Health Connect Corner: Understanding Coordinated Care Organizations

By Susan Salisbury

Every week I'll be sharing insider tips on health care programs, information about health care reform and how health insurance works in Oregon.

And as a Consumer Health Advocate for 211info's Oregon Health Connect program, my two colleagues and I have more than three decades worth of experience helping people find resources.

We are here to answer you questions Monday - Friday 8am to 6pm. Just dial 211 or email us: health.connect@211info.org.


We hear a lot these days about CCOs, or Coordinated Care Organizations, and we expect to receive an ever-increasing number of calls about them on the 211 lines. But what exactly are CCOs, and what do they mean for the people of Oregon?

The idea behind CCOs is a state plan for patient-centered care that better coordinates physical and mental -- and eventually dental -- care under one entity, with local resources working together to improve health care practice and the health of participants. The focus for each CCO is prevention and better coordinated management of chronic conditions while lowering costs, but actual OHP benefits will not change.

Beginning Oct. 1, 2012, many Open Card OHP clients have received notices informing them that they were being enrolled in a CCO effective Nov. 1. There are a few exemptions to this transfer: American Indians, Alaska Natives and OHP members who have dual eligibility in both Medicare and Medicaid have the option to continue to receive Open Card benefits if they so choose.

With few exceptions, all OHP members will receive care through a CCO. Exemptions may be requested through a member’s caseworker, but few will be approved. If a member’s provider is not part of the member’s CCO or if a needed service is not provided by the CCO, the provider may contact the CCO about contracting with them. Letters have been sent to OHP members in advance of CCOs being established in local communities. 

You can learn even more on the Oregon Health Authority's website.