OHP managed care information

This page provides information for and about the managed care plans that contract with the Division of Medical Assistance Programs (DMAP) to provide medical and dental care to over 75 percent of Oregon Health Plan (OHP) clients.

For more information about how managed care plans contribute to the success of the Oregon Health Plan, refer to the OHP Overview and OHP Annual Reports.

For information about the mental health organizations (MHOs) that contract with the Addictions and Mental Health Division (AMH) to provide mental health services, go to AMH’s Mental Health Organizations page. 

• Announcements 
• Contract information
• Contractors meetings
• Enrollment information
• Managed care contracts
• Quality improvement information
• Other helpful links

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Contact information

OHP clients have contact information for their managed care plans listed on their coverage letter. Public contact information is also available in the following documents. 

• Chemical Dependency Organization (CDO) 
• Dental Care Organizations (DCO) 
• Fully-Capitated Health Plans (FCHP) 
• Mental Health Organizations (MHO) – For more information, refer to the MHO page.
• Physician Care Organization (PCO) 

Contractors meetings

OHP contractors meetings are public meetings. Meeting dates and times are available on the OHP Public Meetings page. This page contains additional information about the contractors meetings.

Enrollment information

• OHP managed care plans by county – OHP clients use these “comparison charts” to determine what managed care plan to enroll in when they apply or reapply for OHP coverage. 
• For information about current and past enrollment rates for all contracted plans, refer to the OHP enrollment reports. 

Managed care contracts

For information about DMAP’s current contracts with participating CDO, DCOs, FCHPs, and PCO: 

• Go to the Oregon Procurement Information Network (ORPIN) Web site. 
• Click on “Browse contracts,” then do a keyword search for “organization” (check the “In Title” box). 

For information about AMH’s contracts with participating MHOs, go to the MHO page.

Quality improvement information

This section provides information on how DMAP oversees the care provided by the contracted plans according to protocols established by the federal Centers for Medicaid and Medicare Services (CMS). 

• External Quality Review Oversight (EQRO) requirements 
• Evaluations and comparative assessments of managed care plans 

Other helpful links

• Capitation rates and per-capita cost information – Information from DHS Actuarial Services about current and past rates paid to contracted plans and how the rates were determined. 
• DMAP policies, rules and guidelines 
• DMAP staff transmittals - Memos DMAP sends to DHS staff about client announcements, provider announcements, managed care plan service area changes, and more. 
• Health Services Integration – Information about DHS efforts to integrate physical health care, oral health care, mental health and addiction services. 
• MMIS-MCO Workgroup archive - Past meeting minutes and handouts, Q&A and other information related to implementation of the Medicaid Management Information System (MMIS). 
• Prioritized list information - Current list, recent changes and pending changes. You can eSubscribe to receive e-mail updates from the Health Services Commission whenever prioritized list information changes. 
• Weekly 7-11 carve-out list (Excel or PDF) – Mental health drugs are “carved out” of the managed care capitation rates. This means that DMAP pays for these drugs for all clients, including those in managed care. This list is subject to change without notice.

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