QuickTake:

A draft letter from Trillium Community Health Plan indicates network gaps remain days before the Feb. 1 transition. Nearly 96,000 people on Medicaid in Lane County are being automatically switched from coverage previously provided by PacificSource Community Solutions.

Essential background

The PacificSource-to-Trillium transition can be confusing. Here are three basics to understand: 

  1. Medicaid coverage in Lane County is provided through the Oregon Health Plan, administered by the Oregon Health Authority, the state’s health agency. People in the plan are called members.
  2. The authority contracts with coordinated care organizations, or CCOs — typically insurance companies — which deliver members’ benefits through networks of health care providers.
  3. In Lane County, those CCOs are PacificSource Community Solutions and Trillium Community Health Plans. But PacificSource will no longer operate as a CCO after Jan. 31, 2026. PacificSource members will move to Trillium Feb. 1.

With less than 48 hours until its “go live” date, Trillium leadership has written a letter to local elected officials saying that Trillium is still working to expand its network for nearly 96,000 people in Lane County who use Medicaid for health care.

The insurer is trying to minimize how many members will need to change clinics, doctors and hospitals they accessed through PacificSource Community Solutions, according to a draft of the letter obtained by Lookout Eugene-Springfield.

Trillium sent the letter Friday afternoon, Jan. 20, to Eugene and Springfield city council members, Lane County commissioners and legislators representing local communities.

About 90% of PacificSource primary care providers contract with Trillium, along with 84% of behavioral health providers.

But that means:

  • Between 15,000 and 25,000 PacificSource members still have doctors or clinics that are not in Trillium’s network. 
  • About 10% — 9,600 — of those have primary care providers outside Trillium’s network.
  • Nearly 16% — 15,360 — of those have behavioral health providers outside the network.

The letter to leaders did not say the gap closed, but said Trillium expects the number to eventually be close to 98%, meaning most members will not need to change their primary care provider. That would leave about 1,900 people looking for primary care providers.

Regarding behavioral health, the letter said, “we are adding 275 new behavioral health providers, including group and private practice providers, with additional expansion efforts underway.” It did not say whether that would close the out-of-network gap for members.

Courtney Johnston, a Trillium spokesperson, provided the text of the letter to Lookout Eugene-Springfield. She did not identify which Trillium executive wrote it. 

Oregon Health Authority communications staff and leadership have not responded to any of Lookout Eugene-Springfield’s emails or calls about the transition since Jan. 9.

Below is how the letter describes its network as of Friday and outlines a framework it calls “transition of care,” which allows members to continue seeing their current providers for 30, 60 or 90 days after the Feb. 1 transition, depending on individual needs. 

Hospitals and primary care 

Trillium will continue expanding its network, according to the letter. The chart below includes specifics from the letter and details the company and other health providers shared previously.

Hospitals
Primary Care Clinics 		Status Details 
BestMedIn network “System configuration is underway.” — Trillium 
Kaiser Out of network, active negotiations  “Agreement terms are being finalized, and Kaiser has agreed to continue seeing patients while the terms are completed.” — Trillium 
McKenzie Willamette Medical Center Out of network, finalizing agreement “Reimbursement terms are agreed to, and contract language is actively being finalized.” — Trillium 
Oregon Medical GroupOut of network, active negotiations  “Remains positive.”  — Trillium 
PeaceHealth In network “PeaceHealth accepts all forms of Medicaid and will continue to do so.” — PeaceHealth 

Behavioral health

Trillium did not provide specific clinic names for behavioral health services, as it did for hospitals and primary care clinics, but outlined the following in its letter:

  • Provider engagement: Trillium said it has held extensive conversations with large, medium and solo behavioral health providers. The company said many providers described the impact they have on patients’ lives and their interest in continuing to serve Medicaid members.
  • Network expansion: Trillium said it is adding 275 new behavioral health providers, including group and private practice providers, with additional expansion underway.
  • Member access and continuity of care: Trillium said members may continue seeing out-of-network behavioral health providers after the transition-of-care period ends through its prior authorization process, which it said is intended to ensure uninterrupted access to services.
  • Ongoing provider outreach: Trillium said it is encouraging behavioral health providers interested in contracting to reach out, and said it is continuing to engage with the behavioral health community as it expands its network to meet members’ needs.

Transition of care 

Trillium rolled out what it calls a “transition of care,” which allows members to keep seeing their current providers for 30, 60 or 90 days, depending on individual needs. Here are some of the details:

For most members: 

30 days for physical health and dental; 60 days for behavioral health.

For members with Medicaid & Medicare: 

90 days for physical health, dental and behavioral health.

For members with specific high-risk conditions: 

People undergoing surgery, who are pregnant, and with high-risk needs can finish treatment they began as PacificSource members.

After the transition of care window closes, members can still see out-of-network providers but must obtain prior authorization. 

Where to find information

Lookout Eugene-Springfield continues to follow developments and report what it can with limited information from officials. Readers with questions or who want to share their experiences can email newsroom@lookoutlocal.com.

Here are sources for additional information:

  • Oregon Health Authority public information website on the transition. 
  • Trillium Community Health Plan has mailed welcome packets to new members that include ID cards, a welcome letter, and information about benefits and available support.
  • Trillium has a provider database so members can check whether their providers are in network.

Ashli Blow brings 12 years of experience in journalism and science writing, focusing on the intersection of issues that impact everyone connected to the land — whether private or public, developed or forested.