Gettysburg, Pa, June 10, 2019 (GLOBE NEWSWIRE) -- OPEN MINDS has released an updated suite of Medicaid market intelligence resources on the state of Oregon. The resources include analysis of the Oregon’s Medicaid system, Medicaid managed care vendor contracts, and additional state-specific information.
Oregon has fifteen health plans called Coordinated Care Organizations (CCOs). Over 90% of the Oregon Health Plan members are enrolled in health plans. Contracts for the fifteen health plans are available for download.
CCOs are managed care entities that are either local community-based organizations or statewide organizations that have community-based participation in governance. Individuals only have a choice of CCO if more than one CCO is available where they live.
Image from the Oregon Authority.
CCO service areas are currently defined by ZIP Code and/or county.
- Advanced Health
- AllCare
- Cascade Health Alliance
- Columbia Pacific Eastern Oregon
- Health Share of Oregon
- InterCommunity Health Network
- Jackson Care Connect
- PacificSource Community Solutions – Central Region
- PacificSource Community Solutions – Columbia Gorge Region
- PrimaryHealth
- Trillium Community Health Plan
- Umpqua Health Alliance – ADAPT
- Advanced Health – County Mental Health Programs
- Willamette Valley Community Health – Mid-Valley Behavioral Care Network
- Yamhill Community Care – Yamhill County
CCOs receive a “global budget” that represents the total cost of care for all services for which the CCOs are responsible and held accountable for managing, either through performance incentives and/or being at financial risk for paying for health care services.
- 5.75% of the CCO capitation rate is withheld and returned based on performance on a set of quality metrics.
A small group of individuals still receive managed care benefits through the pre-2012 managed care delivery system. 50,098 people receive managed care services outside of a CCO. These include PACE, Dental Care Organizations, Mental Health Organizations, and Primary Care Organizations.
Note: Oregon is currently in the process of re-procuring the CCOs. At least one current CCO—Willamette Valley Community Health—did not respond to the re-procurement and three new CCOs have submitted bids. The state plans to announce the winners in July 2019 and contracts will go-live in January 2020.
The Oregon Medicaid Managed Care Contracts are available now for all Elite OPEN MINDS Circle members. Individual contracts may be purchased in the OPEN MINDS shop for $1,500 each.
Additionally, the OPEN MINDS team has four in-depth profiles of the Oregon state health system:
- Oregon Health Care System Landscape: An OPEN MINDS State Profile, which provides information on each state’s largest health plans, Medicaid expansion policy, health insurance marketplace plans, demographics, population health insurance coverage by payer, and more.
- Oregon Medicaid System: An OPEN MINDS State Profile, which provides a detailed exploration of each state’s Medicaid financing system, including a review of the managed care financing systems, largest health plans by enrollment, key players in the state Medicaid department, and plans for future system changes and contract reprocurements.
- Oregon Behavioral Health System State Profile Report, which provides a comprehensive listing of behavioral health benefits in the state, care coordination programs related to behavioral health, and behavioral health subcontractors for health plans.
- Oregon Medicaid/Medicare Dual Eligible System: An OPEN MINDS State Profile, which provides an overview of each state’s dual eligible financing system, as well as the largest Medicare health plans serving dual eligibles and details on new initiatives involving the dual eligible population.
The Oregon suite of state profiles is now available now for the Elite OPEN MINDS Circle members. In addition, the OPEN MINDS team has a wealth of additional Oregon-specific resources. A monthly OPEN MINDS market intelligence update is available to all health and human services executives. To sign up, OPEN MINDS Circle members should set their email preferences under the My Account Settings.
All of these resources, and more, are available as part of an OPEN MINDS Circle Elite membership. Membership includes unlimited organizational access to all OPEN MINDS content and databases, plus executive education events, and other exclusive Elite member benefits. Learn more about becoming an Elite OPEN MINDS Circle member online at www.openminds.com/elite.
ABOUT OPEN MINDS
OPEN MINDS is an award-winning information source, executive education provider, and business solutions firm specializing in the domains of health and human services serving consumers with chronic conditions and complex support needs. For thirty years, we’ve been pioneers for change – helping organizations implement the transformational business practices they need to succeed in an evolving market with new reimbursement, competition, policies and regulations.
OPEN MINDS is powered by a national team of experienced executives and subject matter experts with specific expertise and experience in nine key market areas – mental health, addictions, chronic conditions, autism and intellectual/developmental disabilities, long-term care, children’s services, social services, juvenile justice, and corrections health care. Our mission is to improve the quality of care for consumers with complex support needs by improving the effectiveness of those serving them – provider organizations, payer and insurance organizations, government agencies, pharmaceutical organizations, and technology firms. Learn more at www.openminds.com