2020-11-12T13:05:12-06:00 2019-12-31 KPMG LLP 1918 Eighth Avenue Suite 2900 Seattle WA 98101 990 2019-01-01 930933975 CareOregon Inc % Teresa Kennedy Learn CFO CARE 5034164100 315 SW 5TH AVE PORTLAND OR 97204 TERESA KENNEDY LEARN CFO 5034161415 2020-11-06 true LISA M MEYER P01490170 2069134000 2020-11-05 199.207.253.96 91023620203175000001 2020-11-12 P 86A74EBFCEE27F7BE023DD8CF584AFFD35DA074E 8787AE8C47AC7A18E705C35B66CD2F80E664658A 2019 2021-01-29 14:40:06Z Eric Hunter 315 SW 5TH AVE PORTLAND OR 97204 1278190830 false X WWW.CAREOREGON.ORG X 1994 OR CAREOREGON IS A NON-PROFIT HEALTH PLAN WHOSE MISSION IS CULTIVATING INDIVIDUAL WELL-BEING AND COMMUNITY HEALTH THROUGH PARTNERSHIPS, SHARED LEARNING AND INNOVATION. 14 13 1063 150 11844331 287784 254954 1114298304 1214507412 15848863 8631078 17279512 17224732 1147714463 1240618176 3118814 1936060 0 0 90068023 91346469 0 0 0 1003887764 1082922735 1097074601 1176205264 50639862 64412912 427700632 490449468 175433882 161249838 252266750 329199630 X SEE SCHEDULE O false false 1079689173 1184311503 OHP Program - SEE SCHEDULE O FOR DESCRIPTION 18054524 19049687 Medicare Plan - SEE SCHEDULE O FOR DESCRIPTION 1936060 1936060 Charitable Contributions - SEE SCHEDULE O FOR DESCRIPTION 15181207 11146222 1114860964 true true false true false false false false false false true false false true true false false true false false false false false false false false false true false true false false false false false false false false false false false false true true true true false false true 2301 0 true 1063 true true true false false false false false false false false false false false X 14 13 false false false false false false false true true false false true true true true true true true true true true OR X Teresa Kennedy Learn CFO 5034161415 315 SW 5th Avenue Portland OR 97204 X ERIC C HUNTER CEO, PRESIDENT & BOARD OF DIRE 32.24 7.76 X X 552705 0 30385 AMIT R SHAH CHIEF MEDICAL OFFICER 30.36 9.64 X 413470 0 23692 DOUGLAS R LUTHER SR. MED DIRECTOR, OPERATIONS 31.6 8.4 X 348488 0 21532 TERESA K LEARN CFO, BOARD TREASURER 30.92 9.08 X 317446 0 34404 WILLIAM J KENNEDY SR. MED DIRECTOR, ADV ILLNESS 21.88 18.12 X 300061 0 47313 REBECCA RAMSAY VP, HOUSECALL PROVIDERS 21.2 18.8 X 255983 0 49660 ERIN D FAIR CLO, BOARD SECRETARY 32.32 7.68 X 272611 0 30174 ALYSSA FRANZEN VICE PRESIDENT, DENTAL 37.04 2.96 X 258322 0 32267 CARL D STEVENS MEDICAL DIRECTOR 40.0 0.0 X 249072 0 37403 SAFINA KOREISHI MEDICAL DIRECTOR 40.0 0.0 X 247674 0 27679 NATHAN CORLEY VP, INFO SVCS & ANALYTICS 31.62 8.38 X 241338 0 28458 AMY L DOWD CHIEF OPERATIONS OFFICER 32.88 7.12 X 240800 0 27217 GLENN S RODRIQUEZ BOARD CHAIRMAN 4.0 1.25 X X 0 0 0 SUSAN M HENNESSY BOARD VICE CHAIRMAN 4.0 1.25 X X 0 0 0 VICKIE S GATES BOARD OF DIRECTOR (RETIRED) 4.0 1.25 X 0 0 0 BETH A DEHAMEL BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 JOANNE FULLER BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 DAMIEN R HALL BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 BRENDA I JOHNSON BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 NATHALIE JOHNSON BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 HYOSUK RHEE BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 ROBERT C STEWART BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 TAEKYUNG HAN BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 GINA F NIKKEL BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 WOODRUFF J ENGLISH II BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 KATHLEEN G JONES BOARD OF DIRECTOR 4.0 1.25 X 0 0 0 3697970 0 390184 162 false true false RDA PROJECT MANAGEMENT PO BOX 1417 ASTORIA OR 97103 GENERAL CONTRACTORS 942168 RED CARD SYSTEMS LLC 744 OFFICE PARKWAY SAINT LOUIS MO 63141 CLAIMS PROCESSING 414679 GIFTANGO LLC 111 SW 5TH AVE STE 900 PORTLAND OR 97204 ADMIN & HEALTH MGMT 300000 ATERWYNNE LLP 1331 NW LOVEJOY STE 900 PORTLAND OR 97209 LEGAL SERVICES 290422 KPMG