QuickTake:
State officials plan to find alternative providers for over 90,000 members of the Oregon Health Plan in Lane County, who currently receive services from PacificSource. Trillium, the county’s other coordinated care organization, has expressed a willingness to assist with the transition.
The negotiations between PacificSource and the Oregon Department of Health concluded without reaching a new agreement, resulting in significant changes for more than 90,000 Oregon Health Plan beneficiaries who will need to switch to other providers.
Officials confirmed their intent to introduce new providers by the start of the new year, when PacificSource’s contracts come to an end. Trillium, which also operates in Lane County, has indicated it can support individuals currently enrolled with PacificSource.
Both PacificSource Community Solutions and Trillium Community Health Plans serve as coordinated care organizations, overseeing a network of healthcare providers and managing care for low-income individuals across the state.
Recently, the Springfield-based PacificSource informed the Oregon Health Department that it would not renew its contract as a coordinated care organization for Lane County. However, the company will still provide services to Oregon Health Plan members in eight other counties.
The decision is attributed to rising costs, an increased demand for behavioral health services, and insufficient reimbursement rates from the state, according to PacificSource management.
After a week of uncertainty, the Health Department confirmed on September 26 that PacificSource would exit as a CCO in Lane County.
“The negotiations for the 2026 CCO rate are concluded,” noted Kristen Lambert, spokesperson for the Oregon Department of Health. “We won’t have PacificSource as a CCO in Lane County come 2026.”
She emphasized that there wouldn’t be any immediate alterations to benefits or services for OHP members and that the Oregon Health Authority (OHA) would collaborate with PacificSource to ensure a seamless transition for Lane County members.
The Oregon Department of Health has the option to request up to 90 days of extended coverage in 2026 for Oregon Health Plan members, even if a new provider has not been established by that time, Lambert added.
PacificSource’s leadership recently stated they are open to alternative options presented by the Oregon Department of Health.
“After numerous discussions with the OHA, we haven’t reached a resolution,” mentioned Taylor. “We remain committed and are open to collaborating to find a sustainable solution.”
PacificSource spokesperson Lauren Thompson indicated they would coordinate with other CCOs to facilitate the transition of care, particularly with Trillium, which serves approximately 30,000 residents in Lane County.
Regarding the capacity to absorb the influx of 90,000 patients, Trillium spokesman Courtney Johnson conveyed through email that they are prepared to handle the transition.
“Trillium understands the need for stability in healthcare during these transitions and is working closely with the Oregon Department of Health to ensure continuity of care for all impacted community members,” she stated.
Specific details about the ongoing negotiations concerning the CCO from the Oregon Department of Health and the office of Governor Tina Kotek have not been disclosed.
Spokesman Lucas Bezella mentioned that Governor Kotek is closely monitoring the situation regarding PacificSource’s decision to not renew its contract and is in discussions with OHA leadership to minimize any disruption in care and ensure adequate coverage for the community.
