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Organization Name and Address:
CareOregon, Inc.
522 S.W. Fifth AV Suite 200
Portland, OR 97204
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Contact name:
Susan Crites
Contact e-mail:
critesc@careoregon.org
Medical Director:
Margaret Rowland, M.D. |
Phone / fax:
(503)-416-1774
fax: (503) 416-3704
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CEO:
Dave Ford |
Web site:
www.careoregon.org
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COO:
Fritz Rankin
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Years Operational:
11 years (started 2/94) |
CFO:
Fritz Rankin |
Enrollment level, by payer:
92,071 Oregon Health Plan (Medicaid)
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Percent of enrollment served by CHC clinics:
55%
Corporate status:
Not for profit: 501 © 3
Certifications (JACHO, NCQA, HMO):
None |
Governance:
Board of Directors (9 Members—4 representing CHC’s; 3 representing
Academic Health Center, 2 representing physicians)
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Reserve requirements:
Established by State Medicaid Contract; variable based on membership |
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Network description:
Statewide primary care network of 9 CHCs with 22 clinic sites; 10
primary care clinics affiliated with academic health center; 4 IPAs
with 50 affiliated practices; additional contracts with 65 private
groups with 80 clinical sites. Primary care network includes 1100
practitioners. Contract with health departments in each county served
for public health services. Contract with 2700 specialists statewide,
including practice affiliated with academic health center, 3 IPAs
and multiple private groups and practices. Hospital network includes
two multi-hospital networks (8 total sites) plus 28 community and
general hospitals.
Pharmacy benefit and management:
Pharmacy benefit manager, MedImpact Healthcare Systems. Plan is capitated for all prescription
drugs, excluding neurontin, Depakote, and psychotropic (schedule
7-11 drugs). Plan has a closed formulary and covers OTC when prescribed
by PCP. Plan produces Pocket Provider Prescribing Guide and formulary
booklets. Formulary is also available on the plan website.
TPA/Information systems:
Contract with Best Choice Administrators, subsidiary of ODS Health
Plans for claims processing and member eligibility processing.
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