LLP PO BOX 120922 DEPT 0922 DALLAS TX 75312 AUDIT & TAX SERVICES 274333 7 0 254954 254954 Premium Revenue 524114 1184311503 1184311503 Management Fee 541611 21343927 19836508 1507419 Patient Revenue 621610 7055306 7055306 TRAINING & CONSULTING REVENUE 611430 526634 119359 407275 ALL OTHER PROGRAM SERVICE REVENUE 900099 1270042 1247073 22969 1214507412 8301767 8301767 0 0 416659 139582 277077 0 277077 277077 37762383 37394406 38666 367977 -38666 329311 329311 0 0 0 0 0 0 0 0 0 Employee Lease Revenue 541511 16947655 7040987 9906668 16947655 1240618176 1219610736 11844331 8908155 1936060 1936060 0 0 0 2248547 971587 1276960 0 0 48837365 32073452 16763913 5261194 3348608 1912586 23734594 15979641 7754953 11264769 7103140 4161629 0 445995 445995 280208 280208 224312 224312 0 410571 410571 9249619 3996648 5252971 632691 574180 58511 1947315 968615 978700 7696511 148205 7548306 0 1716768 11111 1705657 631197 441278 189919 0 445393 137242 308151 -46807 -46807 0 3552468 3552468 210763 210763 Physical healthcare expense 959368318 959368318 MENTAL HEALTHCARE EXPENSE 46319077 46319077 DENTAL HEALTHCARE EXPENSE 39294179 39294179 All other expenses 10544157 2189623 8354534 1176205264 1114860964 61344300 0 31157 3438 78938759 96501190 0 0 20948538 13423179 0 0 0 0 926227 0 6041 6514 5216083 4419548 47801277 29973353 19339711 17827924 264626481 331450884 0 0 0 0 0 0 37667635 26816791 427700632 490449468 21057303 27281011 0 177 242524 210315 0 0 0 0 0 0 0 0 0 0 154134055 133758335 175433882 161249838 X 252237842 329075686 28908 123944 252266750 329199630 427700632 490449468 X 64412912 18019968 -5500000 X false true X true false X 1144558 339602 474102 287784 254954 2501000 918922129 862474890 816414092 1106930891 1212569748 4917311750 0 0 0 920066687 862814492 816888194 1107218675 1212824702 4919812750 0 0 0 4919812750 6384386 6830965 7332802 7203622 8718426 36470201 0 6384386 6830965 7332802 7203622 8718426 36470201 865461 246730 1112191 0 926451073 869645457 824220996 1115287758 1221789858 4957395142 0.99242 0.99269 0.00736 0.00713 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 33513 407767 441280 1175763984 1176205264 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 92888 266623 180750 441280 981541 250000 250000 250000 250000 1000000 1500000 18676 22897 33513 75086 Part II-A, Line 1 CareOregon participates in lobbying activities that include testifying at public policy hearings, and meeting with legislators to discuss Oregon Health Plan related issues. CareOregon does not participate in or contribute to political candidate campaigns or political parties. 2704520 2704520 22683736 11184738 11498998 161083 161083 0 5361929 4630372 731557 16890009 13997160 2892849 17827924 FEDERAL INCOME TAXES 109000 INTERCOMPANY RECEIVABLE 3281912 RISK CORRIDOR RECEIVABLE 5221792 PAY FOR PERF CCO INCENTIVES 17900000 DEPOSITS AND OTHER ASSETS 304087 26816791 0 CLAIMS PAYABLE 100593126 RISK CORRIDOR PAYABLE 639380 MANAGED CARE CONTRACTS PAYABLE 1587770 INTERCOMPANY LIABILITIES 258169 PAY FOR PERF PROVIDER INCENTIVES 29764757 PREMIUM RECOUPMENT PAYABLE 915133 133758335 X Form Sch D Part X Line 2 THE INTERNAL REVENUE SERVICE (IRS) HAS RECOGNIZED CAREOREGON AS EXEMPT FROM FEDERAL INCOME TAXES UNDER PROVISIONS OF SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE. THE WHOLLLY-OWNED SUBIDIARY, HEALTH PLAN OF CAREOREGON (HEALTH PLAN), IS ALSO A 501 (C) (3) TAX-EXEMPT NONPROFIT ENTITY. HEALTH PLAN IS A MEDICARE ADVANTAGE PLAN REPORTED ON A SEPARATE FORM 990. HEALTH PLAN HAS HELD THIS STATUS SINCE DECEMBER 31, 2016. THE WHOLLY-OWNED SUBSIDIARIES, CARE ACCESS, LLC; COLUMBIA PACIFIC CCO,LLC; JACKSON CARE CONNECT CCO, LLC; HOUSECALL PROVIDERS SERVICES, LLC, ARE SINGLE-MEMBER LIMITED LIABILITY CORPORATIONS, WORKING TO FURTHER CAREOREGON'S EXEMPT PURPOSE. ALL OF THESE LLCS ARE TREATED AS DISREGARDED ENTITIES FOR FEDERAL TAX PURPOSES AND ARE REPORTED WITH THE PARENT'S FINANCIAL RESULTS ON ITS FORM 990. