Transitioning Dental Care Organizations (DCOs)
Dental care organizations (DCOs) are prepaid managed care organizations that contract, on a capitated basis, with the Oregon Health Authority (OHA). Currently there are five contracted DCOs providing dental services for Oregon Health Plan open card members. There are approximately 60,000 individuals serviced through this arrangement. While the coordinated care organizations (CCOs) operate on a five-year procurement cycle, the DCOs have not gone through such a procurement process since 2008. The DCO contract has gone through an annual restatement process incorporating legislative and rule changes. These changes, often developed for CCOs, have implications for DCOs as a result of this contractual relationship.
With the implementation of CCO 2.0, significant changes were made resulting in new contractual requirements. The resulting administrative burden was overwhelming for DCOs, given their membership and budget is smaller than CCOs. Given this state, efforts were made to re-examine the current relationship between OHA and DCOs and find a solution that could best serve the needs of this population.
DCO members will move to CCOs, effective January 1, 2023
Through a collaborative effort between OHA and DCOs, the decision was made to assign these members to CCOs through the activation of the CCO-F plan type. The CCO-F plan type is for the provision of dental services only. As a CCO member, these individuals will be able to access non-emergent medical transportation (NEMT) and utilize care coordination resources. This change will be effective January 1, 2023. Most DCOs have existing contractual relationships with most CCOs, which may facilitate less member disruption. Over the next year, OHA will work with DCOs and CCOs to ensure the smooth transition of DCO members.