The Oregon Health Authority announced it approved a five-year contract allowing AllCare Health to continue managing Oregon Health Plan benefits.
OHA had previously approved a one-year contract for AllCare Health and three other organizations it said hadn’t submitted enough evidence in their applications to win five-year contracts. Other organizations across the state received either five-year contracts or didn’t get contracts.
The state is launching higher standards beginning in 2020 for coordinated care organizations, which manage the mental, physical and dental care for the 1 in 4 Oregonians on the Oregon Health Plan.
“AllCare Health is excited to continue providing local, supportive care to the people of Southern Oregon,” said Dr. Thomas Eagan, AllCare CCO board chair. “AllCare’s board of governors and staff are dedicated to the next five years and beyond, as Oregon continues to lead the nation in health care delivery innovation through comprehensive, holistic care.”
Headquartered in Grants Pass, AllCare Health has 50,000 members in Josephine, Jackson, Curry and Douglas counties.
Jackson Care Connect, another CCO serving Jackson County, already has received a five-year contract to continue managing OHP benefits.
Organizations that received one-year contracts had to submit more information to show they could meet the higher goals of what has been dubbed CCO 2.0. Goals include improving mental health care, addressing nonmedical issues like housing that impact people’s health and controlling costs.
Like AllCare, the CCOs Cascade Health Alliance and Umpqua Health Alliance submitted additional information and have now been awarded five-year contracts. Yamhill Community Health, the remaining CCO with a one-year contract, is making progress on a remediation plan, state officials said.
“I appreciate the steps AllCare, Cascade Health Alliance and Umpqua Health Alliance have taken to show they are ready to meet the higher bar we’ve set in CCO 2.0,” OHA Director Patrick Allen said. “We recognize that CCOs play a vital (role) in their communities. We look forward to partnering with these three CCOs over the next five years to improve the lives of OHP members and make health care more affordable in the communities these CCOs serve.”
Although AllCare now has a five-year contract, more than 10,000 Jackson County residents will still see changes to their OHP plan. AllCare has about 25,000 clients in Jackson County.
The state is moving at least 10,000 Jackson County OHP members from AllCare to Jackson Care Connect.
AllCare wasn’t able to secure a contract for primary care with a Medford-based network representing more than 500 local doctors.
The doctors’ network said it wanted to streamline and use only one CCO. Doctors said they chose Jackson Care Connect because of a strong working relationship with that CCO. AllCare patients can still visit the doctors, but only on a referral basis.
In more turmoil for OHP, many Southern Oregon patients had to switch to a new CCO after the state didn’t award the CCO PrimaryHealth either a one-year or five-year contract. PrimaryHealth scored highly in providing patient care, but state officials worried the organization might not remain financially solvent.