2015-11-11T18:03:15-06:00 2014-12-31 KPMG LLP 1918 Eighth Avenue Suite 2900 Seattle WA 98101 990 2014-01-01 930933975 CAREOREGON INC % Teresa Kennedy Learn CFO CARE 5034164100 315 SW 5TH AVE 9TH FLOOR PORTLAND OR 97204 TERESA K LEARN CFO 5034164100 2015-11-06 true Sue Robison P00560072 2069134000 2014 2016-02-25 16:41:14Z PATRICK J CURRAN 315 SW 5TH AVE 9TH FLOOR PORTLAND OR 97204 900438729 false X WWW.CAREOREGON.ORG X 1994 OR CAREOREGON IS A COMMUNITY BENEFIT ORGANIZATION WHOSE MISSION IS TO CULTIVATE INDIVIDUAL WELL-BEING AND COMMUNITY HEALTH THROUGH SHARED LEARNING AND INNOVATION 13 12 596 132 12597507 -4627775 1526389 1676151 558281700 840286926 4422837 4804077 124128 4697825 564355054 851464979 5307241 1782086 0 0 37632819 48055496 0 0 0 522031439 714210334 564971499 764047916 -616445 87417063 214783906 364099954 73726162 132374373 141057744 231725581 X CAREOREGON IS A COMMUNITY BENEFIT ORGANIZATION WHOSE MISSION IS TO CULTIVATE INDIVIDUAL WELL-BEING AND COMMUNITY HEALTH THROUGH SHARED LEARNING AND INNOVATION. true true 706968977 821378772 OHP PROGRAM - SEE SCHEDULE O FOR DESCRIPTION. 9238556 9583882 MEDICARE PLAN - SEE SCHEDULE O FOR DESCRIPTION. 1782086 1782086 CHARITABLE CONTRIBUTIONS- SEE SCHEDULE O FOR DESCRIPTION. 18592383 9324272 736582002 true true false true false false false false false false true true false false true true false true false false true false false false false false false true false true false false false false false false false false false false false false true true true true false false true 2112 0 true 596 true true true false false false false false false false false false X 13 12 true false true false false false false true true false false true true true true true true true true false OR X Teresa Kennedy Learn CFO 5034161415 315 SW 5th Avenue Suite 900 Portland OR 97204 John Barton McMullan Jr Board Chairman 4.0 1.0 X X 0 0 0 Vickie S Gates Board Vice Chairman 4.0 1.0 X X 0 0 0 Brendan John Barnicle Board Director 4.0 1.0 X 0 0 0 Colleen A Cain Board Director 4.0 1.0 X 0 0 0 Beth A deHamel Board Director 4.0 1.0 X 0 0 0 Joanne Fuller Board Director 4.0 1.0 X 0 0 0 Damien Richard Hall Board Director 4.0 1.0 X 0 0 0 Brenda Irene Johnson Board Director 4.0 1.0 X 0 0 0 Nathalie Johnson Board Director 4.0 1.0 X 0 0 0 Christopher J Krenk Board Director 4.0 1.0 X 0 0 0 Glenn S Rodriquez Board Director 4.0 1.0 X 0 0 0 Robert C Stewart Board Director 4.0 1.0 X 0 0 0 Patrick J Curran CEO, President, Board Director 40.0 6.4 X X 421799 0 34577 Katherine A Ellis COO, Board Secretary 40.0 6.4 X 227564 0 32398 Margaret S Rowland Chief Medical Officer 40.0 6.6 X 403175 0 36647 Teresa K Learn CFO, Board Treasurer 40.0 8.5 X 233416 0 32926 Scott W Clement Chief Network Officer 40.0 6.4 X 214479 0 37988 Rodney Meyer Director of Info Syems 40.0 6.5 X 161191 0 41774 Thomas DeVaney Dir Claims & Cust Services 40.0 5.6 X 151561 0 22535 Douglas R Luther Medical Dir. Behav. Health 40.0 6.6 X 258168 0 27624 Amit R Shah Med Dir Clinical Informatics 40.0 6.6 X 244234 0 26279 William J Kennedy Medical Director 40.0 6.6 X 233734 0 44847 Stefanie Cao Medicare Marketing Manager 0.5 39.5 X 179614 0 29383 Martin Taylor Director Public Policy 40.0 6.3 X 171362 0 19912 2900297 0 386890 67 false true false CDW Direct LLC PO Box 75723 Chicago IL 60675 Comp Equip, Maint. 