The Oregon Health Authority will stick with one coordinated care organization to oversee Medicaid in Clatsop, Columbia and Tillamook counties.
The state intends to award a new five-year contract to Columbia Pacific Coordinated Care Organization, which has administered the Oregon Health Plan in the three counties since 2012. Greater Oregon Behavioral Health Inc. had partnered with Moda Inc. to compete for the contract, but the state opted for one organization for the region.
Coordinated care organizations function like regional health care managers, working with providers to improve prevention, manage chronic illness and contain costs in Medicaid, the health insurance program for the poor and disabled.
There are more than 24,000 patients on the Oregon Health Plan in the three counties.
“We have a strong network of providers who partner with us for clinical innovation and integration and we work closely with members and community leaders to develop and implement our five-year regional health improvement plan,” Columbia Pacific CEO Mimi Haley said in a statement. “These partnerships are critical in propelling us ever forward to realize health transformation and investments in our rural communities.”
Columbia Pacific is a subsidiary of CareOregon, the state’s largest provider of Medicaid benefits. The new contract will take effect in January.
GOBHI and Moda had wanted to extend a successful partnership in Eastern Oregon to the North Coast. Moda also lost a bid to expand into Lane County.
“We’re disappointed,” said Kevin Campbell, the CEO of GOBHI. “We hoped for a different outcome and we’re evaluating just what this means.”
The state described the second phase of the coordinated care experiment as “CCO 2.0,” with greater expectations the reforms will lead to better health care outcomes and control spending. The new contracts cover nearly 1 million patients in the Oregon Health Plan and are worth more than $6 billion a year.
The state allowed competing coordinated care organizations to share oversight in some parts of Oregon, but not on the North Coast.
Evaluation results for the two bids showed a contrast between Columbia Pacific and GOBHI and Moda.
Columbia Pacific received passing grades in all six categories: finance; business administration; care coordination and integration; clinical and service delivery; delivery system transformation; and community engagement.
GOBHI and Moda only received passing grades in finance and community engagement.
“We made a determination based on that,” said Dave Baden, the chief financial officer for the Oregon Health Authority. “It made sense to award to Columbia Pacific based on the results of the evaluation.”
Clatsop County commissioners and some health care and mental health providers had urged the state to choose one coordinated care organization for the region, warning of the potential for bureaucratic complexity in navigating competing interests.
“We just look forward to continuing to have positive relationships with them, and hope that whatever driver there was for other entities to provide support to a separate CCO option, that we can work collaboratively to make it a more positive experience,” said Monica Steele, the interim county manager.
The competition led to some realignment locally in advance of the state’s announcement.
GOBHI had been a partner with Columbia Pacific before the decision to work on a competing bid with Moda.
Columbia Pacific chose to have CareOregon — not GOBHI — administer financing for Clatsop Behavioral Healthcare, the county’s mental health and addiction treatment contractor. GOBHI put the crisis respite center building in Warrenton up for sale and withdrew from the board that governs the facility.
“While GOBHI has been a great partner, we are relieved to have only one CCO in our region,” Amy Baker, the executive director of Clatsop Behavioral Healthcare, said in an email. “Aligning our practices to the expectations of a single CCO allows us to continue to make client care the priority rather than diverting precious resources into administrative functions.
“We believe a single CCO was the best possible outcome. We are looking forward to furthering our partnership with (Columbia Pacific) and continuing to build on improved outcomes for our clients.”