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State officials say they will secure a replacement provider for the more than 90,000 Oregon Health Plan members in Lane County now served by PacificSource. Trillium, the county’s other coordinated care organization, said it can support the transition.
Due to incomplete information provided by the Oregon Health Authority, this article needed to be updated. The additional 90 days of coverage OHA can require PacificSource to provide for Oregon Health Plan members would start after approval of PacificSource’s transition plan. Additionally, while there are several paths for OHA to provide coverage to Oregon Health Plan members, one option could be to initiate a new process where all Lane County coordinated care organizations, including PacificSource, apply to provide coverage for Medicaid patients.
Contract negotiations between PacificSource and the Oregon Health Authority have ended without a new agreement, leaving the coverage of more than 90,000 people on the Medicaid-funded Oregon Health Plan to transition to another provider.
State officials said they intend to have a new provider in place by the start of the year, when the contract with PacificSource expires. Trillium, the other organization providing Oregon Health Plan coverage in Lane County, said it has the capacity to serve people currently enrolled with PacificSource.
PacificSource Community Solutions and Trillium Community Health Plans are coordinated care organizations (CCO), which manage networks of providers and care for people who are low-income for the state.
Last week, the Springfield-based insurer PacificSource informed the Oregon Health Authority (OHA) of its intent to not renew its contract as a CCO in Lane County. PacificSource will continue serving Oregon Health Plan (OHP) members in eight other counties, however.
PacificSource cited as reasons: rising costs, growing demand for behavioral health care and state reimbursement rates that executives said do not cover expenses.
After a week of uncertainty, the health authority’s communication team confirmed Friday, Sept. 26, that by filing its intent to not renew Sept. 18, PacificSource will no longer be a CCO in Lane County.
“CCO rate negotiations for 2026 are over,” Oregon Health Authority spokesperson Kristen Lambert said. “It is certain they will no longer be a CCO in Lane County in 2026.”
Monday, Sept. 29, Lambert contacted Lookout Eugene-Springfield with details she did not understand or convey last week.
“The nuance that I didn’t understand or convey is that there are several paths forward for transitioning to another network provider. One potential path is that OHA could initiate a procurement process for Lane County and all CCOs would be eligible to apply – including PacificSource,” she said.
She also clarified that once PacificSource has a transition plan for its current contract, the Oregon Health Authority can require the insurer to provide up to 90 additional days of coverage for Oregon Health Plan members into 2026, if a new provider has not been found.
The health authority maintains that people will not experience disruptions and do not need to take any action as of late September.
PacificSource leadership said last week it would be open to alternatives with Oregon Health Authority — discussions that remain on the table, said Erin Fair Taylor, the company’s vice president of Medicaid programs.
“After many conversations with OHA over the past few months, we were unable to arrive at a solution,” said Taylor. “We are still committed and open to working with OHA to find a sustainable path forward.”
PacificSource spokesperson Lauren Thompson also said that it would work with other CCOs to transition care. The other CCO in Lane County is Trillium, serving about 30,000 county residents.
In response to whether Trillium could absorb 90,000 patients, spokesperson Courtney Johnston said in an email, “Trillium has the capacity to support this transition.”
“Trillium recognizes the importance of stability in health care, especially during times of transition, and we are working closely with the Oregon Health Authority to provide continuity of care for all impacted members in our communities,” she said.
Oregon Health Authority did not provide specific details about CCO negotiations, nor did Gov. Tina Kotek’s office.
Spokesperson Lucas Bezerra said Kotek is “closely monitoring PacificSource’s decision not to renew its contract” and “is engaged with OHA leadership to minimize care disruption for members and ensure adequate coverage in the region.”
This story has been updated to correct the spelling of Courtney Johnston’s name.
Ben Botkin, Lookout Eugene-Springfield’s politics and policy correspondent, contributed to this report.
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