1328435 EBS Master LLC PO Box 572490 Murray UT 84157 Claims Processing 800097 AterWynne LLP 1331 NW Lovejoy Suite 900 Portland OR 97209 Legal Services 296597 IDEO LLC 100 Forest Avenue Palo ALto CA 94301 Consulting Services 286532 HealthTrio LLC 400 S Colorado Blvd Suite 540 Denver CO 80246 Web Portal Hosting 280519 13 1676151 1676151 PREMIUM REVENUE 524114 821378772 821378772 MANAGEMENT FEE 541610 17476744 9634822 7841922 TRAINING REVENUE 611430 423853 129055 294798 TRANSFORMATION REVENUE 900099 245600 245600 ALL OTHER PROGRAM SERVICE REVENUE 900099 761957 744893 17064 840286926 4246791 4246791 0 0 594318 578312 16006 0 16006 11813 4193 48719415 208114 48026105 344138 693310 -136024 557286 -249909 807195 0 0 56915 25195 31720 31720 EMPLOYEE LEASE REVENUE 541610 4650099 4650099 4650099 851464979 832133142 12597507 5058179 1782086 1782086 0 0 0 0 0 0 1877935 1071463 806472 0 0 0 0 0 35669602 20410391 15259211 0 2838680 1658202 1180478 0 4487625 2907157 1580468 0 3181654 1863171 1318483 0 117862 13522 104340 0 316567 5315 311252 0 130429 0 130429 0 190547 0 190547 0 0 0 543428 320974 222454 0 4723675 3374451 1349224 38516 27490 11026 0 1047067 642540 404527 0 5506216 2644627 2861589 0 0 0 0 0 885546 610224 275322 0 410240 249700 160540 0 0 0 0 0 429786 111155 318631 0 0 0 0 0 0 0 0 0 3154744 2839650 315094 110824 9635 101189 0 PHYSICAL HEALTHCARE EXPENSE 604911635 604911635 PASS THROUGH REVENUE EXPENSE 45319556 45319556 MENTAL HEALTHCARE EXPENSE 30911794 30911794 DENTAL HEALTHCARE EXPENSE 21987944 21987944 -6526042 -7090680 564638 764047916 736582002 27465914 0 500 600 27368206 35772435 0 42879 18087588 31058396 0 0 0 0 1200000 0 11940 18565 2556478 2424917 41139667 21213216 20553441 19926451 96673754 199064054 47355434 74596348 0 0 0 0 976565 1195309 214783906 364099954 7807201 12551708 0 22500 23714 1428773 0 0 0 0 0 0 0 0 0 0 65895247 118371392 73726162 132374373 X 140458742 231475581 599002 250000 0 0 141057744 231725581 214783906 364099954 X 87417063 3252289 -1515 X false true X true true true X 0 50000 362543 1526389 1676151 3615083 464742418 568153396 584644518 558281700 832133142 3007955174 0 0 0 464742418 568203396 585007061 559808089 833809293 3011570257 0 0 0 3011570257 3681803 4069125 4221135 4037837 4841109 20851009 0 3681803 4069125 4221135 4037837 4841109 20851009 8676 5740 0 14416 0 468432897 572278261 589228196 563845926 838650402 3032435682 0.99315 0.99220 0.00685 0.00780 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 190546 190546 763857370 764047916 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 202052 136450 193465 190547 722514 250000 250000 250000 250000 1000000 1500000 52149 30001 82150 Lobbying Activities CareOregon participates in lobbying activities that include testifying at public policy hearings, meeting with legislators to discuss Oregon Health Plan related issues, hosting educational sessions and supporting or opposing ballot measures that impact Oregon Health Plan members. CareOregon does not participate or contribute to political candidate campaigns or political parties. false 2704520 2704520 19018602 6369339 12649263 286705 209506 77199 9312297 6971680 2340617 9817543 7662691 2154852 19926451 POOLED FUNDS 74596348 F 74596348 0 CLAIMS PAYABLE 59837904 MAP RECOUPMENT PAYABLE 