The latest chapter of coordinated care organization (CCO) reform, CCO 2.0, is taking shape. After more than two years of policy work by the Oregon Health Policy Board (OHPB) and direction from the governor to restructure and improve Oregon’s CCOs, nineteen organizations submitted initial proposals to be considered for contracts to serve the Oregon Health Plan’s (OHP) nearly 1 million members. 

Where are We Now?

In early July, the Oregon Health Authority (OHA) announced its intent to award 15 organizations contracts to serve as CCOs. In selecting the contracts, OHA evaluated proposals on the following criteria:

  • Care coordination and integration;
  • Delivery system transformation;
  • Community engagement;
  • Clinical and service delivery;
  • Business administration; and
  • Finance

Eleven of the selected organizations are expected to receive five-year contracts: Columbia Pacific CCO, Eastern Oregon CCO, Healthshare, InterCommunity Health Network, Jackson Care Connect, Pacific Source Central Oregon, Pacific Source Columbia Gorge, Pacific Source Lane, Pacific Source Marion-Polk, Trillium Community Health Plan, and Advanced Health.

Four applicants are expected to receive one year contacts: AllCare, Cascade Health Alliance, Umpqua Health Alliance, and Yamhill County CCO. According to OHA, these entities “did not did not fully demonstrate the ability to meet the CCO 2.0 criteria. These applicants will be placed on remediation plans to show they can meet the higher expectations of CCO 2.0, with technical support from OHA. OHA will extend contracts beyond one year for CCOs that show they can meet the goals of CCO 2.0. If a CCO does not receive a contract beyond one year, OHA will work with the local community to cover that service area through another CCO.”

Major changes to CCOs from in the current system include:

  • Lane County: Pacific Source will now share Lane County with Trillium. Trillium currently serves as Lane County’s sole CCO entity. 
  • Metro Region: Healthshare will no longer be the sole CCO. Trillium was approved as a second CCO and Family Care, a former CCO in the region, no longer exists. 
  • Marion-Polk: the original CCO did not reapply. The sole selectee is a new Pacific Source entity.  

CCOs by County

**Areas where CCO options have changed and multiple CCOs will be accessible for OHP members to choose from are indicated with asterisks in the list below. CCOs whose services areas cover part of the county are noted in italics along with the covered zip codes.

County Coordinated Care Organization (CCO)
Baker Eastern Oregon Coordinated Care Organization, LLC
Benton InterCommunity Health Network Coordinated Care Organization
Clackamas **Health Share of Oregon; Trillium Community Health Plan, Inc.**
Clatsop Columbia Pacific CCO, LLC
Columbia Columbia Pacific CCO, LLC
Coos Advanced Health
Crook PacificSource Community Solutions – Central OR
Curry AllCare CCO, Inc.; Advanced Health
Deschutes PacificSource Community Solutions – Central OR
Douglas Umpqua Health Alliance, LLC, 97441, 97467 and 97473 excluded; AllCare CCO, Inc. (97410, 97442); Trillium Community Health Plan, Inc. (97424, 97436, 97441, 97467, 97473, 97493)
Gilliam Eastern Oregon Coordinated Care Organization, LLC
Grant Eastern Oregon Coordinated Care Organization, LLC
Harney Eastern Oregon Coordinated Care Organization, LLC
Hood River PacificSource Community Solutions – Columbia Gorge
Jackson **AllCare CCO, Inc.; Jackson Care Connect**
Jefferson PacificSource Community Solutions – Central OR
Jospehine AllCare CCO, Inc
Klamath Cascade Health Alliance, LLC (97601, 97602, 97603, 97604, 97621, 97622, 97623, 97624, 97625, 97626, 97627, 97632, 97633, 97634, 97639); PacificSource Community Solutions – Central OR (97731, 97733, 97737, 97739)
Lake Eastern Oregon Coordinated Care Organization, LLC
Lane **PacificSource Community Solutions – Lane; Trillium Community Health Plan, Inc**
Lincoln InterCommunity Health Network Coordinated Care Organization
Linn InterCommunity Health Network Coordinated Care Organization; Trillium Community Health Plan, Inc. (97446)
Malheur Eastern Oregon Coordinated Care Organization, LLC
Marion PacificSource Community Solutions – Marion Polk
Morrow Eastern Oregon Coordinated Care Organization, LLC
Multnomah **Health Share of Oregon; Trillium Community Health Plan Inc.**
Polk **PacificSource Community Solutions – Marion Polk, Yamhill County Care Organization (97101, 97304, 97347, 97371, 97378, 97396, 97396, 97347, 97396)**
Sherman Eastern Oregon Coordinated Care Organization, LLC
Tillamook Columbia Pacific CCO, LLC
Umatilla Eastern Oregon Coordinated Care Organization, LLC
Union Eastern Oregon Coordinated Care Organization, LLC
Wallowa Eastern Oregon Coordinated Care Organization, LLC
Wasco PacificSource Community Solutions – Columbia Gorge
Washington **Health Share of Oregon; Trillium Community Health Plan, Inc.; Yamhill County Care Organization (97119, 97123, 97123, 97132, 97132, 97140)**
Wheeler Eastern Oregon Coordinated Care Organization, LLC
Yamhill Yamhill County Care Organization

What’s Next?

Before completing the more than $6 billion procurement process, OHA will conduct a review to determine readiness for each of the potential 15 CCOs. Contracts for 2020 are expected to be signed by September 30.

Background

This extensive CCO 2.0 process began with a 2017 directive by the governor to the OHPB to provide recommendations that would continue to improve health outcomes, increase value, and manage costs as CCOs enter a second phase of five-year contracts. Governor Brown established four key priorities for CCO 2.0:

  • Focus on social determinants and equity;
  • Increase value and pay for performance;
  • Improve the behavioral health system; and
  • Maintain sustainable cost growth.

In response to the governor’s directive, the OHPB produced over 40 policy recommendations to be sought in CCO 2.0 revamp process. These recommendations informed OHA as to how to proceed with their contract award process and direct what services organizations would be required to offer.

AOC’s Involvement

As CCO 2.0 contracts are finalized in the coming months, Association of Oregon Counties (AOC) staff (Andy Smith) will continue to monitor important aspects of contract negotiations and the final period of contract execution. Commissioners who are interested in CCO related issues are encouraged to attend AOC’s Health and Human Services (HHS) Steering Committee meetings; the next HHS meeting will be on Monday, September 9th from 8:15 a.m. to 10:00 a.m. at the Local Government Center as part of AOC’s Legislative Day.

Contributed by: Megan Chuinard | Public Affairs Associate