charts the progress of global budgeting and shared savings models currently underway in various states.