oregon health plan

Felisa Hagins says the state has failed to ensure that Oregon’s coordinated care organizations have the financial incentive next year to improve access to care for diverse populations.

A longtime member of the board that advises the state on health policy and reform questioned the state’s commitment to ensuring equitable health care to low-income Oregonians.

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Health experts support the direction of the state’s latest health care policies but say it remains unclear how the state will get there.

Oregon has adopted a set of goals to reform health care, make Medicaid spending more efficient and improve the health of the one in four Oregonians covered by the insurance.

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Oregon To Increase Medicaid Spending In 2019, Will Miss Spending Goals

Coordinated care organizations will receive an average of 4 percent more each month than in 2018, overshooting the 3.4 percent growth target.

The Oregon Health Authority will pay coordinated care organizations 4.2 percent more for Medicaid patients in 2019 than in 2018, missing its goal of keeping cost increases to 3.4 percent or less. 

By: 
Jessica Floum

Oregon's Uninsured Rate Stagnates

Many without insurance qualify for Medicaid and up to one-half of those with insurance are not fully covered because their deductibles or expenses are too high.

The percentage of Oregonians without health insurance has stagnated in the past two years, new data show.

By: 
Lynne Terry

Opinion: Challenges for the Next Phase of Integrated Medicaid Care in Oregon

The Oregon Health Plan launched an ambitious system a decade ago to integrate medical and dental care. It is now working on a reform of the system, which is plagued with problems.

Ten years ago, Oregon embarked on the very ambitious plan to integrate mental health, addictions, dental and physical health care into the Oregon Health Plan.

By: 
Bob Nikkel

Oregon State Hospital Wants Patients to Keep Medicaid Insurance

Currently, people lose their Oregon Health Plan coverage when they enter the state mental hospital and must wait to have their insurance reinstated upon discharge. A change in law could provide a boost to CCOs, since they can’t be billed for care received in the state hospital.

Oregon State Hospital officials have a new strategy for ensuring patients do not have to worry about their health insurance when they leave -- never cutting off their Medicaid coverage in the first place.

By: 
Chris Gray
Although FamilyCare stopped operating as a coordinated care organization on Jan. 31, it is still suing the Oregon Health Authority in state court over rate-setting for Medicaid. Now the Oregon Health Authority’s director has filed a federal lawsuit challenging the nonprofit.

The Oregon Health Authority has sued FamilyCare in federal court, out of apparent concern that the former coordinated care organization’s continuing dispute with the state could jeopardize 2018 Medicaid agreements with Oregon’s 15 surviving CCOs.

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As they jump through a difficult re-enrollment process, 147,000 Medicaid members have been caught outside coordinated care organizations with little access to care, which could cause the state and CCOs to lose $200 million per year in Medicaid funding, mostly from federal sources.

The Oregon Health Authority’s Medicaid renewal plan is marooning recipients for weeks or months in a separate system outside the state’s coordinated care organizations, limiting members access to care and keeping funds away from the local CCOs

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Waiver Delayed but not in Trouble

Saxton says CMS may offer additional financial support beyond the $1.25 billion request.

Oregon’s federal waiver to keep the Oregon Health Plan alive another five years remains on track, with continued discussions between the Centers for Medicare & Medicaid Services, but the waiver won’t be approved by December, despite efforts by the Oregon Health Authority.

By: 
Diane Lund-Muzikant

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