When Trillium Community Health Plan in Lane County and other coordinated care organizations were launched in Oregon four years ago, the state put no limits on the profits they could reap.
But starting this year, Oregon will impose a limit on CCOs’ profits.
CCOs are the for-profit or nonprofit groups that manage taxpayer-funded health services for low-income and disabled people through the Oregon Health Plan, Oregon’s version of Medicaid.
CCOs will be required to spend on health-related services — such as doctor visits and patient care — at least 80 percent of the per-patient Medicaid money they receive, said Lori Coyner, Oregon Medicaid director. The balance — 20 percent — can be spent by the CCO on nonhealth items, such as staff wages, executive salaries, and dividends — or profits — paid to shareholders.
The federal Affordable Care Act imposed these spending ratios on commercial health insurance plans and Medicare, the taxpayer-funded health plan for seniors, but …
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