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CCO Update
Health care reform

“What are CCOs? What do they mean for my family’s health care?”

Phil Miller, MD
Philip Miller, MD with patient Howard Lee Smith
and his mother

Coordinated Care Organizations (CCOs) are in the news a lot lately. Under a new state law, beginning this summer, CareOregon members and others on the Oregon Health Plan (OHP) will be served by a new kind of health plan called a CCO.

The most important thing to know is that most CareOregon members won’t see many changes right away. With the new CCOs, they’ll keep the same doctors, specialists and clinics. Their benefits stay the same. And for now, they’ll still be served by CareOregon’s member and support services.

So what is different? In each community, one or more CCOs will serve as the umbrella for various provider groups, hospitals, health plans and agencies all working together to serve OHP members. (For example, in Washington, Clackamas and Multnomah counties, CareOregon is joined by the county health departments, Kaiser Permanente, Providence Health & Services, Legacy Health, Tuality Healthcare, Adventist Health, OHSU, Central City Concern, Oregon Nurses Association, Oregon Medical Association and others in a single CCO called the Tri-County Medicaid Collaborative.) By joining forces, we can better meet members' needs and work cooperatively across different organizations.

That means combining medical and mental health, as well as addiction services under a single CCO.  Members will still have access to their usual providers, hospitals and services, we’ll just all be working more closely together. For a good overview of what a CCO is, check out these websites: http://www.oahhs.org/public-docs/video/what-ccos-mean-to-oregon.html

CareOregon is working with other plans and providers, as well as our members, to help form CCOs in a number of counties. Each CCO will be unique to its community, and have its own local governance and advisory councils made up of members and providers based in the area.

Over time, the goal of the CCOs will be to provide members with greater support. For example, right now CareOregon and other plans aren’t allowed to pay for telephone or email doctor visits. Once the new CCOs are fully developed, that may be an option. So, instead of taking time off work in order to visit the doctor with a simple question, a member may be able to call instead. The CCOs will also work more closely with community and social agencies, so if a member has barriers to health, like homelessness, hunger or multiple health conditions, we’ll be better able to help.

Some communities are starting their CCOs as early as August 1. Other CCOs should be working later this year. So in the future there may be different names on the health plan ID card and member materials. But the health care coverage and the doctors members see should be the same. And the goal is for care — and health — to be better.