Oregon

Medicaid program name: Oregon Health Plan (OHP)

Medicaid ACO program name: Coordinated Care Organizations (CCOs)

Status: Active

Summary:

Oregon began its statewide Coordinated Care Organization (CCO) program for all Medicaid beneficiaries in 2012 using an 1115 waiver that included substantial initial Federal funding. The CCO program is patterned on Medicare ACOs and is a state-wide reform program that includes a Medicaid global budget with an annual growth cap and a quality pool bonus program. The global budget places CCOs at risk for health care costs. The Oregon Health Authority (OHA) currently has contracts with 15 CCOs that serve OHP members across the state, coordinating physical, behavioral and oral health care. CCOs work at a local level to transform the health care delivery system and lower costs. In 2020, Oregon began four-year contracts focusing on four priority areas: improving the behavioral health system, increasing value, focusing on social determinants of health and health equity, and maintaining sustainable cost growth. These new contracts, referred to as “CCO 2.0” began in January 2020 and run through 2024. These contracts have realigned service areas based on counties, increased emphasis on dental and behavioral health integration, and provide more support for community partners of health plans.

More Information:

• CCO 2.0: The Future of Coordinated Care
• FAQs for CCO 2.0
• Refining Oregon’s Medicaid Transformation Strategy through CCO 2.O: A Q&A with the Oregon Health Authority (2019)
• Oregon’s Coordinated Care Model
• Oregon’s Medicaid Reform And Transition To Global Budgets Were Associated With Reductions In Expenditures (2017)
• Evaluation of Oregon’s 2012-2017 Medicaid Waiver (2017)