Through the coordinated care model, Oregonians are experiencing improved, more integrated care. With a focus on primary care and prevention, health plans using the coordinated care model are able to better manage chronic conditions and keep people healthy and out of the emergency department.
Key elements of the coordinated care model include:
Coordinated Care in Oregon
The coordinated care model was first implemented in coordinated care organizations (CCOs). A coordinated care organization is a network of all types of health care providers (physical health care, addictions and mental health care and sometimes dental care providers) who have agreed to work together in their local communities to serve people who receive health care coverage under the Oregon Health Plan (Medicaid). CCOs are focused on prevention and helping people manage chronic conditions, like diabetes. This helps reduce unnecessary emergency room visits and gives people support to be healthy. Today, there are 16 CCOs operating in communities around Oregon.
The coordinated care model was also implemented by the Public Employees' Benefit Board for state employees. There are multiple plans available to employees across the state, all of which feature coordinated care to bring about better health and better care at lower costs.
How coordinated care organizations work
CCOs are local. They have one budget that grows at a fixed rate for mental, physical and ultimately dental care. CCOs are accountable for health outcomes of the population they serve. They are governed by a partnership among health care providers, community members, and stakeholders in the health systems that have financial responsibility and risk.
How coordinated care is different
Before CCOs, the system separated physical, behavioral and other types of care. That made things more difficult for patients and providers and more expensive for the state.
CCOs have the flexibility to support new models of care that are patient-centered and team-focused, and reduce health disparities. CCOs are able to better coordinate services and also focus on prevention, chronic illness management and person-centered care. They have flexibility within their budgets to provide services alongside today's OHP medical benefits with the goal of meeting the Triple Aim of better health, better care and lower costs for the population they serve.
Across Oregon, CCOs are working on a local level to transform the health care delivery system to bring better health, better care and lower costs to Oregonians. To provide status updates on the state's progress towards these goals, the Oregon Health Authority (OHA) publishes regular reports showing quality and access data, financial data, and progress toward reaching benchmarks. View the latest Health System Transformation Report.