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN INTEREST EXPENSE AND OTHER ADMINISTRATIVE EXPENSES, RESPECTIVELY. HOUSECALL PROVIDERS, PC - ORGANIZED IN APRIL 2017 AS A PROFESSIONAL CORPORATION, HOUSECALL PROVIDERS, PC (HCP PC) IS 51% OWNED BY THE ORGANIZATION'S CHIEF MEDICAL OFFICER AND 49% OWNED BY THE PARENT. EFFECTIVE MAY 31, 2017, THROUGH AN ASSET TRANSFER AGREEMENT,CERTAIN ASSETS AND LIABILITIES OF HOUSECALL PROVIDERS, INC. RELATED TO HOME-BASED PRIMARY CARE SERVICES WERE TRANSFERRED TO HCP PC WHICH PROVIDES MEDICAL CARE, INTEGRATING PRIMARY AND PALLIATIVE SERVICES FOR HOMEBOUND MEMBERS AND PROVIDES CERTAIN PROVIDER SERVICES TO HCP LLC AND THE ORGANIZATION. THE ASSETS TRANSFERRED WERE PRIMARILY NET RECEIVABLES, WHICH EXCEEDED THE LIABILITIES. THE EXCESS OF $1,149,778 WAS RECORDED AS CONTRIBUTIONS RECEIVED. ALTHOUGH THE PARENT OWNS THE MINORITY INTEREST OF HCP PC, THEY RETAIN ULTIMATE CONTROL. UPON THE DISSOLUTION OF HCP PC, ITS NET ASSETS WOULD BE DISTRIBUTED TO THE PARENT. FOR PURPOSE OF FINANCIAL REPORTING, HCP PC IS CONSOLIDATED AS A WHOLLY OWNED SUBSIDIARY. HCP PC APPLIED FOR ITS EXEMPTION STATUS FROM FEDERAL INCOME TAX EFFECTIVE MAY 31,2017. HOUSECALL PROVIDERS, PC WILL FILE A SEPARATE FORM 990. true Asian Health and Service Center 9035 SE Foster Rd Portland OR 97266 931192100 501(c)(3) 11000 AHSC 36TH ANNUAL CONFERENCE Basic Rights Oregon PO Box 40625 Portland OR 97240 931266613 501(c)(3) 5500 Ignite Gala and Fundraiser Catholic Charities 2740 SE Powell Blvd Portland OR 97202 930386801 501(c)(3) 7500 Celebration of Hope event Central City Concern 232 NW Sixth Avenue Portland OR 97209 930728816 501(c)(3) 389994 Housing is Healthcare Projects Clackamas Women's Services 256 Warner Milne Rd Oregon City OR 97045 930900119 501(c)(3) 10000 Expansion of Camp HOPE Oregon Elevate Oregon 12215 NE Marx St Portland OR 97230 272151955 501(c)(3) 20000 In school mentoring for at risk kids Girl Scouts of Oregon and SW Washington 9620 SE Barbur Blvd Portland OR 97219 930399051 501(c)(3) 25000 Girl Scouts Beyond Bars Good in the Hood 4815 NE 7th Portland OR 97211 465165196 501(c)(3) 7000 Music Festival and Parade IRCOS International Language 10301 NE Glisan St Portland OR 97220 930806295 501(c)(3) 23750 Housing for Single Individuals Kids Unlimited of Oregon 821 N Riverside Medford OR 97501 931329922 501(c)(3) 10000 KidsPasstoPlay La Clinica Del Velle Family Health CTR Inc 3617 S Pacific Highway Medford OR 97501 943096772 501(c)(3) 170115 Primary Care Investment Fund Program Multnomah County Health Department 421 SW Oak Street 201 Portland OR 97204 936002309 County 536025 Funding Project - MCMH Target Native American Youth and Family Center 5135 NE Columbia Blvd Portland OR 97218 931141536 501(c)(3) 10000 NAYA 15TH ANNUAL GALA Northwest Regional Education Service District 5825 NE Ray Circle Hillsboro OR 97124 205449967 501(c)(3) 25000 Columbia County Trauman Informed Care Network Off The Sideline 2809 SE Clinton St Portland OR 97202 474585067 501(c)(3) 20000 PROVIDING SPORT SCHOLARSHIPS Oregon Public Health Institute 411 NE 19th Ave Bldg 1 Portland OR 97232 931259522 501(c)(3) 14000 Recovery Community Summit and Walk for Recovery Portland Industrialization Center 717 N Killingsworth Ct Portland OR 97217 930593858 501(c)(3) 40000 In School Mental Health Services Portland Street Medicine 825 NE Multnomah St Portland OR 97212 824209837 501(c)(3) 10000 Grant for Portland Street Medicine Van Rogue Community College 3345 Redwood Hwy Grants Pass OR 97527 930777701 501(c)(3) 40000 MEDICATION ASSISTED TREATMENT PROGRAM Donation for Health Care Equipment Rogue Retreat 1410 W 8th St Medford OR 97501 931261999 501(c)(3) 7500 Laundry and Shower Trailer Maintenance Schoolhouse Supplies 4916 NE 122nd Ave Portland OR 97230 204223437 501(c)(3) 10500 Tools for Schools Backpack Program Soul District Business Association PO Box 11565 Portland OR 97211 930843715 