Multnomah officials question state approval of Oregon Health Plan care organization owned by Fortune 500 company

TRIBUNE FILE PHOTO - Multnomah Chair Deborah Kafoury is raising concerns about the bid to provide health care to low-income Oregonians submitted by a subsidiary of a Missouri-based health care giant, Portland Tribune - News  Local officials were surprised and dismayed by last week's news that one of the largest for-profit companies in the country may win a potentially lucrative state contract to provide health care to low-income people in greater Portland.

The state last week granted Trillium Community Health, owned by the Missouri-based Centene Corp., preliminary approval for a contract to administer the Oregon Health Plan in Clackamas, Multnomah and Washington counties.

But the approval to be certified as a state-sanctioned "coordinated care organization," or CCO, is contingent upon showing Trillium has the support and interest of local providers and entities so it can provide care— and Multnomah officials say that on their part, at least, that support is not there. And they've shared their concerns with Gov. Kate Brown and the Oregon Health Authority.

"We're disappointed that the Oregon Health Authority plans to award contracts to both Health Share of Oregon and Trillium Community Health Plan," said Multnomah County Chair Deborah Kafoury in an emailed response to questions from the Portland Tribune. "We've shared our concerns with the Governor's Office and OHA. We believe a single CCO in our region will better support our collective goals of providing better care, improving our community's health and holding down costs."

Trillium and Centene did not immediately respond to a request for comment.

About 1 million Oregonians belong to the Oregon Health Plan, or one in four Oregonians. To qualify for its free care, individual members must earn no more than $1,396 per month, or $2,887 for a family of four.

On July 9, state health officials announced that 15 care organizations would be granted regional contracts around the state. In the tri-county area, Trillium will compete with Health Share of Oregon, an entity that has local county officials on its board.

County officials say their concern is about quality health care. though Trillium already has a state contract In Lane County.

Centene bought Trillium and its pre-existing state contract in 2015, sparking concerns since Oregon Health Plan reforms adopted in 2012 called for locally-run, locally based health care organizations.

Said Kafoury, "we're concerned that Trillium lacks the network adequate to provide primary care, behavioral health, and hospital care for the community members we serve. Trillium has a small overall network and a history in Lane County, but not in Multnomah, Clackamas and Washington Counties, and the evaluation report did not show any letters of support from any Metro hospitals."

Kafoury questioned the validity of Trillium's application to the state.

"We also have questions about community support for Trillium becoming a second CCO. Trillium listed 22 letters of support, including six from Multnomah, Clackamas and Washington Counties. That is concerning because Multnomah, Clackamas and Washington Counties did not submit letters of support. What we did send was a statement that we were not interested in entering into a Memorandum of Understanding with Trillium. We don't have one currently, and neither does Clackamas or Washington Counties.

"We would like OHA to address these concerns. The healthcare for thousands of our community members depends on them."

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