27635389 HOSPITAL REIMBURSEMENT PAYABLE 308331 GRADUATE MEDICAL EDUCATION PAY 125504 SPECIAL NEEDS RATE GROUP RISK PAYABLE 5295000 PAY FOR PERFORMANCE INCENTIVE PAYABLE 25169264 118371392 X Part X, Line 2 The Internal Revenue Service has recognized CareOregon as exempt from federal income taxes under provisions of Section 501(c)(3) of the Internal Revenue Code. The wholly owned subsidiary, Health Plan, is a taxable nonprofit entity. Income taxes or benefits arise primarily from the tax effects of the Health Plan's transactions reported in the financial statements, and consists of taxes currently due or receivable plus deferred taxes. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to temporary timing differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis, measured by enacted tax rates for years in which the taxes are expected to be paid or recovered. Income taxes are accounted for using an asset and liability approach that requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of temporary differences between the financial statement and tax basis of assets and liabilities at the applicable enacted tax rates. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized. The factors used to assess the likelihood of realization include the Organization's forecast of future taxable income and available tax planning strategies that could be implemented to realize the net deferred tax assets. Failure to achieve forecasted taxable income in applicable tax jurisdictions would not affect the ultimate realization of deferred tax assets in 2015, due to sufficient taxes paid in 2013 available for net operating loss (NOL) carryback or carryforward, though it could result in an increase in the Organization's effective tax rate on future earnings beyond the available carryback periods. The wholly-owned subsidiaries, CareOregon Community Health, LLC; Care Access, LLC; Columbia Pacific CCO, LLC; Jackson County CCO, LLC; and Lean Healthcare West are single-member limited liability corporations, working to further CareOregon's exempt purpose. All of these LLCs are treated as disregarded entities for federal tax purposes and are reported with the parent's financial results on its Form 990. The Organization recognizes the tax benefit from uncertain tax positions only if it is more likely than not that the tax position will be sustained on examination by the tax authorities, based on the technical merits of the position. The tax benefit is measured based on the benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The Organization recognizes interest and penalties related to income tax matters in interest expense and other administrative expenses, respectively. Management regularly assesses the likelihood that deferred tax assets will be recovered from future taxable income, and records a valuation allowance, if necessary, to reduce deferred tax assets to the amounts believed to be realizable. Europe (Including Iceland and Greenland) 1 Program Services CONSULTING SERVICES 37400 North America 0 Program Services TRAVEL EXPENSES 1598 1 1 38998 38998 false false false false false false Part I Line 3 column F Explanation: Accrual true 211 Info 7535 NE Ambassador Pl Ste B Portland OR 97220 930784586 501(c)(3) 21500 Social Service Safety Net NW Grassroots & Communications 7555 SW Hermoso Way 200 Tigard OR 97223 200516607 20000 Integrating Kids Programs E-J Clatsop Community Action 2010 SE Chokeberry Ave Warrenton OR 97146 931010260 501(c)(3) 51500 Food Bank, Fresh Produce Distribution Central City Concern 232 NW Sixth Avenue Portland OR 97209 930728816 501(c)(3) 108400 Being Self Sufficent Project Clackamas Service Center 8800 SE 80th Ave Portland OR 97206 930626175 501(c)(3) 15000 Improve Nutrition & Health for Families Coalition of Community Health Clinics 619 SW 11th Ave Ste 225 Portland OR 97205 911829239 501(c)(3) 145575 Community Assistance Columbia Community Mental Health 58646 McNielty Way St Helens OR 97051 930644303 501(c)(3) 70000 Infant and Early Childhood Mental Health Compass House 332 W 6th St Medford OR 97501 931294230 501(c)(3) 10000 Adults with Chronic Mental Health Issues Community Action Team 125 N 17th St St Helens OR 97051 930554156 501(c)(3) 35000 Lend a Hand Low Income Senior Friends of the Children 44 NE Morris Street Portland OR 97212 931098105 501(c)(3) 42500 31 high needs kindergarten children Gladstone Center for Children & Families 17789 Webster Road Gladstone OR 97027 931284265 501(c)(3) 100279 Trauma Informed School Community Immigrant and Refugee Community Organization 10301 NE Glisan Street Portland OR 97220 930806295 501(c)(3) 30000 CHW Health Promotion Project Kairos Northwest 715 SW Ramsey Ave Grants Pass OR 97527 930686923 501(c)(3) 20000 Children's Mental Health Campus La Clinica Del Valle Family Health Care Inc 3617 S Pacific Hwy Medford OR 97501 943096772 501(c)(3) 74500 Expand Access to Dental Services Lifeworks NW 14600 NW Cornell Road Portland OR 97229 930502822 501(c)(3) 52650 Project Network Campaign Pledge '13 Meals on Wheels People Inc 7710 SW 31st Ave STE 210 Portland OR 97219 930584318 501(c)(3) 12000 Health Equity for Seniors National Brain Tumor Society Inc 124 Watertown St Ste 2D Watertown MA 02472 043068130 501(c)(3) 21180 Sponsor Portland Brain Tumor Walk Northwest Family Services 6200 SE King Rd Portland OR 97222 930841022 501(c)(3) 51250 Alcohol & Drug Prevention Pilot Oregon Center for Public Policy 204 N First St Suite C Silverton OR 97381 961186075 501(c)(3) 13000 Sponsor American Winter Screening In OR Towns Oregon Community Foundation 1221 SW Yamhill Ste 100 Portland OR 97205 237315673 501(c)(3) 40000 Virtual Dentistry Planning Oregon Latino Health Coalition 240 N Broadway Ste 215 Portland OR 97227 261530127 501(c)(3) 21000 Healthcare for all Children Initiative Project Access Now 1311 NW 21st Portland OR 97209 208928388 501(c)(3) 101500 Grant Support Rockwood Pathways Project Young Mens Christian Assoc of Medford OR 522 West Sixth Street Medford OR 97501 930391645 501(c)(3) 33000 Capital Request to Improve Comm Health Rogue Retreat 529 N Riverside Ave Medford OR 97501 931261999 501(c)(3) 30000 Restoring Hope and Health to the Homeless Schoolhouse Supplies 2735 NE 82nd Ave Portland OR 97202 204223437 501(c)(3) 51050 Expand the Impact of Free Store for Teachers Southwest Community Health Center 7754 SW Capital Hwy Portland OR 97219 743050497 501(c)(3) 20000 Culturally Competent Care Street Roots 211 NW Davis Portland OR 97209 931271399 501(c)(3) 6500 Street Roots Weekly Publication Upstream Public Health 240 N Broadway Portland OR 97227 