An Oregon Health Authority report indicates Medicaid expansion in Oregon last year did not mean a spike in costs or emergency room use.  The state says Medicaid costs for inpatient hospital services have decreased about five-and-a-half percent since 2011, despite adding 380,000 enrollees.  CareOregon public policy director Martin Taylor says the development of Coordinated Care Organizations in the state to provide more preventive care has helped.  Oregon’s goal is to reduce Medicaid spending two percent per patient, per year.  The report says emergency room visits by Oregon Health Plan members are down 21 percent since 2011.