Coordinated Care Organizations (CCOs) are a new way for the Oregon Health Plan. They will be the umbrella organizations that govern and administer care for OHP members in their local communities.
CCOs are local health entities that will deliver health care and coverage for people eligible for the Oregon Health Plan (Medicaid), including those also covered by Medicare. CCOs must be accountable for health outcomes of the population they serve. They will have one budget that grows at a fixed rate for mental, physical and ultimately dental care. CCOs will bring forward new models of care that are patient-centered and team-focused. They will have flexibility within the budget to deliver defined outcomes. They will be governed by a partnership among health care providers, community members, and stakeholders in the health systems that have financial responsibility and risk.
Across the state, local stakeholders have already started pulling together to deliver care in a different way.
Today, services such as mental and physical health care are usually offered separately, in fragmented and uncoordinated ways, so that members have gaps in their care. Providers are paid for treating illness, not for preventing it. Members with chronic conditions don't get services that will keep them healthy and help them avoid unnecessary hospitalizations or emergency care.
The potential cost savings for Oregon are substantial -- more than $3 billion over the next five years -- and will ensure that our most vulnerable citizens maintain coverage, while freeing limited resources for other public priorities.