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