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Priorities for the FamilyCare Membership Transition
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In January 2018, FamilyCare Health—one of the state’s largest coordinated care organizations (CCOs)—will close. This change will impact 113,000 Medicaid recipients in the Portland-area and their providers, including a number of independent nurse practitioners. During this transition, Medicaid patients will retain Oregon Health Plan coverage, but will be transferred to a different Portland-area CCO--Health Share of Oregon.

ONA and NPO have been working together with the Oregon Health Authority and other health care partners to help smooth this transition for patients and providers, to ensure patients’ needs are met, and to preserve the established relationship between patients and their providers. ONA and NPO leaders have met with the Oregon Health Authority about our concerns and we will continue advocating for our patients and our members who serve them.

Below are ONA and NPO’s recommendations to OHA and Health Share on how to facilitate a smooth transition for patients and providers.

 

December 29, 2017

TO: The Oregon Health Authority and Health Share of Oregon

FROM: The Oregon Nurses Association and Nurse Practitioners of Oregon

RE: Priorities for the FamilyCare Membership Transition

The abrupt closure of FamilyCare Health will create many complex transitions for patients on the Oregon Health Plan and for the providers who care for them. The Oregon Nurses Association (ONA) and Nurse Practitioners of Oregon (NPO) appreciate that the scale of moving 100,000 patients in a short time makes it difficult to plan a smooth transition for Oregon Health Plan members and providers. However, as this shift takes place we ask you to keep the following priorities in mind:

First, patients’ needs must take priority over the needs of health care providers or health plans. Patients who are currently receiving treatment or are on a care plan should not have their care disrupted. At times like these, it may appear easy to think of people as numbers. Please remember that each person on the Oregon Health Plan has individual rights and needs. This starts with the right to a planned and stable care transition.

Second, value the relationship between patients and their providers. Providers who have an established relationship with FamilyCare patients but do not have a Medicaid contract with a Health Share of Oregon plan need time to contract with a plan. In some cases, establishing a contract requires a credentialing process which commonly takes more than a month. The Oregon Health Authority and Health Share of Oregon should treat this transition as an exceptional event and work to speed up the credentialing and contracting process for providers or allow providers’ additional time to complete it.

Third, take care not to lose small providers. FamilyCare withdrawing from Oregon’s Medicaid system represents a significant loss to the Portland-area health system. There is a risk that the collapse of FamilyCare causes the collapse of parts of the provider network which have built business plans around FamilyCare’s rate structure. A successful transition plan needs to take the stability of small providers into account. In cases where FamilyCare providers can’t survive an abrupt cut to their rates, the Oregon Health Authority should take the lead in creating a bridge plan which gives them the time they need to transition their business model.

Thank you for your ongoing work to ensure a smooth transition for Oregon’s patients and providers.'

Sincerely,

Kathleen Cooper, BSN, RN, CCRN
President, Oregon Nurses Association

Kat Chinn, MS, RN, FNP-BC
Chair, Nurse Practitioners of Oregon

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10/10/2018 » 10/13/2018
41st Annual NPO Education Conference

4/6/2019
9th Annual NPO Pharmacology Conference


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