Several years ago, Oregon redesigned the way Medicaid managed care is delivered. In 2012, then-Gov. John Kitzhaber received a new Section 1115 waiver from the federal government to create Coordinated Care Organizations (CCOs). The waiver required Oregon to control spending growth at rates lower than high-quality Medicaid managed care plans, improve quality of care, and engage local communities to better manage the health of members in the state. Moda Health, in partnership with Greater Oregon Behavioral Health, Inc., created the Eastern Oregon Coordinated Care Organization (EOCCO) out of this initiative.
The Eastern Oregon Coordinated Care Organization is one of 15 CCOs in the state. EOCCO covers 12 rural and frontier counties across over 50,000 square miles with a population of just 250,000. Of this population, 25% are on Medicaid and are served by EOCCO. Rather than maintaining siloed benefits, the Coordinated Care Organization provides services for medical, behavioral, and dental health.
One area of focus for EOCCO has been the social determinants of health, including nutrition, housing, and access – especially access to behavioral health care. Moda has led a VeggieRx program to help local stores stock fresh fruits and vegetables and provides vouchers to members to buy these healthy foods. EOCCO also has funded housing initiatives for low-income residents and helped fund a warming station to provide a sanctuary from cold winter nights. EOCCO worked closely with community health workers, certified by the state, who are vital in helping connect with communities and address social barriers to good health.
The opioid epidemic remains a significant challenge for Oregon, with insufficient pain centers, limited resources, and overwhelmed primary care providers. A group of clinicians, including pharmacists, dentists, primary care physicians, and psychiatrists, make up the Regional Opioid Prescribing Group, which helps inform recommendations on how EOCCO can address the opioid crisis. EOCCO has removed barriers to prescribing buprenorphine, suboxone, and Narcan to facilitate access to treatment.
By aligning incentives, the Eastern Oregon Coordinated Care Organization has created a successful, sustainable model for Medicaid care delivery in rural areas. In 2020, it will be launching the CCO 2.0 model, putting new emphasis on the social determinants of health and health equity, housing supports and services, and investments through the existing infrastructure, network of providers, and community connections.