What is changing with Medicaid/OHP coverage in the Metro area?

Starting in January 2020, the Oregon Health Authority/Oregon Health Plan will add a second CCO to the Portland Metro area. Some CareOregon + Health Share members may be notified that OHP has reassigned them to Trillium, the other CCO, with the option to switch back if they choose.

Download a PDF of this information here.

What does this mean for your patients?

Starting October 16th, OHP members will receive a letter from OHA letting them know whether they’ve been assigned to Health Share of Oregon or Trillium. If they’ve been switched to a different CCO and would prefer to stay with CareOregon + Health Share, they will have from October 16 through November 17, 2019 to switch back. If they are unable to make the switch this fall, they’ll have another opportunity from January 1 through March 31, 2020.

Why should your patients stay with Health Share of Oregon?

  • Most importantly, choosing Health Share as their CCO will allow them to keep their current provider(s).
  • Health Share of Oregon is a locally-based non-profit committed to improving health access.
  • CareOregon, Health Share’s largest health plan, has been helping Oregonians get the health care they need for more than 25 years.

What is changing about Health Share of Oregon?

In January 2020, Health Share of Oregon is reorganizing to include these integrated delivery systems: Providence Health & Services, OHSU Health, Legacy Health/PacificSource, and Kaiser Permanente. CareOregon also remains a Health Plan with Health Share and will manage Behavioral Health Services for all Health Share members. CareOregon will also be managing the Dental Benefit for all Health Share members through existing networks and delegated Dental Plan partners.

If your patients have a preference for their primary care provider (PCP) or if they would like to change their PCP within the four Health Share partners, they will be able to do that during open enrollment from January 1 through March 31, 2020. We will be sending out more information about how members will be able to change their PCP in early October.

What are CareOregon and Health Share of Oregon doing with regard to CCO 2.0?

  1. Improving behavioral health
  2. Addressing social determinants of health and health equity
  3. Increasing value and pay for performance
  4. Maintaining sustainable cost growth.

To stay with CareOregon in 2020, your members will need to:

Select or keep Health Share of Oregon for their OHP coverage when they submit the enrollment form before November 17, 2019. For more information or to find local help visit ohp.oregon.gov or call 877-647-0027. They will need two things to fill out the form on the OHP website, or when they call to get help over the phone:

  1. Their (and each family member’s) Health Share ID number, which they can find on their Member ID card.
  2. The Letter ID from the “Pick Your Plan” letter sent to them by the Oregon Health Plan in October.

OHP Resources:

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