501(c)(3) 10000 MLK Dream Run Susan G Komen Oregon and SW Washington 1500 SW 1st Ave Ste 370 Portland OR 97201 931068897 501(c)(3) 25500 African American Inititative The Lund Report PO Box 82841 Portland OR 97282 263019179 501(c)(3) 15000 OHF Breakfast Sponsor The Shadow Project 2154 NE Broadway Ste 130 Portland OR 97232 651166066 501(c)(3) 26000 Wide Social Emotional Learning for Children w/ Disabilities Tillamook County Habitat for Humanity 4192 Hwy 101 N Tillamook OR 97141 911848416 501(c)(3) 5500 BUILDING PROGRAM Trillium Family Services Inc 3415 SE Powell Portland OR 97202 930386966 501(c)(3) 10000 Black and Gold Gala Event Virginia Garcia PO Box 568 Cornelius OR 97113 930717997 501(c)(3) 192556 MCMH Targets and Milestones achieved 28 0 PART I, LINE 2 Grants and other assistance are provided to organizations in our service area who demonstrate a financial need in regard to improving the delivery of health services in line with our exempt purpose and mission. CareOregon considers each case to verify that the need is documented, legitimate and substantial in nature. Following disbursement of funds, follow-up contact is performed, either verbally or in writing, to verify the appropriate use of the funds, to the extent possible. X true true X X X X false false false false false false false false false ERIC C HUNTER CEO, PRESIDENT & BOARD OF DIRE 447354 104931 420 17083 13302 583090 AMIT R SHAH CHIEF MEDICAL OFFICER 345327 66943 1200 19500 4192 437162 DOUGLAS R LUTHER SR. MED DIRECTOR, OPERATIONS 301150 45858 1480 19500 2032 370020 TERESA K LEARN CFO, BOARD TREASURER 264980 52466 0 18987 15417 351850 WILLIAM J KENNEDY SR. MED DIRECTOR, ADV ILLNESS 276259 23627 175 18169 29144 347374 REBECCA RAMSAY VP, HOUSECALL PROVIDERS 226742 29225 16 18009 31651 305643 ERIN D FAIR CLO, BOARD SECRETARY 226496 45315 800 18710 11464 302785 ALYSSA FRANZEN CARL D STEVENS SAFINA KOREISHI VICE PRESIDENT, DENTAL 222400 35922 0 17039 15228 290589 NATHAN CORLEY MEDICAL DIRECTOR 222224 26479 369 17268 20135 286475 AMY L DOWD MEDICAL DIRECTOR 224015 22249 1410 17059 10620 275353 NATHAN CORLEY VP, INFO SVCS & ANALYTICS 207818 33520 0 15748 12710 269796 AMY L DOWD CHIEF OPERATIONS OFFICER 235786 0 5014 11970 15247 268017 PART I, LINE 1A CareOregon reimbursed health club dues for Eric Hunter, Douglas Luther, William Kennedy, and Safina Koreishi in the amount of $420, $280, $175, and $210 respectively. This reimbursement was included as taxable compensation to these parties. SUPPLEMENTAL INFORMATION TO 2019 FORM 990 FOR CAREOREGON, INC. PART III, LINE 1 TAX-EXEMPT PURPOSE AND MISSION OF CAREOREGON CAREOREGON IS A NONPROFIT HEALTH PLAN ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATION AND SCIENTIFIC PURPOSES. IT CONTRACTS WITH SEVERAL COORDINATED CARE ORGANIZATIONS (CCOS) AND WITH THE OREGON HEALTH AUTHORITY (OHA) TO MANAGE CARE AND PROVIDE HEALTH CARE SERVICES TO MEDICAID ENROLLEES. BY LISTENING TO OUR MEMBERS AND EXPLORING INNOVATIVE SOLUTIONS WITH OUR PROVIDERS AND COMMUNITIES, WE HELP OREGONIANS PREVENT ILLNESS AND LIVE BETTER LIVES. EVERY DAY, WE STRENGTHEN OUR COMMUNITIES BY MAKING HEALTH CARE WORK FOR EVERYONE. WE PROVIDE MANAGED CARE SERVICES TO APPROXIMATELY 260,000 OREGON HEALTH PLAN (MEDICAID) MEMBERS THROUGH OUR PARTNERSHIPS WITH THREE COORDINATED CARE ORGANIZATIONS, AND TO APPROXIMATELY 12,000 MEDICARE MEMBERS. OUR MEMBERS ARE LOCATED IN THE PORTLAND METROPOLITAN AREA, SOUTHERN OREGON AND THE NORTHERN OREGON COASTAL COUNTIES. . TWO OF OUR CCOS ARE LIMITED LIABILITY CORPORATIONS (LLCS) OWNED BY CAREOREGON: JACKSON COUNTY CCO, LLC (JACKSON CARE CONNECT), IN JACKSON COUNTY; AND COLUMBIA PACIFIC CCO, LLC, IN COLUMBIA, TILLAMOOK AND CLATSOP COUNTIES. . HEALTH SHARE OF OREGON (HEALTH SHARE) IS MADE UP OF FOUR HEALTH PLANS (KAISER PERMANENTE, PROVIDENCE, TUALITY AND CAREOREGON), THREE COUNTY MENTAL HEALTH DEPARTMENTS, AND NINE DENTAL CARE ORGANIZATIONS. CAREOREGON PROVIDES