Ore. clears first coordinated care organizations

By The Associated Press Published: May 31, 2012 at 4:18 PM PDT
Ore. clears first coordinated care organizations
FILE - In this Feb. 23, 2012, file photo, Family nurse practitioner Terrance James examines Kamiyan Cooper, 1, as his mother Kesha Wilson looks on, at the Multnomah County's Mid County Health Center Thursday, in Portland, Ore. The Obama administration is buying into Oregon's ambitious health care initiative, announcing Thursday that it's tentatively agreed to chip in $1.9 billion over five years to help get the program off the ground. The federal government could save $1.5 trillion over the next 10 years if all 50 states adopted the plan according to Oregon Gov. John Kitzhaber. (AP Photo/Rick Bowmer, file)

SALEM, Ore. (AP) - The Oregon Health Authority has tentatively certified 11 groups as the state's first coordinated care organizations under an overhaul of the Oregon Health Plan.

Applications from three organizations were rejected because they didn't meet the legal criteria. Another was certified in four of the 12 counties it applied to serve. The rejected organizations can reapply.

Coordinated care organizations will be responsible for integrating health care for low-income patients on Medicaid, and the state hopes they can find new ways to improve health care and lower costs. The concept was the centerpiece of a health care overhaul sought by Gov. John Kitzhaber and approved by the Legislature.

Health Authority officials said the eleven organizations that were "provisionally certified" must submit more information and negotiate a contract before they will be formally approved. The state also must evaluate them to decide whether they're ready for the task.

The organizations represent the first wave of applicants and are on track to begin operating, collectively, in all or part of 26 counties on Aug. 1. More organizations are expected to apply later this year to launch in September, October or November.

Two organizations are on track for approval to operate in the Portland area, where most of Oregon's Medicaid patients live.

The Tri-County Medicaid Collaborative is a joint venture by several of the health care companies operating in Portland, including the major hospitals, the three counties that comprise the metro area and some of the existing Medicaid providers. FamilyCare, an existing Medicaid plan, broke from the collaborative and also was given provisional approval.

Only one organization was approved to cover Klamath County, where two organizations submitted proposals and a bitter feud played out publicly among politicians and civic leaders.

The state gave provisional approval only to an application led by Cascade Comprehensive Care, a company owned by local doctors and the hospital that manages the existing Medicaid contract for most of Klamath County. Greater Oregon Behavioral Health, which is based in The Dalles and has sought to cover Medicaid patients across much of Eastern Oregon, was rejected.

The organization can reapply, and there's no limitation on the number of coordinated care organizations that can be approved for a particular area.

To be certified by the state, potential coordinated care organizations must be able to prove they meet specific qualifications. The criteria include the composition of the governing board, the level of community engagement and their ability to successfully integrate mental, medical and dental care.

Copyright 2012 The Associated Press.