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Learn how OHA sets reimbursement rates for the OHP managed care plans and OHP's estimated monthly health care costs for each biennium.
Capitation rate development reports
These annual reports explain how the capitation (or Per Member Per Month) rates to be paid to contracted OHP managed care plans are developed. Exhibits 3 through 5 in the reports include the specific rates. All reports are listed by effective date.
- Nov. 1, 2012 - For Coordinated Care Organizations only
- Jan. 1, 2011
- Jan. 1, 2010: Also see the addendum for Jan. 1, 2010 to Dec. 31, 2010 and the addendum for July 1, 2010 to Dec. 31, 2010.
- Oct. 1, 2009
- Jan. 1, 2009
- Sept. 1, 2008
- Jan. 1, 2008
- July 1, 2008: These rates reflect legislative action that repealed the benefit reductions enacted beginning Jan. 1, 2007 (e.g., dental, vision, and OTC drug reductions).
- Jan. 1, 2007
- Jan. 1, 2006
- Oct. 1, 2005
- Oct. 1, 2004
- Oct. 1, 2003
- Oct. 1, 2002
- Oct. 1, 2001
Expected per capita cost reports
These biennial reports estimate the per capita (or Per Member Per Month) cost of covering health care services for everyone on OHP. These reports help OHA determine each biennium's budget for the Oregon Health Plan. All reports are listed by budget period. Exhibit 13 includes the specific per capita cost estimates.