PHYSICAL HEALTH MANAGED CARE SERVICES TO MOST OF HEALTH SHARE'S MEMBERS, AND A PORTION OF HEALTH SHARE'S DENTAL HEALTH MANAGED CARE SERVICES. THIS PARTNERSHIP SERVES OREGON HEALTH PLAN MEMBERS IN MULTNOMAH, CLACKAMAS AND WASHINGTON COUNTIES. HEALTH SHARE IS A SEPARATE CCO UNRELATED TO CAREOREGON THAT ENGAGES CAREOREGON FOR MOST OF ITS ADMINISTRATIVE SERVICES. . YAMHILL COMMUNITY CARE ORGANIZATION IN YAMHILL COUNTY IS A SEPARATE CCO THAT ENGAGES CAREOREGON FOR MOST OF ITS ADMINISTRATIVE SERVICES. . CAREOREGON DENTAL, A LINE OF BUSINESS OF CAREOREGON, PROVIDES DENTAL SERVICES TO MEMBERS OF HEALTH SHARE AND OREGON HEALTH PLAN'S OPEN CARD PROGRAM IN THE PORTLAND METRO REGION. . THE WAY TO WELLVILLE IS A FIVE-YEAR PROJECT SUPPORTED BY CAREOREGON AND COLUMBIA PACIFIC CCO IN CLATSOP COUNTY. IT IS ONE OF FIVE WAY-TO-WELLVILLE PROJECTS CURRENTLY UNDERWAY IN THE U.S., WHICH HELP PROMOTE HEALTH IMPROVEMENT IN THE COMMUNITIES TAKING PART. SCHOOLS, PARKS AND RECREATION, CIVIC GROUPS, POLICE AND FIRE DEPARTMENTS, HEALTH PLANS, HOSPITALS, PROVIDERS AND PRIVATE CITIZENS COLLABORATE ON PROGRAMS THAT IMPROVE WELLNESS. . HOUSECALL PROVIDERS SERVICES, LLC, A MEMBER OF THE CAREOREGON FAMILY, PROVIDES HOME-BASED CARE AND HOSPICE SERVICES. HOUSECALL PROVIDERS, PC, OFFERS MEDICAL CARE, INTEGRATING PRIMARY AND PALLIATIVE SERVICES FOR HOMEBOUND PATIENTS IN THE PORTLAND METRO REGION. . UNDER A CONTRACT WITH OHA, CAREOREGON PROVIDES CARE COORDINATION TO AMERICAN INDIANS AND ALASKA NATIVES ON THE OREGON HEALTH PLAN. THE ORIGINAL REQUEST FOR THIS PROGRAM CAME FROM THE NINE FEDERALLY RECOGNIZED TRIBES IN OREGON BASED ON THE POSITIVE REPUTATION CAREOREGON HAS FOR CARE SUPPORT. THE TRIBES, OHA AND CAREOREGON COLLABORATED ON THE PROGRAM DESIGN. . ALL CCOS, INCLUDING THOSE IN THE CAREOREGON FAMILY OF COMPANIES, PROVIDE THE OREGON HEALTH PLAN HEALTH CARE SERVICES TO ALL CHILDREN AND TEENS IN THE STATE, REGARDLESS OF IMMIGRATION STATUS UNDER THE COVER-ALL-KIDS PROGRAM. IT INCLUDES PHYSICAL, DENTAL AND BEHAVIORAL HEALTH CARE. ALL COVERED SERVICES ARE FREE. PART III, LINE 4 STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS A. OREGON HEALTH PLAN (MEDICAID) PROGRAM THROUGH THE CCOS AND CAREOREGON DENTAL, CAREOREGON PROVIDES HEALTH CARE SERVICES TO MORE THAN 255,000 MEDICAID MEMBERS BY CONTRACTING WITH NETWORKS OF COMMUNITY AND PRIVATE MEDICAL PROVIDERS THROUGHOUT THE STATE OF OREGON AND DENTAL PROVIDERS IN THE PORTLAND METRO REGION. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. B. MEDICARE PLAN ON BEHALF OF HEALTH PLAN OF CAREOREGON, PARENT CAREOREGON ADMINISTERS CAREOREGON ADVANTAGE(COA)PLUS, A MEDICARE SPECIAL NEEDS PLAN (SNP). COA PLUS PROVIDES CONTINUITY OF COVERAGE FOR MEMBERS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID. THE CONTINUITY BENEFITS BOTH PATIENTS AND PROVIDERS BY ENSURING A COORDINATED AND CONVENIENT MEANS OF RECEIVING AND DELIVERING QUALITY CARE. OUR MEDICARE PLANS SERVED APPROXIMATELY 12,000 MEMBERS IN 2019. C. CHARITABLE CONTRIBUTIONS WITH CAREOREGON'S GOAL OF CONTINUOUSLY INVESTING IN THE COMMUNITIES WE SERVE, WE CONTRIBUTED ABOUT $3.5 MILLION IN 2019 TO OTHER NONPROFIT CHARITABLE ORGANIZATIONS THAT STRIVE TO IMPROVE HEALTH CARE IN OREGON AND TO IMPROVE HEALTH CARE STATUS OF VULNERABLE AND UNDERSERVED POPULATIONS. D. OTHER PROGRAM SERVICES THE CCOS WE SUPPORT PROVIDE ACCESS FOR APPROXIMATELY 260,000 LOW-INCOME OREGONIANS. OUR WORK INVOLVES COORDINATING QUALITY HEALTH CARE FOR MEMBERS AND CONTRACTING WITH PUBLIC AND PRIVATE PROVIDERS TO PROVIDE HEALTH CARE SERVICES, INCLUDING PHYSICAL, MENTAL AND ORAL HEALTH. WE PROVIDE CUSTOMER SERVICE FUNCTIONS FOR THESE CCOS, ASSIST WITH HEALTH IMPROVEMENT PLANS FOR THE VARIOUS COMMUNITIES AND PROVIDE TECHNICAL SUPPORT FOR INFORMATION SERVICES, HUMAN RESOURCES, COMMUNICATIONS, PROCESS IMPROVEMENT AND OTHER FUNCTIONS. THESE SERVICES RESULT IN BETTER ACCESS TO QUALITY HEALTH CARE, LOWER COSTS AND IMPROVED CARE FOR