Oregon’s New Medicaid Care Model Uses Capitated Reimbursement and Coordinated Care Organizations; May Change How Clinical Laboratories Are Paid
Other states are studying Oregon’s innovative Medicaid experiment, which could lead to different forms of reimbursement for clinical laboratories
Once again, Oregon’s Medicaid program is blazing a new trail in the delivery of healthcare. This time, Oregon is organizing its Medicaid services—known as the Oregon Health Plan—to do two things. First, it is developing 16 coordinated care organizations (CCOs) across the state. Second, those Medicaid beneficiaries who represent the majority of costs to the program will receive special case management and clinical services.
Because there will be capitated payments to providers under this program, clinical laboratory managers and pathologists will want to understand how medical laboratories will be reimbursed by the Oregon Health Plan. (more…)