421579435 501(c)(3) 31750 Early Childhood Dental Welless Project Virginia Garcia PO Box 568 Cornelius OR 97113 930717997 501(c)(3) 364000 Grant Support, Pathway to Wellness Wallace Medical Concern 124 NE 181st Ave Portland OR 97230 930853709 501(c)(3) 10000 Healthworks Base Camp Children Activity Vernonia Health Center Board 510 Bridge St Vernonia OR 97064 930710567 501(c)(3) 15000 Prog Director Develop Sustainable Business Model Northwest Medical Foundation Tillamook 1000 Third St Tillamook OR 97141 930622075 501(c)(3) 7500 Provide Tech Assist, Training, & Consult for System of Care Reedsport School District 105 2260 Longwood Dr Reedsport OR 97467 930565903 SCHOOL DISTRICT 10000 Program to retain struggling 9th Graders The Public Health Foundation of Columbia County PO Box 995 St Helens OR 97051 810622430 501(c)(3) 15000 Serving the Underserved in Vernonia Community Health Center 19 Myrtle St Medford OR 97504 237366812 501(c)(3) 6500 Event Sponsorship for Health Luncheon 34 1 PART I, LINE 2 GRANT MONITORING GRANTS AND OTHER ASSISTANCE ARE PROVIDED TO ORGANIZATIONS IN OUR SERVICE AREA WHO DEMONSTRATE A FINANCIAL NEED IN REGARD TO IMPROVING THE DELIVERY OF HEALTH SERVICES IN LINE WITH OUR EXEMPT PURPOSE AND MISSION. CAREOREGON CONSIDERS EACH CASE TO VERIFY THAT THE NEED IS DOCUMENTED, LEGITIMATE, AND SUBSTANTIAL IN NATURE. FOLLOWING DISBURSEMENT OF FUNDS, FOLLOW-UP CONTACT IS PERFORMED, EITHER VERBALLY OR IN WRITING, TO VERIFY THE APPROPRIATE USE OF THE FUNDS, TO THE EXTENT POSSIBLE. X true true X X X X false false false false false false false false false Patrick J Curran CEO, President, Board Director 322174 0 76625 0 23000 0 21999 0 12578 0 456376 0 0 0 Katherine A Ellis COO, Board Secretary 198147 0 6529 0 22888 0 20589 0 11809 0 259962 0 0 0 Margaret S Rowland Chief Medical Officer 352745 0 27430 0 23000 0 23400 0 13247 0 439822 0 0 0 Teresa K Learn CFO, Board Treasurer 189899 0 20517 0 23000 0 20120 0 12806 0 266342 0 0 0 Scott W Clement Chief Network Officer 187210 0 16350 0 10919 0 19663 0 18325 0 252467 0 0 0 Douglas R Luther Medical Dir. Behav. Health 232643 0 2525 0 23000 0 23204 0 4420 0 285792 0 0 0 Amit R Shah Med Dir Clinical Informatics 201718 0 25524 0 16992 0 21781 0 4498 0 270513 0 0 0 William J Kennedy Medical Director 196447 0 2287 0 35000 0 21534 0 23313 0 278581 0 0 0 Stefanie Cao Medicare Marketing Manager 161123 0 991 0 17500 0 15858 0 13525 0 208997 0 0 0 Martin Taylor Director Public Policy 141178 0 15368 0 14816 0 15439 0 4473 0 191274 0 0 0 Rodney Meyer Director of Info Syems 130376 0 13811 0 17004 0 15304 0 26470 0 202965 0 0 0 Thomas DeVaney Dir Claims & Cust Services 137821 0 13740 0 0 0 16517 0 6018 0 174096 0 0 0 PART I, LINE 1A HEALTH CLUB DUES CAREOREGON REIMBURSED HEALTH CLUB DUES FOR KATHERINE ELLIS, COO & BOARD SECRETARY, DOUGLAS LUTHER, MEDICAL DIRECTOR OF BEHAVIORAL HEALTH, AND WILLIAM KENNEDY, MEDICAL DIRECTOR IN THE AMOUNT OF $105, $350, AND $390, RESPECTIVELY. THIS REIMBURSEMENT WAS INCLUDED AS TAXABLE COMPENSATION TO THESE PARTIES. SUPPLEMENTAL INFORMATION TO 2014 FORM 990 FOR CAREOREGON, INC. PART I, LINE 1 TAX-EXEMPT PURPOSE AND MISSION OF CAREOREGON CAREOREGON IS A NON-PROFIT HEALTH SERVICES ORGANIZATION PROVIDING HEALTH PLAN SERVICES, EDUCATION AND COMMUNITY BUILDING SUPPORT TO PARTNER HEALTH PLANS