OUR MEMBERS AND FOR THE COMMUNITIES WE SERVE. CCOS ARE RESPONSIBLE FOR: . INTEGRATING PHYSICAL, MENTAL, DENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT TO ENSURE BETTER CARE FOR THE WHOLE PERSON. . MAINTAINING A COMMUNITY CARE ADVISORY COUNCIL, MADE UP OF AT LEAST 51 PERCENT CONSUMERS, TO ADVISE THE STAFF AND BOARD OF DIRECTORS. . PROVIDING PATIENT-CENTERED PRIMARY CARE HOME (PCPCH) CLINICS. . IMPLEMENTING CONSISTENT ALTERNATIVE PAYMENT METHODOLOGIES THAT ALIGN PAYMENT WITH HEALTH OUTCOMES. . WORKING WITH THEIR COMMUNITIES TO IMPLEMENT COMMUNITY HEALTH ASSESSMENTS AND ADOPTING ANNUAL COMMUNITY HEALTH IMPROVEMENT PLANS. . ENCOURAGING MEANINGFUL USE OF ELECTRONIC HEALTH RECORDS AND HEALTH INFORMATION EXCHANGE. . ENSURING COMMUNICATIONS, OUTREACH, MEMBER ENGAGEMENT AND SERVICES ARE TAILORED TO CULTURAL, HEALTH LITERACY AND LINGUISTIC NEEDS. . DEVELOPING AND IMPLEMENTING A QUALITY IMPROVEMENT PLAN FOCUSED ON ELIMINATING RACIAL, ETHNIC AND LINGUISTIC DISPARITIES IN ACCESS, QUALITY OF CARE, EXPERIENCE OF CARE AND OUTCOMES. CCOS MUST REPORT ON A VARIETY OF PERFORMANCE METRICS EACH YEAR. CCOS MAY EARN BONUS DOLLARS FOR MEETING OR EXCEEDING BENCHMARKS FOR SOME IDENTIFIED METRICS. CAREOREGON'S PARTNER CCOS HAVE CONSISTENTLY BEEN AMONG THE TOP PERFORMING CCOS FOR QUALITY POOL METRICS, WHICH INCLUDE SCREENINGS, HEALTH OUTCOMES AND PAY FOR PERFORMANCE. IN 2019, WE CONTINUED TO PROVIDE COMMUNITY OUTREACH, SUPPORT AND CARE COORDINATION SERVICES TO HIGH-RISK MEMBERS IN MULTNOMAH, WASHINGTON AND CLACKAMAS COUNTIES THROUGH CAREOREGON; IN JACKSON COUNTY THROUGH JACKSON CARE CONNECT; IN COLUMBIA, TILLAMOOK AND CLATSOP COUNTIES THROUGH COLUMBIA PACIFIC CCO. WE ENCOURAGE CLINICS TO PROVIDE THE BEST PRIMARY CARE POSSIBLE THROUGH OUR VARIOUS IMPROVEMENT AND INCENTIVE-PAYMENT PROGRAMS. THE GOAL OF THESE PROGRAMS IS TO BUILD SYSTEMS AND PROCESSES FOR PROACTIVE PANEL MANAGEMENT; TEAM-BASED CARE; CASE MANAGEMENT; PATIENT EMPOWERMENT FOR SELF-MANAGEMENT; INTEGRATION OF PHYSICAL, MENTAL AND ORAL HEALTH CARE; IMMUNIZATION AND DISEASE-SPECIFIC PATIENT REGISTRIES; AND SAME-DAY AND EXTENDED-HOUR MEMBER ACCESS TO THE CARE TEAM. ALL THESE IMPROVEMENTS HAVE THE GOAL OF COST-EFFECTIVE, CONTINUOUS AND COORDINATED CARE. OUR PERSONALIZED HEALTH PROGRAMS FOCUS RESOURCES ON INDIVIDUAL NEEDS AND WELL-BEING. WE SUPPORT MEMBERS WHO ARE AT HIGH RISK AND/OR HAVE COMPLEX HEALTH CONDITIONS BY PROVIDING COORDINATED CARE THAT TAKES INTO CONSIDERATION PAST TRAUMAS. WE FOCUS ON EACH PERSON'S PSYCHOSOCIAL AND CARE MANAGEMENT NEEDS AND HELP MEMBERS TRANSITION FROM HOSPITAL TO HOME. WE PROVIDE HOME-BASED CARE SERVICES AND MEDICATION MANAGEMENT, AND DEVELOP SPECIALTY PRIMARY CARE TEAMS TO ADDRESS NEEDS. . REGIONAL CARE TEAM - A TEAM OF SOCIAL WORKERS EXPERIENCED WITH MENTAL HEALTH AND SUBSTANCE USE DISORDER WHICH DEVELOPS PARTNERSHIPS BASED ON MUTUAL TRUST WITH MEMBERS WHO FACE THE GREATEST HEALTH CHALLENGES. THE TEAM ADDRESSES MEMBERS' LIVING CONDITIONS AS WELL AS HEALTH CONDITIONS TO HELP MEMBERS TRANSITION TO OVERALL WELL-BEING. . TRANSITIONS IN CARE - FOCUS ON THE HOSPITALIZED DUAL-ELIGIBLE POPULATION, WORKING WITH THEM BEFORE THEY ARE DISCHARGED TO REDUCE THE RISK OF READMISSION. . CARE COORDINATION - COORDINATION OF MULTI-DISCIPLINARY CARE FOR PATIENTS WITH COMPLEX MEDICAL ISSUES. . PALLIATIVE CARE - SUPPORT FOR TERMINALLY ILL PATIENTS, REDUCING HOSPITAL AND EMERGENCY DEPARTMENT UTILIZATION RATES. . ADVERSE CHILDHOOD EXPERIENCES (ACES) TRAINING AND SERVICE - BY PARTNERING WITH OUR HEALTH PLANS, WE FOCUS ON TRAINING STAFF, PROVIDERS, EDUCATORS AND OTHER COMMUNITY MEMBERS ABOUT THE IMPORTANCE OF RECOGNIZING ACES. PROVIDERS PRACTICING TRAUMA-INFORMED CARE TAKE INTO ACCOUNT THE PATIENT'S HISTORY, AND ADJUST THEIR TREATMENT TO SUPPORT THE INDIVIDUAL'S COPING CAPACITY. . ON SEPTEMBER 30, 2019, JACKSON COUNTY CCO, LLC SIGNED A FIVE-YEAR CONTRACT WITH THE OREGON HEALTH AUTHORITY TO SERVE MEDICAID ENROLLEES