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Oregon Kicks Off Next Phase In Medicaid Reform

Oregon’s years-long effort to reform Medicaid took a big step Tuesday. The Oregon Health Authority awarded coordinated care contracts to 15 organizations.

They’re spread across the state and serve almost a million people on the Oregon Health Plan.

This new phase is known as CCO 2.0, and the state hopes it will reduce costs, improve access to mental health services, and reward providers for improving health — not just for treating people.

Oregon Health Authority Director Pat Allen, said the CCOs will also spend some health care money on problems outside the doctor’s office — like housing and hunger.

“The most cost effective health care system is one that you don’t have to use very often because you’re healthy to begin with," Allen said.

"And that’s really what we’re shooting for."

Of the coordinated care organizations, 11 were awarded five-year contracts. Four only got one-year contracts, and have to prove themselves over time.

PrimaryHealth in Josephine County was the only current CCO whose application to continue administering Medicaid was denied, due to concerns reported in the organization’s financial review. AllCare CCO has now been awarded a contract to serve Josephine County.

Three new applicants were also denied.

In October 2018, at the request of Gov. Kate Brown, the Oregon Health Policy Board approved a comprehensive set of policies aimed at improving the health of Oregon Health Plan members, addressing health disparities, controlling program costs, and continuing to transform health care delivery in the state. These priorities were affirmed during an extensive public meeting process involving 2,500 Oregonians across the state.

Jackson Care Connect is one of the CCOs to get a full five-year contract. CEO Jennifer Lind said she was pleased with Tuesday's announcement.

“As the sole nonprofit CCO serving southern Oregon, our application was backed by more than 40 letters of support from local partners and providers," Lind said. "We are looking forward to continue working with them and furthering our mission of improving the health, well-being and equity of our community."

There were some changes in how CCOs will be organized. For example, Trillium CCO in Lane County has been awarded a contract to operate in the Portland metro market. And Pacific Source, which operates in Bend and along the Columbia River Gorge, will now operate in Lane County too.

“We look forward to working together with CCOs and communities to build on the gains of the first six years of health transformation and address gaps and challenges that persist in the state’s health care system,” Allen said.

Copyright 2019 Oregon Public Broadcasting. To see more, visit Oregon Public Broadcasting.