AND THEIR MEMBERS. WE ARE COMMITTED TO CULTIVATING INDIVIDUAL WELL-BEING AND COMMUNITY HEALTH REGARDLESS OF INCOME OR SOCIAL CIRCUMSTANCES, WITH A FOCUS NOT JUST ON HEALTH CARE, BUT ON TOTAL HEALTH THROUGH SHARED LEARNING AND INNOVATION. TEAMING WITH HEALTH PLAN MEMBERS, THEIR FAMILIES AND COMMUNITIES, CAREOREGON HELPS INDIVIDUALS LIVE BETTER LIVES, PREVENT ILLNESSES AND RESPOND QUICKLY AND EFFECTIVELY TO HEALTH ISSUES. CAREOREGON PROVIDES CARE SUPPORT AND DISEASE MANAGEMENT SERVICES TO HIGH-RISK MEMBERS, COORDINATES CARE AND PROVIDES UTILIZATION MANAGEMENT SERVICES, OFFERS CONTINUITY OF COVERAGE FOR THOSE ELIGIBLE FOR MEDICAID, MEDICARE OR BOTH. WE SUPPORT AND ACTIVELY WORK WITH PROVIDERS AND MEDICAID COORDINATED CARE ORGANIZATIONS TO IMPLEMENT QUALITY IMPROVEMENT EFFORTS AND PRIMARY CARE REDESIGN. WE CONTRACT WITH PUBLIC AND PRIVATE PROVIDERS AND WORK WITH THE LEGISLATURE AND COMMUNITY-BASED ORGANIZATIONS TO IMPROVE THE HEALTH OF OREGONIANS. PART I, LINE 8-22 SUMMARY - REVENUE AND EXPENSES CAREOREGON EXPERIENCED AN APPROXIMATE $287 MILLION INCREASE IN TOTAL REVENUE AND AN APPROXIMATE $199 MILLION INCREASE IN EXPENSES IN 2014 COMPARED TO 2013. THE INCREASE IN REVENUE WAS PRIMARILY DUE TO THE SURGE IN MEDICAID MEMBERSHIP RELATED TO THE AFFORDABLE CARE ACT (ACA) EXPANSION EFFECTIVE JANUARY 2014. THE INCREASE IN EXPENSES WAS MAINLY RELATED TO THE INCREASE IN PURCHASED HEALTHCARE AND ADMINISTRATIVE EXPENSES TO SERVE THE ADDITIONAL MEMBERSHIP. PART III, LINE 2 NEW PROGRAM SERVICES IN 2014, CAREOREGON STARTED A "STARTING STRONG" PROGRAM WHICH IS OFFERING INCENTIVES TO PREGNANT WOMEN, NEW MOMS AND BABIES IN OUR JACKSON CARE CONNECT CCO (COORDINATED CARE ORGANIZATION) FOR TAKING HEALTHY ACTIONS. EXAMPLES OF HEALTHY ACTIONS ARE ATTENDING PRENATAL AND DENTAL APPOINTMENTS, BRINGING BABIES TO WELL-CHILD CHECK-UPS, ATTENDING CHILDBIRTH PREPARATION, PARENTING, NUTRITION AND DIABETES MANAGEMENT CLASSES. INCENTIVES INCLUDE HIGH CHAIRS, INFANT CAR SEATS AND BABY SUPPLIES. CLATSOP COUNTY IS ONE OF THE FIVE COMMUNITIES IN THE NATION THAT WAS SELECTED FOR A FIVE-YEAR HEALTH IMPROVEMENT CHALLENGE CALLED "WAY TO WELLSVILLE." LED BY OUR COLUMBIA PACIFIC CCO AND OTHER PARTNERS, THE PROGRAM'S PRIORITIES ARE FIGHTING OBESITY AND IMPROVING ACCESS TO HEALTHY FOODS, PRENATAL EDUCATION AND CARE, AND BETTER ACCESS TO MENTAL HEALTH, SUBSTANCE ABUSE AND CHEMICAL DEPENDENCY SERVICES. ALSO IN CLATSOP COUNTY, CAREOREGON PROVIDED A GRANT TO HELPING HANDS REENTRY CENTERS TO LAUNCH A PILOT PROJECT WITH PRIORITIES INCLUDING REDUCING CALLS TO 911 AND HELPING CONNECT INDIVIDUALS QUICKLY TO THE CARE THEY NEED. THE GRANT FUNDS SUPPORT CAREOREGON'S RURAL HEALTH EQUITY GOALS. MOREOVER, CAREOREGON INVESTED IN HOUSING WITH SERVICES LLC IN 2014. HOUSING WITH SERVICES LLC IS A COLLABORATION AMONG SERVERAL NON-PROFIT ORGANIZATIONS IN THE COMMUNITY AND A GOVERNMENT AGENCY, PROVIDING HEALTH AND SOCIAL SERVICES FOR SENIORS AND ADULTS WITH SPECIAL NEEDS WHO LIVE IN CERTAIN AFFORDABLE AND PUBLIC HOUSING DEVELOPMENTS. PART III, LINE 3 CEASED PROGRAMS CAREOREGON HAD FORMED A WHOLLY OWNED, SINGLE-MEMBER SUBSIDIARY, PRIMARYHEALTH OF JOSEPHINE COUNTY, LLC (PRIMARYHEALTH), IN MAY 2012. PRIMARYHEALTH SERVED OREGON HEATLH PLAN (OHP) MEMBERS IN JOSEPHINE COUNTY AND CONTRACTED WITH OREGON HEALTH MANAGEMENT