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OHP Rate Development


The Oregon Health Plan (OHP) is our state Medicaid program. It provides health coverage for low-income Oregonians that include working families, children, pregnant women, single adults, seniors and more. The Oregon Health Authority (OHA) has contracted with a variety of health entities, known as Coordinated Care Organizations or CCOs, to manage and deliver health care for most of these people eligible for Medicaid. OHA pays CCOs to cover these individuals with capitation rates. Capitation rates are a predetermined payment that depends on the individual's OHP eligibility status and is paid to CCOs on a monthly basis dependent on enrollment. 

These capitation rates are developed and certified by OHA's contracted actuaries on a yearly basis. The process and methodology used to develop capitation rates are governed by federal and state regulations. CMS requires Oregon's capitation rates be Actuarially Sound and follow applicable Actuarial Standards of Practice, which are developed by the Actuarial Standards Board

OHA releases 2024 CCO capitation rates 

October 17, 2023

Oregon Health Authority (OHA) has finalized the 2024 capitation rates for coordinated care organizations (CCOs). These rates are the per-member-per-month amounts the state pays CCOs to coordinate health care for Oregonians who are members of the Oregon Health Plan (OHP). Overall CCO rates met the legislatively approved budget for 2024 and CCOs continue to be financially stable. The rate increase represents a 3.4 percent rate of growth for 2024 compared to 2023.

“As we continue to process redeterminations across over 1.4 Oregonians, the CCO rates represent a sustainable source of funding to ensure quality is delivered to members on the Oregon Health Plan," said Interim OHA Director, Dave Baden. 

The average net payment in 2024 is $518, which is approximately 3.4 percent more than the comparable average per-member, per-month payment in 2023. These rates renew and continue the historic investment to increase behavioral health reimbursement rates that began January 2023 by Oregon Legislature’s. For more information on the increases to the behavioral health rates, please click here

There are 12 rate categories for CCOs, which take into account the average cost for members in these specific categories. For example, the state pays CCOs more for members who are disabled than it does for children because members who are disabled generally have higher health care costs. The rates are also based on average provider rate costs in each region.

2024 Aggregate CCO Rate Comparison

2019-2024 Capitation Rate Reports

2019-2023 Contract Rate Sheets

Dental Distribution Plan Summary

The SB 5561 bill appropriates $19 million General Fund to the Oregon Health Authority (OHA) for a one-time increase in payments to dental care providers to support costs associated with maintaining access and service levels for medical assistance program enrollees. OHA has distributed this funding, using a methodology recommended by dental care and coordinated care organizations. Below are the follow-up reports summarizing how the funds were spent to meet the intent of appropriation.


Please contact:
Actuarial Services

For more information

American Academy of Actuaries
CMS Medicaid Home
Coordinated Care Organizations
Forecasting Reports
Health Evidence Review Commission (HERC)
Oregon Health Plan