IN JACKSON COUNTY THROUGH DECEMBER 2024. . ON SEPTEMBER 30, 2019, COLUMBIA PACIFIC CCO, LLC SIGNED A FIVE-YEAR CONTRACT WITH THE OREGON HEALTH AUTHORITY TO SERVE MEDICAID ENROLLEES IN COLUMBIA, TILLAMOOK ABD CLATSOP COUNTIES THROUGH DECEMBER 2024. . ON DECEMBER 6, 2019, CAREOREGON, INC. SIGNED AN INTEGRATED COMMUNITY NETWORK PARTICIPATION CONTRACT WITH HEALTH SHARE. THIS PARTNERSHIP PROVIDES PHYSICAL HEALTH MANAGED CARE SERVICES TO MOST OF HEALTH SHARES MEMBERS AND BEHAVIORAL AND DENTAL HEALTH MANAGED CARE SERVICES TO ALL OF HEALTH SHARES MEMBERS IN MULTNOMAH, CLACKAMAS AND WASHINGTON COUNTIES. PART IV, LINE 12/12A CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2019, AN AUDIT WAS PERFORMED ON THE CONSOLIDATED ENTITY WHICH INCLUDES CAREOREGON, INC., HEALTH PLAN OF CAREOREGON, INC., CARE ACCESS LLC, COLUMBIA PACIFIC CCO, LLC, JACKSON COUNTY CCO, LLC, HOUSECALL PROVIDERS SERVICES, LLC, AND HOUSECALL PROVIDERS, PC. PART VI, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS AMIT SHAH, MD IS A CHIEF MEDICAL OFFICER OF CAREOREGON AND SERVES AS A MEMBER OF THE BOARD OF DIRECTORS OF HOUSECALL PROVIDERS, PC. SHAH HOLDS 51% OWNERSHIP AND CAREOREGON HOLDS 49% OF HOUSECALL PROVIDERS, PC WHICH IS A FULLY-CONSOLIDATED SUBSIDIARY OF CAREOREGON FOR FINANCIAL REPORTING PURPOSES. PART VI, LINE 11A FORM 990 TO GOVERNING BODY CAREOREGON'S FORM 990 GOES THROUGH MULTIPLE LAYERS OF REVIEWS BEFORE IT IS REVIEWED BY THE CFO, FINANCE COMMITTEE AND THE BOARD OF DIRECTORS. THE FORM 990 IS REVIEWED AND DISCUSSED AT THE FINANCE COMMITTEE MEETING. ALL REVIEWERS ARE GIVEN TIME TO RESPOND WITH ANY REVISIONS. AFTER INCORPORATION OF ALL REVISIONS, THE FORM 990 IS REDISTRIBUTED TO THE REVIEWERS FOR A FINAL REVIEW PRIOR TO FILING. PART VI, LINE 12C ENFORCEMENT OF CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST POLICY OF CAREOREGON IS DISTRIBUTED TO THE BOARD MEMBERS ANNUALLY. IT APPLIES TO DIRECTORS, OFFICERS AND KEY EMPLOYEES (ON THE BASIS OF TESTS SET FORTH IN IRS FORM 990), AND ANY OTHER INDIVIDUAL IN A POSITION TO EXERCISE SIGNIFICANT INFLUENCE OVER A DECISION HAVING MATERIAL ECONOMIC IMPACT FOR CAREOREGON (COLLECTIVELY COVERED PERSONS). THE CONFLICT OF INTEREST POLICY IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD. AN ANNUAL CONFLICT OF INTEREST DECLARATION AND INDEPENDENCE QUESTIONNAIRE IS DISTRIBUTED TO ALL COVERED PERSONS. THROUGH THE DISTRIBUTED DOCUMENT, EACH COVERED PERSON SIGNS AND ACKNOWLEDGES THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY AND REPORTS FAMILY AND BUSINESS RELATIONSHIPS THAT ARE USED TO DETERMINE THE INDEPENDENCE OF A DIRECTOR PURSUANT TO THE DEFINITION AND TESTS SET FORTH IN IRS FORM 990. THE GOVERNANCE COMMITTEE REVIEWS THE RESPONSES TO THE ANNUAL QUESTIONNAIRES AND MAKES RECOMMENDATIONS TO THE FULL BOARD ON ANY RESOLUTIONS OR ACTIONS REQUIRED TO MITIGATE ANY CONFLICTS OF INTEREST. FOR 2019, THERE WERE NO CONFLICTS OF INTEREST REQUIRING RESOLUTION OR ACTIONS. AT THE BEGINNING OF EACH MEETING OF THE BOARD OF DIRECTORS, THE CHAIR ASKS ALL MEMBERS PRESENT TO DECLARE ANY CONFLICTS OF INTEREST SO THE BOARD IS UPDATED ON ANY NEW CONFLICTS THAT MAY HAVE ARISEN SINCE THE LAST ANNUAL QUESTIONNAIRE. ALL SIGNED CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENTS AND INDEPENDENCE QUESTIONNAIRES ARE RETAINED AT CAREOREGON'S OFFICE. IF FOR A SPECIFIC MATTER REQUIRING BOARD ACTION, A CONFLICT OF INTEREST EXISTS, AS DETERMINED BY THE BOARD, AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE MEETING, DISCLOSING THE EXISTENCE OF HIS OR HER INTEREST AND SHALL DISCLOSE ALL MATERIAL FACTS. FOLLOWING THE PERSON'S DISCLOSURES AND AFTER ANY DISCUSSION WITH THE BOARD, THE INDIVIDUAL LEAVES THE MEETING WHILE THE BOARD INDEPENDENTLY DISCUSSES THE MATTER BEFORE IT VOTES ON THE PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. IF THERE IS REASONABLE QUESTION ABOUT THE APPROPRIATENESS OF THE PROPOSED TRANSACTION OR ARRANGEMENT, THE CHAIR SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTIONS OR ARRANGEMENTS. AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL EVALUATE THE RESULTING ALTERNATIVES PRESENTED BY THE APPOINTED PERSON OR COMMITTEE. IF AN APPROPRIATE CONFLICT-FREE ALTERNATIVE IS NOT REASONABLY ATTAINABLE, THE BOARD SHALL DETERMINE BY MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE ORIGINAL TRANSACTION OR ARRANGEMENT IS IN CAREOREGON'S BEST INTEREST, FOR CAREOREGON'S OWN BENEFIT, WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CAREOREGON, AND WHETHER THE TRANSACTION IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. THE BOARD SHALL THEN VOTE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE EVALUATION OF THE FOREGOING. WHETHER THE ORIGINAL TRANSACTION OR ARRANGEMENT IS IN CAREOREGON'S BEST INTEREST, FOR CAREOREGON'S OWN BENEFIT, WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CAREOREGON, AND WHETHER THE TRANSACTION IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. THE BOARD SHALL THEN VOTE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE EVALUATION OF THE FOREGOING. PART VI, LINE 15A AND 15B PROCESS OF DETERMINING COMPENSATION MARKET DATA ON THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVE POSITIONS (CEO, COO, CFO, CLO, AND CMO) IS PROVIDED ANNUALLY BY AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT USING COMPARABLE ORGANIZATIONS BY INDUSTRY, PROFIT/NON-PROFIT STATUS AND REVENUE SIZE. THE COMPENSATION COMMITTEE, CONSISTING OF A MAJORITY OF INDEPENDENT BOARD MEMBERS, REVIEWS MARKET DATA, EVALUATES CEO PERFORMANCE AND REVIEWS CEO RECOMMENDATIONS FOR COMPENSATION FOR OTHER EXECUTIVE OFFICERS. THE COMMITTEE PRESENTS ITS RECOMMENDATIONS FOR CEO TO THE BOARD. DECISIONS ARE MADE IN A BOARD MEETING. THE BOARD REVIEWS THE RECOMMENDATION FOR THE COMPENSATION OF ALL OTHER EMPLOYEES AS PART OF THE BUDGET APPROVAL PROCESS. THE PROCESS OF DETERMINING THE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY OFFICERS INCLUDES A REVIEW OF AN INDEPENDENT CONSULTANT'S REPORT OF COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS AND IS GUIDED BY WRITTEN COMPENSATION PRACTICES. WITH THE CEO AND ALL OTHER OFFICERS ABSENT FROM THE MEETINGS, THE BOARD APPROVES THE SALARY OF THE CEO. THIS PROCESS WAS LAST UNDERTAKEN ON MARCH 13, 2020 FOR THE CEO, AND THE CEO'S RECOMMENDATIONS FOR OTHER OFFICERS. THERE IS CONTEMPORANEOUS DOCUMENTATION OF THIS PROCESS AND THE RESULTS. PART VI, LINE 18 AND 19 PUBLIC INSPECTION THE TAX RETURN INFORMATION IS AVAILABLE UPON REQUEST. WHILE NO REQUIREMENT TO MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXISTS, CAREOREGON WILL CONSIDER ALL REQUESTS FOR THESE DOCUMENTS ON A CASE-BY-CASE BASIS. PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES IN 2019, CAREOREGON TRANSFERRED $5,500,000 TO HOUSECALL PROVIDERS, PC TO SUPPORT ITS OPERATIONS. COLUMBIA PACIFIC CCO LLC 315 SW FIFTH AVENUE PORTLAND OR 97204 455532847 MEDICAID OR 160808814 29631414 CAREOREGON JACKSON COUNTY CCO LLC 315 SW FIFTH AVENUE PORTLAND OR 97204 455499608 MEDICAID OR 160732065 27698687 CAREOREGON HOUSECALL PROVIDERS SERVICES LLC 315 SW FIFTH AVENUE PORTLAND OR 97204 821474020 HOSPICE SVC OR 7267904 2078677 CAREOREGON CARE ACCESS LLC 315 SW FIFTH AVENUE PORTLAND OR 97204 270630449 MEDICAL BLDG OR 317015 4149888 CAREOREGON HEALTH PLAN OF CAREOREGON INC 315 SW FIFTH AVENUE PORTLAND OR 97204 463264330 MEDICARE OR 501(C)(3) 10 CAREOREGON true HOUSECALL PROVIDERS PC 315 SW FIFTH AVENUE PORTLAND OR 97204 821663503 MEDICAL CARE OR 501(C)(3) 10 CAREOREGON true false false false false false false false false false false false true true true true false true true false HEALTH PLAN OF CAREOREGON l,n 19049687 ACTUAL COST HEALTH PLAN OF CAREOREGON q 1570272 REIMBURSED HOUSECALL PROVIDERS PC l,n,o 7827808 ACTUAL COST HOUSECALL PROVIDERS PC m 1136967 CLINICAL SERV HOUSECALL PROVIDERS PC q 752333 REIMBURSED HOUSECALL PROVIDERS PC r 5500000 TRANSFERRED