SERVICES (OHMS) TO OPERATE THE PLAN. CAREOREGON'S MEMBERSHIP INTEREST IN PRIMARYHEALTH WAS SOLD TO OHMS IN JANUARY 2014. CAREOREGON HAD FORMED A WHOLLY OWNED, SINGLE-MEMBER SUBSIDIARY, CAREOREGON COMMUNITY HEALTH LLC (COMMUNITY HEALTH), IN APRIL 2010, TO PROVIDE INCREASED CLINIC ACCESS TO QUALITY HEALTHCARE FOR CAREOREGON MEMEBERS AND THOSE IN THE CLINIC COMMUNITIES. CAREOREGON CONTRIBUTED ASSETS TO FORM A NEW INDEPENDENT 501(C)(3) CORPORATE ENTITY, NEIGHBORHOOD HEALTH CENTER (NEIGHBORHOOD HEALTH), WHICH RUNS THE EXISTING CLINIC OPERATIONS AND ALSO OFFERS DENTAL SERVICES IN OREGON CITY. CAREOREGON PROVIDED SUPPORT AND ADMINISTRATIVE SERVICES UNDER AGREEMENTS WITH NEIGHBORHOOD HEALTH. REMAINING ADMINISTRATIVE FUNCTIONS WERE COMPLETED DURING 2014 AND COMMUNITY HEALTH WAS DISSOLVED IN DECEMBER 2014. SIGNIFICANT CHANGES THE AFFORDABLE CARE ACT (ACA) PROVIDES STATES WITH ADDITIONAL FEDERAL FUNDING TO EXPAND THEIR MEDICAID PROGRAMS AND COVER ADULTS UNDER AGE 65 WITH INCOME UP TO 133% OF THE FEDERAL POVERTY LEVEL. THE ACA EXPANSION INCREASED MEDICAID PHYSICAL MEMBERSHIP OF CAREOREGON AND THE CCOS CAREOREGON SUPPORTS BY APPROXIMATELY 45%. DENTAL MEMBERSHIP INCREASED BY APPROXIMATELY 40%. OHA BEGAN TO TRANSFER THE ADMINISTARTION OF NON-EMERGENT MEDICAL TRANSPORTATION (NEMT) TO THE CCOS IN 2014. JACKSON CARE CONNECT BEGAN OFFERING NEMT BENEFITS IN OCTOBER 2014. PART III, LINE 4 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS A. OHP PROGRAM THROUGH THE CCOS, CAREOREGON PROVIDES HEALTH CARE SERVICES TO OVER 250,000 MEDICAID MEMBERS BY CONTRACTING WITH NETWORKS OF COMMUNITY AND PRIVATE MEDICAL PROVIDERS THROUGHOUT THE STATE OF OREGON. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. B. MEDICARE PLAN ON BEHALF OF HEALTH PLAN OF CAREOREGON, PARENT CAREOREGON ADMINISTERS CAREOREGON ADVANTAGE PLUS HMO-POS SNP (HEALTH MAINTENANCE ORGANIZATION-POINT OF SERVICE MEDICARE SPECIAL NEEDS PLAN). HMO-POS SNP PROVIDES CONTINUITY OF COVERAGE FOR MEMBERS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID. THE CONTINUITY BENEFITS BOTH PATIENTS AND PROVIDERS BY ENSURING A COORDINATED AND CONVENIENT MEANS OF RECEIVING AND DELIVERING QUALITY CARE. WE ALSO ADMINISTER CAREOREGON ADVANTAGE STAR HMO-POS, A LOW COST MEDICARE ADVANTAGE PLAN. OUR MEDICARE PLANS SERVE OVER 11,000 MEMBERS. C. CHARITABLE CONTRIBUTIONS WITH CAREOREGON'S CONTINUOUS GOAL OF INVESTING IN THE COMMUNITY, WE CONTRIBUTED APPROXIMATELY $1.8 MILLION IN 2014 TO OTHER CHARTIABLE ORGANIZATIONS THAT STRIVE TO IMPROVE HEATLH CARE IN OREGON AND TO IMPROVE HEALTH CARE STATUS OF VULNERABLE AND UNDERSERVED POPULATIONS. D. OTHER PROGRAM SERVICES THE CCOS WE SUPPORT PROVIDE ACCESS FOR OVER 250,000 LOW-INCOME OREGONIANS. OUR WORK INVOLVES COORDINATING QUALITY HEALTH CARE FOR MEMBERS AND CONTRACTING WITH PUBLIC AND PRIVATE PROVIDERS TO PROVIDE HEALTH CARE SERVICES. WE PROVIDE CUSTOMER SERVICE FUNCTIONS FOR THESE CCOS, ASSIST WITH HEALTH IMPROVEMENT PLANS FOR THE VARIOUS COMMUNITIES AND PROVIDE TECHNICAL SUPPORT FOR INFORMATION SERVICES, COMMUNICATIONS, PROCESS IMPROVEMENT AND OTHER FUNCTIONS. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. IN 2014 WE CONTINUED TO PROVIDE COMMUNITY OUTREACH, SUPPORT AND CARE COORDINATION SERVICES TO HIGH-RISK MEMBERS IN MULTNOMAH, WASHINGTON AND CLACKAMAS COUNTIES UNDER A CENTER FOR MEDICARE AND MEDICAID INNOVATIONS (CMMI) GRANT. THE CMMI GRANT IS A THREE-YEAR AWARD THROUGH JUNE 30, 2015 AIMED AT DEVELOPING NEW INTEGRATED MODELS OF CARE TO IMPROVE HEALTH OUTCOMES AND REDUCE COSTS FOR THE ADULT MEDICAID POPULATION. WE ENCOURAGE CLINICS TO PROVIDE THE BEST PRIMARY CARE POSSIBLE THROUGH OUR VARIOUS IMPROVEMENT AND INCENTIVE-PAYMENT PROGRAMS TO BUILD SYSTEMS AND PROCESSES FOR PROACTIVE PANEL MANAGEMENT, TEAM-BASED CARE, NURSE-LED CASE MANAGEMENT, PATIENT EMPOWERMENT FOR SELF-MANAGEMENT, INTEGRATION OF PHYSICAL AND MENTAL HEALTH CARE, IMMUNIZATION AND DISEASE-SPECIFIC PATIENT REGISTRIES, AND SAME-DAY AND EXTENDED-HOUR MEMBER ACCESS TO THE CARE TEAM. ALL OF THESE IMPROVEMENTS ARE DONE WITH THE GOAL OF COST-EFFECTIVE, CONTINUOUS, AND COORDINATED CARE. OUR MODEL IS ONE OF LEARNING FOR THE MEMBER; ACTING FOR THE POPULATION. WE PARTICIPATE ACTIVELY IN THE INSTITUTE OF HEALTHCARE IMPROVEMENT'S "TRIPLE AIM," A NATIONAL PROGRAM THAT LOOKS AT MAXIMIZING RESULTS IN THREE AREAS: OUTCOME EXCELLENCE, PATIENT SATISFACTION AND COST EFFECTIVENESS. WE CONTINUED TO WORK WITH CLINICS TO IMPROVE THEIR PATIENT-CENTERED MEDICAL HOMES. WE HAVE EXPANDED THE COLLABORATIVE TO CLINICS (PATIENT AND POPULATION CENTERED PRIMARY CARE) IN MORE RURAL SETTINGS, TO HELP THEM TRANSFORM THEIR PROCESSES, DATA SYSTEMS, AND WORKFORCE TO IMPROVE PATIENT EXPERIENCE AND OUTCOMES. CAREOREGON IS THE NORTH AMERICAN PROVIDER OF NATIONAL HEALTH SERVICE PROGRAMS, SUCH AS RELEASING TIME TO CARE (RT2C). THE RT2C PROGRAM ENGAGES HOSPITALS IN IMPROVEMENT PROCESSES ONE UNIT AT A TIME. LED BY THE NURSING STAFF, IT USES LEAN TECHNIQUES TO HELP ELIMINATE INTERRUPTIONS, ELIMINATE WASTE IN PROCESSES AND BETTER ORGANIZE THE NURSES' ENVIRONMENT. THIS TIME IS THEN REFOCUSED ON PATIENT-CENTERED ACTIVITIES IN ORDER FOR NURSES TO DELIVER BETTER, SAFER AND MORE RELIABLE CARE LEADING TO AN IMPROVED CARE EXPERIENCE. THE RT2C PROGRAM IS NOW INFLUENCING PROCESS IMPROVEMENT THROUGHOUT THE HOSPITALS INVOLVED, AND THE NUMBER OTHER CHANGES IN NET ASSETS OR FUND BALANCES PART XI, LINE 9 PARTNERSHIP INCOME FROM K-1 REPORTED FOR TAX, NOT INCLUDED IN BOOKS $1,515 -------- TOTAL $1,515 Columbia Pacific CCO LLC 315 SW Fifth Avenue Suite 900 Portland OR 97204 455532847 Health Plan OR 139847239 12255010 CareOregon Jackson County CCO LLC 316 SW Fifth Avenue Suite 900 Portland OR 97204 455499608 Health Plan OR 148521161 34176627 CareOregon PrimaryHealth of Josephine County LLC 317 SW Fifth Avenue Suite 900 Portland OR 97204 455492679 Health Plan OR CareOregon Care Access LLC 318 SW Fifth Avenue Suite 900 Portland OR 97204 270630449 Medical Bldg OR 110962 3577367 CareOregon CareOregon Community Health LLC 319 SW Fifth Avenue Suite 900 Portland OR 97204 272429270 Med Clinic OR 142 CareOregon Lean Healthcare West LLC 320 SW Fifth Avenue Suite 900 Portland OR 97204 462514040 Training OR 356732 92648 CareOregon Health Plan of CareOregon Inc 315 SW Fifth Avenue Suite 900 Portland OR 97204 463264330 Medicare OR CareOregon C Corp -6555616 57796975 1.00000 true false false false false false false false false false false false true false true false false true false false Health Plan of CareOregon l 7525301 Actual Cost Health Plan of CareOregon n 2058581 Actual Cost Health Plan of CareOregon q 1319477 Reimbursed