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Flexible Services

In January 2026 the Oregon Health Authority changed the health-related services program name to flexible services. This change was based on feedback from coordinated care organizations (CCOs), community partners and Oregon Health Plan (OHP) members to alleviate confusion with OHP covered benefits for health-related social needs. For more information, please read the July 2025 memo to CCOs about the name change.

Overview

Flexible services give CCOs a way to address social determinants of health for CCO members and the broader community. For CCOs to use federal Medicaid funds to pay for flexible services, they must comply with state and federal criteria, including the OHA Flexible Services Brief, Oregon Administrative Rules (OARs 410-141-3500 and 410-141-3845), and the Code of Federal Regulations (45 CFR 158.150 and 45 CFR 158.151). The history of flexible services and how it has evolved is detailed in the OHA Flexible Services Brief.

Definition

Flexible services are non-covered services that complement covered benefits under Oregon's Medicaid State Plan to improve member and community health and well-being. There are two types of flexible services: 

  • Member-level flexible services, which are cost-effective services provided to a member to complement covered benefits, and
  • Community-level flexible services, which are interventions for the broader community-that focus on improving population health and health care quality. These initiatives include members but are not necessarily limited to members. They can also include investments in health information technology.

Flexible services spending

CCOs are required to report annual flexible services spending to OHA through their Exhibit L Financial Reports (template available on the CCO Contract Forms webpage). OHA reviews all annual CCO spending to ensure it meets flexible services criteria. The most recent spending summaries are available here, and prior year summaries can be requested by reaching out to Flexible.Services@oha.oregon.gov.

Office hours

General CCO questions
9:05–9:30 a.m. all sessions
2026: Jan. 2, April 3, July 10, Oct. 2

CCO memos 

Flexible services information for OHP members

If you are an Oregon Health Plan member and enrolled in a CCO, learn how to request flexible services (multiple languages available).

Flexible services guidance

General guidance

  • Flexible Services Brief (updated December 2025) – Defines flexible services, describes examples of flexible services used among CCOs, and explains how OHA incorporates flexible services into CCO payments.
  • Flexible Services FAQ (updated December 2025) – Answers frequently asked questions (FAQ) about flexible services. This FAQ will be updated as additional questions are addressed.
  • Examples of Approved Flexible Services Spending – English (updated December 2025) / Español (update coming soon)

Cross spending program guidance

Topic-specific resources

Reporting and evaluation

Flexible services learning opportunities

Webinars

Note: Prior to 2026 flexible services were called health-related services. 

​Hear examples from your CCO colleagues of effective changes to streamlining flexible services through pre-approved lists, contracting with community partners and bulk purchasing. Learn tangible steps and strategies to improve your HRS flex processes to support your members, partners and flex program staff.

  • Slides
  • Recording (4/30/25)
  • Audience: CCO HRS flex program staff and leadership​​​​

Coordinated care organizations (CCOs) share case studies about successfully streamlining and integrating HRS and SHARE spending programs. Examples presented include implementation strategies, best practices and overcoming challenges. CCOs will gain actionable insights to improve community partner experience and outcomes for members, with the goal of reducing the complexity of multiple funding streams. 

Audience: CCO leadership and program staff who implement HRS and SHARE programs in their communities. 

Slides / Recording (4/17/25)​

​This peer-sharing and learning session focused on improving HRS flexible (flex) services. Hear from your CCO colleagues with examples of effective changes to align HRS flex processes with health-related social needs (HRSN) covered services while centering health equity. Learn tangible steps and strategies to improve your HRS flex processes to support your members, partners and flex program staff.  

​Join us for an overview of a new braided funding concepts document. This document will provide example scenarios illustrating how CCOs can braid multiple funding streams, including health-related services (HRS), Supporting Health for All through REinvestment (SHARE) and in lieu of services (ILOS). Using a community-based approach, we'll show example scenarios of Oregon Health Plan members navigating their community context and services, and how a CCO can strategically address community-specific opportunities and leverage community strengths to support them. This webinar will be most beneficial for CCO staff overseeing Medicaid spending programs in their communities. 

​Cliff Coleman, MD, MPH, presents an overview of health literacy, discusses the role of health literacy in advancing health equity and provides CCOs with strategies to effectively communicate with Medicaid patients. Dr. Cliff Coleman is a practicing family medicine physician at Oregon Health & Science University and national expert in health literacy and doctor-patient communication. 

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Events

To request materials from prior events (2019–2024), reach out to Flexible.Services@oha.oregon.gov. 

CCO flexible services policy and procedure submissions


Contact

If you have questions, please email the OHA flexible services team at Flexible.Services@oha.oregon.gov. 

Note: The OHA staff who manage this email account do not have access to OHP member information and are not able to help request flexible services for members.