OHA Announces 10% Medicaid Payment Increase, Affecting 1.4 Million Oregonians

A 10.2% increase in Medicaid insurer payments next year by the Oregon Health Authority (OHA) will help Coordinated Care Organizations (CCOs) operate within the margins of restrained budgets.

Facing federal policy shifts and rising healthcare costs, the OHA is working with partners across the state to protect access to quality care for Oregon Health Plan (OHP) members, while providing essential services to low-income earners in the state.

Tidings Data Snapshot
2026 CCO payment update in one glance
10.2%
Average increase in CCO payments per person for 2026
1.4M+
People covered statewide by the Oregon Health Plan
16
Coordinated care organizations managing OHP benefits
3
Cost levers OHA flagged for 2026: directed payments / quality pool / supplemental payments

Source: Oregon Health Authority news release: OHA works to protect quality health care across Oregon (Oct 17, 2025)
Dailytidings.com

 

More Than 1.4 Million Oregonians Are Covered by Oregon Health Plan

There are more than 1.4 million people in Oregon covered by the OHP, which is serviced by 16 CCOs statewide, providing physical, behavioral, and dental healthcare for members.

The biggest contributor to increased OHP costs has been the post-pandemic demand for behavioral healthcare, placing strain on CCO budgets.

 

Every Public Dollar Must Deliver Maximum Value

In a press statement, OHA Director Dr. Sejal Hathi says the OHA is making a concerted effort to ensure that ‘every public dollar continues to deliver maximum value to the people of Oregon.’

Dr. Hathi says the OHA is also working in partnership with CCOs to evaluate cost-saving measures to offset the higher CCO rates.

 

Lane County CCO Withdraws from Renewing Contract

Collaborative efforts with CCOs and partners have resulted in renewed contracts for 2026 in all but one of the 16 regions. (click here for more details)

PacificSource has informed the OHA that it would not renew its CCO contract for Lane County, affecting about 92,000 people.

ItemLane County details
Who is impactedAbout 96,000 OHP members currently enrolled with PacificSource in Lane County (Trillium already serves about 36,000 members).
Coverage change datePlanned shift to Trillium begins Feb 1, 2026, with OHA oversight on member notices and continuity of care.
Member notice timingOHA says members should get written notice at least 30 days before the move.
Transition of careMembers in active treatment can keep current providers for 60 days after the change (90 days for dual eligible members).
Network continuity goalOHA says the intent is continuity and minimal disruption, including monitoring access and capacity during the transition.

 

However, Trillium Community Health Plan, another CCO already serving 36,000 people in Lane County, has been given the go-ahead by OHA to broaden its coverage in the region.

In the meantime, OHA is negotiating with PacificSource to continue serving the region until the beginning of February 2026. Members can expect a notification from OHA and PacificSource in the coming weeks.

“OHA acknowledges that everyone in Oregon’s Medicaid system – from state government and CCOs to hospitals and health care providers – must respond in ways that sustain access to quality care.

The agency will continue working with partners across the state to develop durable solutions that protect coverage, sustain provider networks, and preserve OHP’s long-standing commitment to equitable, high-quality care,” says Dr. Hathi.

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