Oregon Health Plan Payments To Regional Healthcare Organizations Set To Increase In 2027

Oregon plans to increase payments next year to the regional organizations that manage healthcare for most Oregon Health Plan members, according to the Oregon Health Authority.

Those groups, called coordinated care organizations, or CCOs, bring together providers to arrange medical, dental, and mental health and addiction services for people enrolled in the state’s Medicaid program. Oregon has 15 of these organizations.

The proposed 2027 rates would pay the organizations an average of $627.68 per member each month. These are state payments to the organizations that coordinate care, rather than premiums charged to Oregon Health Plan members. Federal approval is still pending.

OHA said the rates represent an average increase of 6.1% over 2026 when excluding a one-time maternity care investment that temporarily increased payments this year. When those maternity payments are included in the comparison, the increase is 5.6%.

“Oregon Health Authority remains focused on ensuring people enrolled in the Oregon Health Plan can receive quality healthcare well into the future,” said OHA Chief Financial Officer Rochelle Layton. “Our updated 2027 rates support the financial stability of the coordinated care organizations that help us deliver Medicaid benefits across the state.”

The Oregon Health Plan covers about 1.4 million people, including low-income adults, children, pregnant women, older adults, and people with disabilities. The program is jointly funded by the state and federal governments.

OHA pays the regional organizations primarily through a monthly payment for each enrolled member. State and federal rules require those payments to be sufficient to cover expected costs.

In developing the 2027 rates, the agency considered rising healthcare costs, changes to covered benefits and payment policies, and anticipated coverage losses related to upcoming federal changes.

OHA also reviewed financial information from 2025 and early 2026. The organizations collectively reported a profit margin of 0.8% in 2025, compared with 0.001% in 2024. Preliminary figures from early 2026 indicate their finances have continued to improve, according to the agency.

The rate-setting process included additional public reporting and more opportunities for the organizations to review proposed payments. House Bill 4039, which became law in March, required OHA to use a more transparent, data-driven process.

The agency said it gave the organizations more time to review draft rates, met with them more frequently, released additional supporting information, and made two presentations to the Oregon Health Policy Board before finalizing the proposal.

OHA has submitted the proposed rates to the federal Centers for Medicare & Medicaid Services and expects approval by the end of 2026.

Additional details are available in the agency’s draft 2027 rate development and certification report.